title: Association of opioid agonist therapy with the initiation of antiretroviral therapy - a systematic review.
abstract: OBJECTIVE
  People who inject drugs are at high risk of HIV infection but often face barriers in accessing medical care including access to antiretroviral therapy (ART). Evidence is available about the effectiveness of opioid agonist therapy on drug dependency and risk behaviors. However, it remains scattered regarding access to ART among HIV-positive people who inject drugs. We conducted a systematic review to examine the association of opioid agonist therapy with ART initiation among HIV-positive people who inject drugs.
  
  
  METHODS
  We searched the literature for evidence from seven databases. We conducted a narrative synthesis and meta-analysis to examine the association of opioid agonist therapy with ART initiation.
  
  
  RESULTS
  Five out of 2,901 identified studies met the inclusion criteria. Three out of five studies reported that, HIV-positive people receiving opioid agonist therapy initiated ART more than those not receiving opioid agonist therapy. In meta-analysis, opioid agonist therapy was associated with ART initiation among HIV positive people who inject drugs (pooled odds ratio: 1.68; 95% confidence interval: 1.03-2.73).
  
  
  CONCLUSIONS
  Opioid agonist therapy is positively associated with ART initiation among HIV-positive people who inject drugs. It is important to scale up opioid agonist therapy among people who inject drugs to improve their ART initiation.
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. Electronic address: lindasozy@gmail.com.
authors.forename: Linda Beatrice
authors.initials: LB
authors.lastname: Mlunde
authors.affiliation: Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65015, Dar es Salaam, Tanzania. Electronic address: sunguya@gmail.com.
authors.forename: Bruno Fokas
authors.initials: BF
authors.lastname: Sunguya
authors.affiliation: Department of Psychiatry and Mental Health, Muhimbili National Hospital, P.O. Box 65000, Dar es Salaam, Tanzania. Electronic address: jmbwambo@gmail.com.
authors.forename: Jessie Kazeni Kilonzo
authors.initials: JK
authors.lastname: Mbwambo
authors.affiliation: Department of Psychiatry and Mental Health, Muhimbili National Hospital, P.O. Box 65000, Dar es Salaam, Tanzania. Electronic address: oubuguyu@yahoo.com.
authors.forename: Omary Said
authors.initials: OS
authors.lastname: Ubuguyu
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. Electronic address: jyasuoka@post.harvard.edu.
authors.forename: Junko
authors.initials: J
authors.lastname: Yasuoka
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. Electronic address: mjimba@m.u-tokyo.ac.jp.
authors.forename: Masamine
authors.initials: M
authors.lastname: Jimba
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000819:agonists; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D055030:Drug Users; D015658:HIV Infections / Q000188:drug therapy*; D006679:HIV Seropositivity; D006801:Humans; D055118:Medication Adherence; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D015819:Substance Abuse, Intravenous / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D044966:Anti-Retroviral Agents
keywords: Antiretroviral therapy; HIV; Opioid agonist therapy; People who inject drugs; Review