title: Methadone use among HIV-positive injection drug users in a Canadian setting.
abstract: We examined methadone maintenance therapy (MMT) use among HIV-positive injection drug users (IDU) in Vancouver. Among 353 participants, 199 (56.3%) were on MMT at baseline, and 48 initiated MMT during follow-up. Female gender (adjusted odds ratio [AOR] = 1.73, 95% confidence interval [CI] = 1.14-2.62) and antiretroviral therapy use (AOR = 2.04, 95% CI = 1.46-2.86) were positively associated with MMT use, whereas frequent heroin injection (AOR = 0.34, 95% CI = 0.23-0.50), public injection (AOR = 0.76, 95% CI = 0.59-0.97), syringe borrowing (AOR = 0.54, 95% CI = 0.32-0.90), and nonfatal overdose (AOR = 0.58, 95% CI = 0.36-0.92) were negatively associated with MMT use. The rate of discontinuation of MMT was 12.46 (95% CI = 8.28-18.00) per 100 person years. Frequent heroin use (adjusted hazards ratio = 4.49, 95%CI = 1.81-11.13) was positively associated with subsequent discontinuation of MMT. These findings demonstrate the benefits of MMT among HIV-positive IDU and the need to improve access to and retention in MMT.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
authors.forename: Tyler
authors.initials: T
authors.lastname: Pettes
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.forename: Silvia
authors.initials: S
authors.lastname: Guillemi
authors.forename: Calvin
authors.initials: C
authors.lastname: Lai
authors.forename: Julio
authors.initials: J
authors.lastname: Montaner
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada; D015331:Cohort Studies; D005260:Female; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D015819:Substance Abuse, Intravenous / Q000188:drug therapy*
chemical_list: D008691:Methadone