title: The Impact of Methadone Maintenance Treatment on HIV Risk Behaviors among High-Risk Injection Drug Users: A Systematic Review.
abstract: Injection drug users (IDUs) are at high risk of acquiring HIV infection through preventable drug- and sex-related HIV risk behaviors. In recent decade, there has been a growing evidence that methadone maintenance treatment (MMT) is associated with a significant decrease in both drug- and sex-related risk behaviors among this high-risk population. The better understanding of the relationship between MMT and HIV-related risk behaviors will help to better inform future HIV prevention strategies, which may have policy implications as well. In this systematic review, we therefore aimed to explore the relevant literature to more clearly examine the possible impact of MMT on HIV risks behaviors among high-risk IDUs. The findings thus far suggest that MMT is associated with a significant decrease in injecting drug use and sharing of injecting equipment. Evidence on sex-related risk behavior is limited, but suggest that MMT is associated with a lower incidence of multiple sex partners and unprotected sex. The literature also suggests that the most significant factor in reducing HIV risks was treatment adherence. As such, more attention needs to be given in future studies to ensure the higher rates of access to MMT as well as to improve the adherence to MMT.
authors.affiliation: Department of Community Medicine and Health Care, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, USA; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, USA.
authors.forename: Pramila
authors.initials: P
authors.lastname: Karki
authors.affiliation: Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, USA; Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, USA.
authors.forename: Roman
authors.initials: R
authors.lastname: Shrestha
authors.affiliation: Department of Community Medicine and Health Care, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, USA; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, USA.
authors.forename: Tania B
authors.initials: TB
authors.lastname: Huedo-Medina
authors.affiliation: Department of Community Medicine and Health Care, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, USA; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Copenhaver
keywords: HIV risk reduction; HIV/AIDS; Methadone maintenance treatment; behavioral interventions; injection drug users; opioid-dependence; systematic review