Drug abuse treatment as an HIV prevention strategy: a review.
We review drug abuse treatment as a means of preventing infection with HIV. Thirty-three studies, with an aggregate of over seventeen thousand subjects, were published in peer-reviewed journals from 1988-1998. Research on the utility of drug abuse treatment as an HIV prevention strategy has focused primarily on methadone maintenance treatment (MMT) rather than other modalities such as residential or outpatient drug-free treatment. Recent research provides clear evidence that MMT reduces HIV risk behaviors, particularly needle-use, and strong evidence that MMT prevents HIV infection. There is less definitive evidence that MMT reduces needle-sharing and unsafe sexual behavior, or that other treatment modalities prevent HIV infection. Future research should take into account patient self-selection processes and investigate other treatment modalities for heroin and stimulant abuse to determine their effects on HIV risk behaviors and HIV infection.
Sorensen
J L
JL
Department of Psychiatry, Room 2117, Ward 21, Building 20, UCSF at San Francisco General Hospital, 1001 Potrero Avenue, San Francisco, CA 94110, USA. james@itsa.ucsf.edu
Copeland
A L
AL
D002986:Clinical Trials as Topic; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008691:Methadone / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000534:rehabilitation*
D008691:Methadone