HIV risk-taking behaviour among injecting drug users currently, previously and never enrolled in methadone treatment

Abstract

This study compares the injecting and sexual risk-taking behaviour among injecting drug users (IDUs) currently, previously and never enrolled in methadone maintenance treatment (MMT). All subjects had injected during the 6 months prior to the day of interview. The current MMT group showed significantly lower injecting risk-taking behaviour subscale scores on the HIV Risk-taking Behaviour Scale (HRBS) of the Opiate Treatment Index than the previous MMT and non-MMT groups together. The current MMT group differed from the other two groups in the frequency of injecting and cleaning of injection equipment with bleach. There was no difference between the current MMT group and the other two groups combined in sexual risk-taking behaviour scores on the HRBS. There were no differences between the previous MMT and non-MMT groups in injecting and sexual risk-taking behaviour. HIV seroprevalence was low and there was no difference in seroprevalence between groups. Thus, IDUs currently enrolled in MMT are at reduced risk for HIV infection when compared with IDUs who have previously or never been enrolled in MMT. However, the absence of a difference between the current MMT and other two groups in frequency of sharing behaviours suggests the need for additional strategies among MMT clients to reduce needle-sharing. Possible strategies include the application of relapse prevention interventions and the availability of sterile injecting equipment in MMT clinics. Further research is needed to identify factors which increase attraction and retention of IDUs to MMT.

Initiation of buprenorphine during incarceration and retention in treatment upon release

“…Those who might benefit from opiate replacement therapy (ORT) most often do not receive appropriate care (Nunn et al, 2009). As a result, many return to opioid use after their release (Baker, Kochan, Dixon, Wodak, & Heather, 1995; Binswanger et al, 2007) and are at increased risk for infectious disease(Hammett, 2006; Inciardi & Needle, 1998), overdose (Binswanger et al, 2007) and reincarceration (Binswanger et al, 2007; Gore, Bird, & Ross, 1995; Lipton, Falkin, & Wexler, 1992). Provision of ORT during incarceration or linkage to ORT immediately post release is rare in correctional facilities currently (Nunn et al, 2009; Rich et al, 2005), despite evidence that ORT is effective in reducing morbidity and mortality associated with opiate dependence (Fiellin, Rosenheck, & Kosten, 2001).…”

HCV and HIV Infection among Heroin Addicts in Methadone Maintenance Treatment (MMT) and Not in MMT in Changsha and Wuhan, China

“…MMT is an effective intervention for the management of heroin addiction, reducing levels of heroin use and of risky behaviors (injecting and needle sharing).Therefore, MMT reduces the risk of HIV infection among opiate-dependent patients [9], [10]. But the effectiveness of MMT to control the spread of HCV infection among IDUs has been disputed [11], [12].Despite the widespread use of MMT for opioid addiction in China, there are still many addicts who have never enrolled in MMT [13].…”

Brief report: Methadone treatment of injecting opioid users for prevention of HIV infection

“…In the fourth study 4 there was a nonsignificant reduction in the mean score between intake and 6-month follow-up. Another study 23 reported significantly lower drug risk scores for a cohort of IDU in methadone maintenance with cohorts not in treatment at the time of assessment.…”

“…A third study 4 reported a nonstatistically significant reduction. One study 23 found no difference in sex-related risk scores for IDU currently in methadone maintenance treatment, compared with those previously in, or with no prior history of methadone maintenance.…”