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Caring for HIV-infected drug users: a provider's perspective.

Unlike other populations with HIV (human immunodeficiency virus) infection, injection drug users share a risk behavior that is viewed with disapproval, is illegal, and often is harmful to themselves and others. They also may be more likely than other groups to have underlying psychiatric illnesses and to exhibit sociopathic behavior that can directly compromise their treatment and their efforts to receive care. Moreover, drug users continue to account for an increasing proportion of HIV/AIDS cases in many urban areas in this country and abroad. These factors, as well as the dynamics of addiction itself and the medical complications of substance abuse, can pose difficult clinical and programmatic challenges to care. Despite all this, and perhaps in part because of it, caring for this patient population can provide a unique kind of gratification, and, if one remains open to it, the opportunity for self-discovery.