HIV infection and cocaine use in methadone maintained and untreated intravenous drug users

HIV transmission and the cost-effectiveness of methadone maintenance

“…94 Cocaine injection is clearly a risk factor for HIV 95 : injection cocaine users are more likely than injection opiate users to share drug injection equipment and to engage in other high-risk behaviors. 44,96,97 The risks associated with injection cocaine use extend to individuals in methadone maintenance. 98,99 Evidence regarding the effect of methadone maintenance on cocaine use is mixed: some individuals increase cocaine use after entering methadone treatment, 44 but the overall effect may be a reduction in injection cocaine use.…”

“…44,96,97 The risks associated with injection cocaine use extend to individuals in methadone maintenance. 98,99 Evidence regarding the effect of methadone maintenance on cocaine use is mixed: some individuals increase cocaine use after entering methadone treatment, 44 but the overall effect may be a reduction in injection cocaine use. 44,96 Methadone maintenance clients who also inject cocaine may not reduce risky behavior by as much as clients who do not inject cocaine, so the exclusion of cocaine injection practices from our model may have overstated the benefit of methadone maintenance.…”

“…We assumed that injection drug users not in treatment inject 200 times per year in the low-prevalence community and 225 times per year in the high-prevalence community [38][39][40][41][42][43][44] and that they share needles 20% of the time, 5,[40][41][42][43][45][46][47] leading to 40 and 45 risky injections per year, respectively, in the 2 communities.…”

“…A survey of 424 injection drug users in New Haven, Conn, found that injection drug users in treatment had 60% fewer injections than injection drug users not in treatment. 44 A study of 388 injection drug users who remained in methadone treatment for at least 1 year found that the prevalence of drug injection decreased by 71% compared with the prevalence among injection drug users not in treatment. 48 A study of injection drug users in a special methadone maintenance program for HIV-infected individuals found that injection frequency dropped from 28 days per month to 7 days per month, suggesting a 75% decrease in injection frequency.…”

Substance Use and Sexual Behavior Survey: A Validation Study

“…The studies on this area seem to group on: 1) Drug use and sexuality risk taking behavior, specially related to HIV infection (e.g., Brajevic-Gizdic & Pletikosa, 2008;Darke et al, 1990;Gunsaullus, 2006;Meandzija et al, 1994); 2) Sexual dysfunctions and drug/medication use (e.g., Lorga, 2000;Mintz, O'Hare, O'Brien & Golschmidt, 1974;NCASA, 1999;Smith et al, 1982), and the effects on drug users on treatment, specially on maintenance therapy with methadone and buprenorphine (e.g., Giacomuzzi, Khreis, Riemer, Garber & Ertl, 2009); 3) Drug use to improve sexual performance, and more recently specifically in party contexts (e.g., Calafat, Juan, Becoña, & Montecón, 2008;Mattison, Ross, Wolfson, Franklin, & HNRC Group, 2001), few studies investigated the performance sexual expectations on drug users (Bellis et al, 2008;Rawson, Washton, Domier, & Reiber, 2002).…”