title: The effect of acids on the survival of HIV during drug injection.
abstract: BACKGROUND
  HIV epidemics around the world have been linked to injection drug use. In many instances, the injected drugs are acidic. HIV-1 is known to be labile to acids, but its susceptibility to acids in the conditions in which illicit drugs are injected is unknown.
  
  
  METHODS
  We have combined data from ethnographic studies of injection drug use practices with laboratory virology to replicate and evaluate the effects of exposure to acids that are experienced during drug preparation and injection on HIV-1 viability.
  
  
  RESULTS
  Short exposures to the acids significantly reduced the likelihood of recovering viable HIV-1 once pH is reduced to 2.3, but acidic solutions did not totally eliminate infectious HIV-1 that might contaminate syringes or solutions being injected, even at the lowest pH tested (pH 1.7).
  
  
  CONCLUSIONS
  Acidification of drugs, which is required for dissolving free-base formulations of drugs, can significantly reduce but not eliminate the likelihood that syringes previously used by HIV-1-infected injection drug users infect the next injector. Methamphetamines, which are manufactured under extremely acidic pHs, are unlikely to harbor viable HIV if stored or sold in contaminated injection equipment.
authors.affiliation: Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06520, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Heimer
authors.forename: Mark L
authors.initials: ML
authors.lastname: Kinzly
authors.forename: Helen
authors.initials: H
authors.lastname: He
authors.forename: Nadia
authors.initials: N
authors.lastname: Abdala
mesh_terms: D019343:Citric Acid / Q000494:pharmacology*; D015658:HIV Infections / Q000635:transmission* / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects* / Q000502:physiology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D012996:Solutions
chemical_list: D012996:Solutions; D019343:Citric Acid