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. 1996 Oct;50(5):534–537. doi: 10.1136/jech.50.5.534

Methadone maintenance treatment and HIV risk-taking behaviour among injecting drug users in Berlin.

K Stark 1, R Müller 1, U Bienzle 1, I Guggenmoos-Holzmann 1
PMCID: PMC1060345  PMID: 8944860

Abstract

STUDY OBJECTIVE: To determine whether methadone maintenance treatment (MMT) is effective in reducing the levels of HIV risk-taking behaviour (borrowing and lending of injection equipment, irregular condom use) among injecting drug users (IDUs), and to identify independent predictors of the borrowing of used syringes. DESIGN: Cross sectional study of IDUs in MMT and not in MMT, using standardised interviews for collection of sociodemographic and behavioural data, and laboratory tests for detecting HIV antibodies. SETTING AND PARTICIPANTS: The 612 IDUs were recruited at different services for drug users such as treatment centres, walk in agencies, a hospital, and on the streets. MAIN RESULTS: Of all IDUs, 41% had borrowed and 34% had passed on used injection equipment in the previous six months. In univariate analysis, IDUs receiving MMT had injected less frequently and were significantly less likely to borrow and lend syringes. In logistic regression analysis, MMT was protective against the borrowing of syringes (adjusted odds ratio 0.36, 95% confidence interval 0.2, 0.8), but not against syringe lending nor against sexual risk behaviour (i.e., numbers of sex partners, lack of condom use). Important independent predictors of the borrowing of syringes were injecting drug use in prison, use of sedatives, and sex with another IDU in the previous six months. CONCLUSIONS: MMT may play a significant role in reducing the levels of borrowing of syringes among IDUs. However, additional prevention measures are needed which should specifically address sexual risk behaviour and target subgroups of IDUs with high levels of needle sharing, such as IDUs who have been in prison and and those who are sedative users.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baker A., Kochan N., Dixon J., Wodak A., Heather N. HIV risk-taking behaviour among injecting drug users currently, previously and never enrolled in methadone treatment. Addiction. 1995 Apr;90(4):545–554. doi: 10.1046/j.1360-0443.1995.9045458.x. [DOI] [PubMed] [Google Scholar]
  2. Booth R. E. Predictors of unsafe needle practices: injection drug users in Denver. J Acquir Immune Defic Syndr. 1994 May;7(5):504–508. [PubMed] [Google Scholar]
  3. Chaisson R. E., Moss A. R., Onishi R., Osmond D., Carlson J. R. Human immunodeficiency virus infection in heterosexual intravenous drug users in San Francisco. Am J Public Health. 1987 Feb;77(2):169–172. doi: 10.2105/ajph.77.2.169. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Darke S., Swift W., Hall W., Ross M. Predictors of injecting and injecting risk-taking behaviour among methadone-maintenance clients. Addiction. 1994 Mar;89(3):311–316. doi: 10.1111/j.1360-0443.1994.tb00897.x. [DOI] [PubMed] [Google Scholar]
  5. Des Jarlais D. C., Friedman S. R., Choopanya K., Vanichseni S., Ward T. P. International epidemiology of HIV and AIDS among injecting drug users. AIDS. 1992 Oct;6(10):1053–1068. doi: 10.1097/00002030-199210000-00001. [DOI] [PubMed] [Google Scholar]
  6. Donoghoe M. C., Stimson G. V., Dolan K., Alldritt L. Changes in HIV risk behaviour in clients of syringe-exchange schemes in England and Scotland. AIDS. 1989 May;3(5):267–272. doi: 10.1097/00002030-198905000-00003. [DOI] [PubMed] [Google Scholar]
  7. Gore S. M., Bird A. G., Burns S. M., Goldberg D. J., Ross A. J., Macgregor J. Drug injection and HIV prevalence in inmates of Glenochil prison. BMJ. 1995 Feb 4;310(6975):293–296. doi: 10.1136/bmj.310.6975.293. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hartgers C., van den Hoek A., Krijnen P., Coutinho R. A. HIV prevalence and risk behavior among injecting drug users who participate in "low-threshold" methadone programs in Amsterdam. Am J Public Health. 1992 Apr;82(4):547–551. doi: 10.2105/ajph.82.4.547. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Kang S. Y., De Leon G. Correlates of drug injection behaviors among methadone outpatients. Am J Drug Alcohol Abuse. 1993;19(1):107–118. doi: 10.3109/00952999309002669. [DOI] [PubMed] [Google Scholar]
  10. Müller R., Stark K., Guggenmoos-Holzmann I., Wirth D., Bienzle U. Imprisonment: a risk factor for HIV infection counteracting education and prevention programmes for intravenous drug users. AIDS. 1995 Feb;9(2):183–190. [PubMed] [Google Scholar]
  11. Novick D. M., Trigg H. L., Des Jarlais D. C., Friedman S. R., Vlahov D., Kreek M. J. Cocaine injection and ethnicity in parenteral drug users during the early years of the human immunodeficiency virus (HIV) epidemic in New York City. J Med Virol. 1989 Nov;29(3):181–185. doi: 10.1002/jmv.1890290307. [DOI] [PubMed] [Google Scholar]
  12. Robert C. F., Déglon J. J., Wintsch J., Martin J. L., Perrin L., Bourquin M., Gabriel V., Hirschel B. Behavioural changes in intravenous drug users in Geneva: rise and fall of HIV infection, 1980-1989. AIDS. 1990 Jul;4(7):657–660. [PubMed] [Google Scholar]
  13. Schoenbaum E. E., Hartel D., Selwyn P. A., Klein R. S., Davenny K., Rogers M., Feiner C., Friedland G. Risk factors for human immunodeficiency virus infection in intravenous drug users. N Engl J Med. 1989 Sep 28;321(13):874–879. doi: 10.1056/NEJM198909283211306. [DOI] [PubMed] [Google Scholar]
  14. Stark K., Müller R. HIV prevalence and risk behaviour in injecting drug users in Berlin. Forensic Sci Int. 1993 Nov;62(1-2):73–81. doi: 10.1016/0379-0738(93)90048-f. [DOI] [PubMed] [Google Scholar]
  15. Stark K., Warnecke C., Brinkmann V., Gelderblom H. R., Bienzle U., Pauli G. Sensitivity of HIV antibody detection in saliva. Med Microbiol Immunol. 1993 Jul;182(3):147–151. doi: 10.1007/BF00190267. [DOI] [PubMed] [Google Scholar]
  16. Taylor A., Goldberg D., Emslie J., Wrench J., Gruer L., Cameron S., Black J., Davis B., McGregor J., Follett E. Outbreak of HIV infection in a Scottish prison. BMJ. 1995 Feb 4;310(6975):289–292. doi: 10.1136/bmj.310.6975.289. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ward J., Darke S., Hall W., Mattick R. Methadone maintenance and the human immunodeficiency virus: current issues in treatment and research. Br J Addict. 1992 Mar;87(3):447–453. doi: 10.1111/j.1360-0443.1992.tb01945.x. [DOI] [PubMed] [Google Scholar]
  18. van Haastrecht H. J., van den Hoek J. A., Bardoux C., Leentvaar-Kuypers A., Coutinho R. A. The course of the HIV epidemic among intravenous drug users in Amsterdam, The Netherlands. Am J Public Health. 1991 Jan;81(1):59–62. doi: 10.2105/ajph.81.1.59. [DOI] [PMC free article] [PubMed] [Google Scholar]

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