HIV infection as a predictor of methadone maintenance outcomes in Chinese injection drug users

Zhao, Lin; Holzemer, William L.; Johnson, Mallory O.; Tulsky, Jacqueline P.; Rose, Carol Dawson

doi:10.1080/09540121.2011.596520

Cited by 11 publications

(9 citation statements)

References 37 publications

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“…Our results, which associate the positive influence of harm reduction programmes with decreased dangerous drug use‐related behaviours, are supported by past research, including several small studies which describe the successes of MMT and NEP as harm reduction interventions . Larger studies have variously reported a significant decrease in both high‐risk sexual and drug use behaviour following MMT enrolment in Yunnan .…”

Section: Discussionsupporting

confidence: 88%

HIV epidemic among drug users in China: 1995–2011

Wang¹,

Guo²,

Li³

et al. 2014

Addiction

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Aim To describe trends in the HIV epidemic among drug users (DUs) in China from 1995 to 2011. Design, setting and participants Datasets from China's national HIV/AIDS case reporting and sentinel surveillance systems as of December 2011 were used separately for descriptive analysis. Measures Changes in the geographic distribution of the number of HIV cases and HIV prevalence among injecting drug users (IDUs) and non-IDUs were examined. We also analyzed changes in HIV prevalence among the broader DU population, and drug use-related behaviors including types of drugs used, recent injecting, and recent needle sharing in the context of the rapid scale-up of DU sentinel sites and national harm reduction programs. Findings The HIV epidemic among China's DUs is still highly concentrated in five provinces. Here, HIV prevalence peaked at 30.3% (95% CI [28.6, 32.1]) among IDUs in 1999, and then gradually decreased to 10.9% (95% CI [10.6, 11.2]) by 2011. We observed a rapid increase in the use of “nightclub drugs” among DUs from 1.3% in 2004 to 24.4% in 2011. A decline in recent needle sharing among current IDU from 19.5% (95% CI [19.4, 19.6]) in 2006 to 11.3% (95% CI [11.2, 11.4]) in 2011 was found to be correlated with the rapid scale-up of methadone maintenance treatment (MMT; r(4) = - .94, p = 0.003) harm reduction efforts. Conclusions While needle sharing among current injecting drug users in China has declined dramatically and is correlated with the scale-up of national harm reduction efforts, the recent, rapid increased use of “nightclub drugs” presents a new challenge.

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Section: Discussionsupporting

confidence: 88%

HIV epidemic among drug users in China: 1995–2011

Wang¹,

Guo²,

Li³

et al. 2014

Addiction

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“…At enrollment in the study, participants completed an informed consent and were interviewed by an experienced clinician in a private space at the MMT clinic using a structured interview questionnaire. The questionnaire consisted of demographic information and HIV-related risk behaviors designed by the National Working Group on Community-based Methadone Maintenance Treatment for Opium Dependents in China, and was widely used in MMT related studies in China [35,36]. Participants completed the same survey about their HIV- and drug-related behaviors at each follow-up and provided blood samples for HIV and HCV testing at baseline and 12-month follow-up as a part of the MMT protocol.…”

Section: Methodsmentioning

confidence: 99%

Predictors of continued HIV-risk behaviors among drug users in methadone maintenance therapy program in China—A prospective study

et al. 2013

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BackgroundTo examine the predictors of continued drug- and sex-related HIV-risk behaviors among drug users in methadone maintenance therapy (MMT) programs in China.MethodsWe followed a sample of 5,035 drug users enrolled for the first time in MMT programs at baseline, 6 months, and 12 months utilizing a longitudinal prospective study design. Drug users’ HIV-risk behaviors, MMT characteristics, and drug use, were assessed at all three waves using a structured interview and HIV/HCV status was assessed at baseline and 12-month follow-up using biological specimens.ResultsThe point prevalence of HIV was 7.6% and 78.4% for HCV at baseline. Results of generalized linear mixed logistic regression models revealed that HIV-positive MMT clients were more likely to engage in drug injection (aOR = 1.70) and syringe sharing (aOR = 4.73). HCV-positive clients were more likely to inject drugs (aOR = 2.58), share syringes (aOR = 1.97), and have multiple sexual partners (aOR = 1.47). Adherence to MMT was the most significant predictor of reduced HIV-risk behaviors.ConclusionsOur data confirmed the positive effects of MMT on HIV prevention and underscored the urgency for programs to reduce HIV risk in HIV- and HCV-positive clients. There is a pressing need to strengthen existing counseling services for HIV-positive drug users to reduce their drug-related risk behaviors and to provide counseling for HCV-positive drug users. Further studies are needed to explore interventions to address high dropout rates and low adherence among MMT clients.

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“…Although the instruments used to measure HIV risk behaviors often differ across studies (e.g., Arasteh et al, 2008; Magura et al, 1998), the HIV Risk-taking Behavior Scale (HRBS; Ward, Darke, & Hall, 1990) has become increasingly popular among researchers (e.g., Ghitza, Epstein, & Preston, 2008; Hanson, Alessi, & Petry, 2008; Kaye et al, 2014; Rash & Petry, 2009; Wu et al, 2011; Zhao, Holzemer, Johnson, Tulsky, & Rose, 2012). This psychometrically reliable and valid 11-item questionnaire assesses risky drug use behaviors and risky sexual behaviors (Darke, Hall, Heather, Ward, & Wodak, 1991; Lejuez, Simmons, Aklin, Daughters, & Dvir, 2004; Petry, 2001; Ward et al, 1990).…”

Section: Introductionmentioning

confidence: 99%

Alcohol use disorders are associated with increased HIV risk behaviors in cocaine-dependent methadone patients

Meredith

Rash

Petry

2017

Journal of Substance Abuse Treatment

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People who inject drugs (PWID) are at increased risk of HIV infection. Although methadone maintenance therapy can help lower this risk, many methadone patients continue to engage in HIV risk behaviors, especially patients who use cocaine and alcohol. The purpose of the current study was to investigate relations between alcohol use disorders and HIV risk behavior in 239 cocaine-dependent methadone patients participating in a randomized controlled trial of a behavioral intervention to promote cocaine abstinence. Past 3-month HIV Risk-taking Behavior Scale (HRBS) scores were compared between cocaine-dependent methadone patients who met DSM-IV-TR diagnostic criteria for alcohol abuse or dependence and those who did not meet these criteria. No significant differences in HRBS drug subscale scores were observed between participants with and without alcohol use disorders, indicating risky drug use was similar between groups. However, alcohol use disorder was significantly associated with HRBS sex subscale scores (t=2.59, p=.01), indicating participants with alcohol use disorders were more likely to engage in risky sexual behavior. Item-level analyses of the sex-related HRBS questions showed participants with alcohol use disorders were significantly more likely than participants without alcohol use disorders to have unprotected sex, engage in transactional (paid) sex, and have anal sex. Interventions are needed to reduce risky sexual behavior and attenuate the spread of HIV in this high-risk population.

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HIV infection as a predictor of methadone maintenance outcomes in Chinese injection drug users

Cited by 11 publications

References 37 publications

HIV epidemic among drug users in China: 1995–2011

HIV epidemic among drug users in China: 1995–2011

Predictors of continued HIV-risk behaviors among drug users in methadone maintenance therapy program in China—A prospective study

Alcohol use disorders are associated with increased HIV risk behaviors in cocaine-dependent methadone patients

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