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. 1998 Jun;113(Suppl 1):97–106.

Drug abuse treatment as AIDS prevention.

D S Metzger 1, H Navaline 1, G E Woody 1
PMCID: PMC1307732  PMID: 9722815

Abstract

OBJECTIVE: As the acquired immunodeficiency syndrome (AIDS) epidemic among drug users enters its third decade in the United States, it is important to consider the role playing by substance abuse treatment in the prevention of human immunodeficiency virus (HIV) infection. METHODS: The authors review the research literature, examining findings from studies with behavioral and serologic measures on the association among treatment participation, HIV risk reduction, and HIV infection. RESULTS: Numerous studies have now documented that significantly lower rates of drug use and related risk behaviors are practiced by injecting drug users (IDUs) who are in treatment. Importantly, these behavioral differences, based primarily on self-report, are consistent with studies that have examined HIV seroprevalence and seroincidence among drug users. CONCLUSION: The underlying mechanism of action suggested by the collective findings of the available literature is rather simple-- individuals who enter and remain in treatment reduce their drug use, when leads to fewer instances of drug-related risk behavior. This lower rate of exposure results in fewer infections with HIV. The protective effects of treatment, however, can only be achieved when programs are accessible and responsive to the changing needs of drug users. Future research needs to be directed at developing a better understanding of the factors that enhance treatment entry and retention.

