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

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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.

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Acknowledgments

The authors thank the study participants for their contribution to the research, as well as current and past researchers and staff. We would specifically like to thank Deborah Graham, Tricia Collingham, Caitlin Johnston, and Steve Kain for their research and administrative assistance. The study was supported by the US National Institutes of Health (R01DA021525) and the Canadian Institutes of Health Research (MOP-79297, RAA-79918). Thomas Kerr and M.-J. Milloy are supported by the Michael Smith Foundation for Health Research. M.-J. Milloy is also supported by the Canadian Institutes of Health Research. This research was undertaken, in part, thanks to funding from the Canada Research Chairs program through a Tier 1 Canada Research Chair in Inner City Medicine which supports Dr. Evan Wood.

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Authors and Affiliations

  1. Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, University of British Columbia, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada

    H. Reddon, M.-J. Milloy, A. Simo, J. Montaner, E. Wood & T. Kerr

  2. Faculty of Medicine, University of British Columbia, Vancouver, BC, V6Z 1Y6, Canada

    M.-J. Milloy

  3. Division of AIDS, Department of Medicine, University of British Columbia, Vancouver, BC, V6Z 1Y6, Canada

    J. Montaner, E. Wood & T. Kerr

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  1. H. Reddon
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  2. M.-J. Milloy
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  4. J. Montaner
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  5. E. Wood
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  6. T. Kerr
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Correspondence to T. Kerr.

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Reddon, H., Milloy, MJ., Simo, A. et al. Methadone Maintenance Therapy Decreases the Rate of Antiretroviral Therapy Discontinuation Among HIV-Positive Illicit Drug Users. AIDS Behav 18, 740–746 (2014). https://doi.org/10.1007/s10461-013-0584-z

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