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Substance use contributes to the spread of HIV in two primary ways: by impairing an individual’s ability to make safe choices when engaging in sexual activities, and by causing people to share needles and other drug equipment (20). This is of particular concern as substance use has been linked to an increased risk of HIV transmission (17) and men who have sex with men account for more than half of all new HIV infections in Canada and the United States (18, 19). Men who have sex with men show higher levels of substance use compared to the general population (14-16). These physiological effects depend on numerous factors, such as an individual’s age and body weight, the environment the drug is used in, and the type and amount of substance used (13). Specifically, substances like drugs interfere with the brain’s communication system, altering an individual’s capacity to make decisions and experience of reward and pleasure (12). Substance use refers to the use of any substance, other than food or water, that impacts physiological functioning when introduced into the body (11).
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