Collateral Damage: A Narrative Review on Epidemics of Substance Use Disorders and their Relationships to Sexually Transmitted Infections in the United States

Associations between substance use disorders (SUDs) and outbreaks of HIV and acute viral hepatitis have received considerable attention, but less research has focused on links between SUDs and sexually transmitted infections (STIs), apart from alcohol misuse. This narrative review describes the history of this public health crisis in the US and direct and indirect effects opioids and specific stimulants have on high risk sexual behaviors. We also review the epidemiology of STIs associated with opioids and stimulants in the U.S. and discuss opportunities for integrated interventions.