title: Buprenorphine/naloxone treatment in primary care is associated with decreased human immunodeficiency virus risk behaviors.
abstract: Methadone treatment reduces human immunodeficiency virus (HIV) risk, but the effects of primary-care-based buprenorphine/naloxone on HIV risk are unknown. The purpose of this study was to determine whether primary-care-based buprenorphine/naloxone was associated with decreased HIV risk behavior. We conducted a longitudinal analysis of 166 opioid-dependent persons (129 men and 37 women) receiving buprenorphine/naloxone treatment in a primary care clinic. We compared baseline and 12- and 24-week overall, drug-related, and sex-related HIV risk behaviors using the AIDS/HIV Risk Inventory (ARI). Buprenorphine/naloxone treatment was associated with significant reductions in overall and drug-related ARI scores from baseline to 12 and 24 weeks. Intravenous drug use in the past 3 months was endorsed by 37%, 12%, and 7% of patients at baseline and at 12 and 24 weeks, respectively (p< .001). Sex while you or your partner were "high" was endorsed by 64%, 13%, and 15% of patients at baseline and at 12 and 24 weeks, respectively (p< .001). Inconsistent condom use during sex with a steady partner was high at baseline and did not change over time. We conclude that primary-care-based buprenorphine/naloxone treatment is associated with decreased drug-related HIV risk, but additional efforts may be needed to address sex-related HIV risk when present.
authors.affiliation: Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA. lynn.sullivan@yale.edu
authors.forename: Lynn E
authors.initials: LE
authors.lastname: Sullivan
authors.forename: Brent A
authors.initials: BA
authors.lastname: Moore
authors.forename: Marek C
authors.initials: MC
authors.lastname: Chawarski
authors.forename: Michael V
authors.initials: MV
authors.lastname: Pantalon
authors.forename: Declan
authors.initials: D
authors.lastname: Barry
authors.forename: Patrick G
authors.initials: PG
authors.lastname: O'Connor
authors.forename: Richard S
authors.initials: RS
authors.lastname: Schottenfeld
authors.forename: David A
authors.initials: DA
authors.lastname: Fiellin
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000008:administration & dosage*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000008:administration & dosage*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D011320:Primary Health Care; D012309:Risk-Taking; D012725:Sexual Behavior
chemical_list: D009270:Naloxone; D002047:Buprenorphine