Original Paper

AIDS and Behavior

, Volume 18, Issue 4, pp 740-746

Methadone Maintenance Therapy Decreases the Rate of Antiretroviral Therapy Discontinuation Among HIV-Positive Illicit Drug Users

  • H. ReddonAffiliated withUrban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, University of British Columbia
  • , M.-J. MilloyAffiliated withUrban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, University of British ColumbiaFaculty of Medicine, University of British Columbia
  • , A. SimoAffiliated withUrban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, University of British Columbia
  • , J. MontanerAffiliated withUrban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, University of British ColumbiaDivision of AIDS, Department of Medicine, University of British Columbia
  • , E. WoodAffiliated withUrban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, University of British ColumbiaDivision of AIDS, Department of Medicine, University of British Columbia
  • , T. KerrAffiliated withUrban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, University of British ColumbiaDivision of AIDS, Department of Medicine, University of British Columbia Email author 

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Abstract

We sought to examine whether methadone maintenance therapy (MMT) decreased rates of antiretroviral therapy (ART) discontinuation and was associated with plasma HIV RNA responses among a cohort of illicit drug users. Cumulative ART discontinuation rates were estimated using Kaplan–Meier methods and factors independently associated with ART discontinuation were identified using Cox proportional hazards regression. Engagement in MMT was negatively and independently associated with ART discontinuation [Adjusted Relative Hazard = 0.67 (95 % CI 0.54–0.83); p < 0.001]. Among participants receiving ART and MMT, 81.6 % of plasma HIV-1 RNA assessments were <500 copies/mL, while 65.81 % of HIV-1 RNA assessments among those prescribed ART without MMT were <500 copies/mL (p < 0.001). These results demonstrate that engagement in MMT conferred a protective benefit against ART discontinuation and was associated with a significant increase in plasma HIV RNA suppression among HIV-infected opioid-dependent drug users.

Keywords

HIV Drug use Antiretroviral therapy Methadone Discontinuation