Substance abuse, medications, HIV, and the community.

This article describes the experience of a medical internist caring for thousands of persons living with HIV/AIDS (PLWHA) for more than 23 years, many of whom have abused illicit substances and ethanol. Divided in three major sections, the article looks at the effects of substance abuse on HIV treatment and how a community physician rallies the health team, patients, and the community to address the issues that pose barriers to quality HIV care.