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Selected References

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

  1. Amsel Z., Mandell W., Matthias L., Mason C., Hocherman I. Reliability and validity of self-reported illegal activities and drug use collected from narcotic addicts. Int J Addict. 1976;11(2):325–336. doi: 10.3109/10826087609058803. [DOI] [PubMed] [Google Scholar]
  2. Avins A. L., Lindan C. P., Woods W. J., Hudes E. S., Boscarino J. A., Kay J., Clark W., Hulley S. B. Changes in HIV-related behaviors among heterosexual alcoholics following addiction treatment. Drug Alcohol Depend. 1997 Jan 10;44(1):47–55. doi: 10.1016/s0376-8716(96)01321-x. [DOI] [PubMed] [Google Scholar]
  3. Ball J. C., Lange W. R., Myers C. P., Friedman S. R. Reducing the risk of AIDS through methadone maintenance treatment. J Health Soc Behav. 1988 Sep;29(3):214–226. [PubMed] [Google Scholar]
  4. Booth R. E., Crowley T. J., Zhang Y. Substance abuse treatment entry, retention and effectiveness: out-of-treatment opiate injection drug users. Drug Alcohol Depend. 1996 Sep;42(1):11–20. doi: 10.1016/0376-8716(96)01257-4. [DOI] [PubMed] [Google Scholar]
  5. Booth R. E., Watters J. K. How effective are risk-reduction interventions targeting injecting drug users? AIDS. 1994 Nov;8(11):1515–1524. doi: 10.1097/00002030-199411000-00001. [DOI] [PubMed] [Google Scholar]
  6. Brown L. S., Jr, Burkett W., Primm B. J. Drug treatment and HIV seropositivity. N Y State J Med. 1988 Mar;88(3):156–156. [PubMed] [Google Scholar]
  7. Caplehorn J. R., Ross M. W. Methadone maintenance and the likelihood of risky needle-sharing. Int J Addict. 1995 May;30(6):685–698. doi: 10.3109/10826089509048753. [DOI] [PubMed] [Google Scholar]
  8. Catania J. A., Gibson D. R., Chitwood D. D., Coates T. J. Methodological problems in AIDS behavioral research: influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull. 1990 Nov;108(3):339–362. doi: 10.1037/0033-2909.108.3.339. [DOI] [PubMed] [Google Scholar]
  9. Cooper J. R. Methadone treatment and acquired immunodeficiency syndrome. JAMA. 1989 Sep 22;262(12):1664–1668. [PubMed] [Google Scholar]
  10. Des Jarlais D. C., Friedman S. R., Hopkins W. Risk reduction for the acquired immunodeficiency syndrome among intravenous drug users. Ann Intern Med. 1985 Nov;103(5):755–759. doi: 10.7326/0003-4819-103-5-755. [DOI] [PubMed] [Google Scholar]
  11. Etheridge R. M., Craddock S. G., Dunteman G. H., Hubbard R. L. Treatment services in two national studies of community-based drug abuse treatment programs. J Subst Abuse. 1995;7(1):9–26. doi: 10.1016/0899-3289(95)90303-8. [DOI] [PubMed] [Google Scholar]
  12. Friedman S. R., Jose B., Deren S., Des Jarlais D. C., Neaigus A. Risk factors for human immunodeficiency virus seroconversion among out-of-treatment drug injectors in high and low seroprevalence cities. The National AIDS Research Consortium. Am J Epidemiol. 1995 Oct 15;142(8):864–874. doi: 10.1093/oxfordjournals.aje.a117726. [DOI] [PubMed] [Google Scholar]
  13. Greenfield L., Brady J. V., Besteman K. J., De Smet A. Patient retention in mobile and fixed-site methadone maintenance treatment. Drug Alcohol Depend. 1996 Oct;42(2):125–131. doi: 10.1016/0376-8716(96)01273-2. [DOI] [PubMed] [Google Scholar]
  14. Hahn R. A., Onorato I. M., Jones T. S., Dougherty J. Prevalence of HIV infection among intravenous drug users in the United States. JAMA. 1989 May 12;261(18):2677–2684. [PubMed] [Google Scholar]
  15. Hubbard R. L., Marsden M. E., Cavanaugh E., Rachal J. V., Ginzburg H. M. Role of drug-abuse treatment in limiting the spread of AIDS. Rev Infect Dis. 1988 Mar-Apr;10(2):377–384. doi: 10.1093/clinids/10.2.377. [DOI] [PubMed] [Google Scholar]
  16. Kozel N. J., Adams E. H. Epidemiology of drug abuse: an overview. Science. 1986 Nov 21;234(4779):970–974. doi: 10.1126/science.3490691. [DOI] [PubMed] [Google Scholar]
  17. Marmor M., Des Jarlais D. C., Cohen H., Friedman S. R., Beatrice S. T., Dubin N., el-Sadr W., Mildvan D., Yancovitz S., Mathur U. Risk factors for infection with human immunodeficiency virus among intravenous drug abusers in New York City. AIDS. 1987 May;1(1):39–44. [PubMed] [Google Scholar]
  18. McCusker J., Stoddard A. M., Hindin R. N., Garfield F. B., Frost R. Changes in HIV risk behavior following alternative residential programs of drug abuse treatment and AIDS education. Ann Epidemiol. 1996 Mar;6(2):119–125. doi: 10.1016/1047-2797(95)00128-x. [DOI] [PubMed] [Google Scholar]
  19. McLellan A. T., Arndt I. O., Metzger D. S., Woody G. E., O'Brien C. P. The effects of psychosocial services in substance abuse treatment. JAMA. 1993 Apr 21;269(15):1953–1959. [PubMed] [Google Scholar]
  20. Meandzija B., O'Connor P. G., Fitzgerald B., Rounsaville B. J., Kosten T. R. HIV infection and cocaine use in methadone maintained and untreated intravenous drug users. Drug Alcohol Depend. 1994 Oct;36(2):109–113. doi: 10.1016/0376-8716(94)90092-2. [DOI] [PubMed] [Google Scholar]
  21. Metzger D. S., Woody G. E., McLellan A. T., O'Brien C. P., Druley P., Navaline H., DePhilippis D., Stolley P., Abrutyn E. Human immunodeficiency virus seroconversion among intravenous drug users in- and out-of-treatment: an 18-month prospective follow-up. J Acquir Immune Defic Syndr. 1993 Sep;6(9):1049–1056. [PubMed] [Google Scholar]
  22. Moss A. R., Vranizan K., Gorter R., Bacchetti P., Watters J., Osmond D. HIV seroconversion in intravenous drug users in San Francisco, 1985-1990. AIDS. 1994 Feb;8(2):223–231. doi: 10.1097/00002030-199402000-00010. [DOI] [PubMed] [Google Scholar]
  23. Novick D. M., Joseph H., Croxson T. S., Salsitz E. A., Wang G., Richman B. L., Poretsky L., Keefe J. B., Whimbey E. Absence of antibody to human immunodeficiency virus in long-term, socially rehabilitated methadone maintenance patients. Arch Intern Med. 1990 Jan;150(1):97–99. [PubMed] [Google Scholar]
  24. Orr M. F., Glebatis D., Friedmann P., des Jarlais D. C., Prevots D. R. Incidence of HIV infection in a New York City methadone maintenance treatment program. JAMA. 1996 Jul 10;276(2):99–99. doi: 10.1001/jama.276.2.99b. [DOI] [PubMed] [Google Scholar]
  25. Schuster C. R. Intravenous drug use and AIDS prevention. Public Health Rep. 1988 May-Jun;103(3):261–266. [PMC free article] [PubMed] [Google Scholar]
  26. Serpelloni G., Carrieri M. P., Rezza G., Morganti S., Gomma M., Binkin N. Methadone treatment as a determinant of HIV risk reduction among injecting drug users: a nested case-control study. AIDS Care. 1994;6(2):215–220. doi: 10.1080/09540129408258632. [DOI] [PubMed] [Google Scholar]
  27. Siegal H. A., Carlson R. G., Falck R. S., Wang J. Drug abuse treatment experience and HIV risk behaviors among active drug injectors in Ohio. Am J Public Health. 1995 Jan;85(1):105–108. doi: 10.2105/ajph.85.1.105. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Williams A. B., McNelly E. A., Williams A. E., D'Aquila R. T. Methadone maintenance treatment and HIV type 1 seroconversion among injecting drug users. AIDS Care. 1992;4(1):35–41. doi: 10.1080/09540129208251618. [DOI] [PubMed] [Google Scholar]
  29. Yancovitz S. R., Des Jarlais D. C., Peyser N. P., Drew E., Friedmann P., Trigg H. L., Robinson J. W. A randomized trial of an interim methadone maintenance clinic. Am J Public Health. 1991 Sep;81(9):1185–1191. doi: 10.2105/ajph.81.9.1185. [DOI] [PMC free article] [PubMed] [Google Scholar]

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