Skip to main content
SpringerLink
Log in
Book cover

Biomedical Advances in HIV Prevention pp 161–177Cite as

Substance Use Treatment in the Era of New HIV Prevention Technologies

  • Chapter
  • First Online:

  • 663 Accesses

Abstract

From the start of the AIDS epidemic, a variety of strategies have been implemented in an attempt respond to reduce transmissions among drug users, but these efforts have been narrowly defined, are limited in scope and focused almost exclusively on injection drug use and related risks. The role of non-injection substance use in sustaining sexual transmission and inhibiting effective antiretroviral treatment has been underestimated since the first cases of HIV infection were identified. Substance use remains one of the greatest global challenges to effective risk reduction, access to and retention in HIV care, adherence to antiretroviral medications, and sustained suppression of viral load. This chapter reviews accomplishments and discusses the opportunities and challenges facing the scale-up of HIV prevention technologies in regards to addressing the impact of substance use. Three major topics will be addressed: (1) defining the challenge, (2) medication-assisted treatments for substance use disorders as HIV prevention technologies, and (3) opportunities and challenges for scale-up.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Masur H, Michelis MA, Greene JB, Onorato I, Stouwe RA, Holzman RS, et al. An outbreak of community-acquired Pneumocystis carinii pneumonia: initial manifestation of cellular immune dysfunction. N Engl J Med. 1981;305(24):1431–8.

    Article  PubMed  CAS  Google Scholar 

  2. Ginzburg HM. Intravenous drug users and the acquired immune deficiency syndrome. Public Health Rep. 1984;99(2):206–12.

    PubMed  CAS  Google Scholar 

  3. De Cock KM, Jaffe HW, Curran JW. The evolving epidemiology of HIV/AIDS. AIDS. 2012;26(10):1205–13.

    Article  PubMed  Google Scholar 

  4. Mahy M, Warner-Smith M, Stanecki KA, Ghys PD. Measuring the impact of the global response to the AIDS epidemic: challenges and future directions. J Acquir Immune Defic Syndr. 2009;52(Suppl 2):S152–9.

    Article  PubMed  Google Scholar 

  5. Mathers BM, Degenhardt L, Adam P, Toskin I, Nashkhoev M, Lyerla R et al. Estimating the level of HIV prevention coverage, knowledge and protective behavior among injecting drug users: what does the 2008 UNGASS reporting round tell us? JAIDS-J Acquir Immune Defic Syndr. 2009;52:S132–42.

    Article  Google Scholar 

  6. Bogart LM, Kral AH, Scott A, Anderson R, Flynn N, Gilbert ML, et al. Sexual risk among injection drug users recruited from syringe exchange programs in California. Sex Transm Dis. 2005;32(1):27–34.

    Article  PubMed  Google Scholar 

  7. Kalichman SC, Rompa D, Cage M. Group intervention to reduce HIV transmission risk behavior among persons living with HIV/AIDS. Behav Modif. 2005;29(2):256–85.

    Article  PubMed  Google Scholar 

  8. Bogart LM, Kral AH, Scott A, Anderson R, Flynn N, Gilbert ML, et al. Condom attitudes and behaviors among injection drug users participating in California syringe exchange programs. AIDS Behav. 2005;9(4):423–32.

    Article  PubMed  Google Scholar 

  9. Bluthenthal RN, Do DP, Finch B, Martinez A, Edlin BR, Kral AH. Community characteristics associated with HIV risk among injection drug users in the San Francisco Bay Area: a multilevel analysis. J Urban Health. 2007;84(5):653–66.

    Article  PubMed  Google Scholar 

  10. Townsend L, Mathews C, Zembe Y. A systematic review of behavioral interventions to prevent HIV infection and 2 among heterosexual, adult men in low-and middle-income countries. Prev Sci. 2013;14(1):88–105.

    Article  PubMed  Google Scholar 

  11. Woody GE, VanEtten-Lee ML, McKirnan D, Donnell D, Metzger D, Seage G, et al. Substance use among men who have sex with men: comparison with a national household survey. J Acquir Immune Defic Syndr. 2001;27(1):86–90.

    PubMed  CAS  Google Scholar 

  12. Chesney MA, Koblin BA, Barresi PJ, Husnik MJ, Celum CL, Colfax G, et al. An individually tailored intervention for HIV prevention: baseline data from the EXPLORE study. Am J Public Health. 2003;93(6):933–8.

    Article  PubMed  Google Scholar 

  13. Menza TW, Hughes JP, Celum CL, Golden MR. Prediction of HIV acquisition among men who have sex with men. Sex Transm Dis. 2009;36(9):547–55.

    Article  PubMed  Google Scholar 

  14. Koblin B, Chesney M, Coates T, Mayer K, Agredano F, Aguilu E, et al. Effects of a behavioural intervention to reduce acquisition of HIV infection among men who have sex with men: the EXPLORE randomised controlled study. Lancet. 2004;364(9428):41–50.

    Article  PubMed  CAS  Google Scholar 

  15. Koblin BA, Husnik MJ, Colfax G, Huang Y, Madison M, Mayer K, et al. Risk factors for HIV infection among men who have sex with men. AIDS. 2006;20(5):731–9.

    Article  PubMed  Google Scholar 

  16. MacArthur GJ, Minozzi S, Martin N, Vickerman P, Deren S, Bruneau J et al. Opiate substitution treatment and HIV transmission in people who inject drugs: systematic review and meta-analysis. Br Med J. 2012;345.

    Google Scholar 

  17. Sorensen JL, Copeland AL. Drug abuse treatment as an HIV prevention strategy: a review. Drug Alcohol Depend. 2000;59(1):17–31.

    Article  PubMed  CAS  Google Scholar 

  18. Metzger DS, Woody GE, O’Brien CP. Drug treatment as HIV prevention: a research update. JAIDS-J Acquir Immune Defic Syndr. 2010;55:S32–6.

    Article  Google Scholar 

  19. Bao YP, Liu ZM. Systematic review of HIV and HCV infection among drug users in China. Int J STD AIDS. 2009;20(6):399–405.

    Article  PubMed  Google Scholar 

  20. Li J, Ha T, Zhang C, Liu H. The Chinese government’s response to drug use and HIV/AIDS: a review of policies and programs. Harm Reduct J. 2010;7(1):4.

    Article  PubMed  Google Scholar 

  21. Fiellin DA, Pantalon MV, Chawarski MC, Moore BA, Sullivan LE, O’Connor PG, et al. Counseling plus buprenorphine-naloxone maintenance therapy for opioid dependence. N Eng J Med. 2006;355(4):365–74.

    Article  CAS  Google Scholar 

  22. Bridge TP, Fudala PJ, Herbert S, Leiderman DB. Safety and health policy considerations related to the use of buprenorphine/naloxone as an office-based treatment for opiate dependence. Drug Alcohol Depend. 2003;70(2 Suppl):S79–85.

    Article  PubMed  CAS  Google Scholar 

  23. Sullivan LE, Fiellin DA. Buprenorphine: its role in preventing HIV transmission and improving the care of HIV-infected patients with opioid dependence. Clin Infect Dis. 2005;41(6):891–6.

    Article  PubMed  CAS  Google Scholar 

  24. Sullivan LE, Metzger DS, Fudala PJ, Fiellin DA. Decreasing international HIV transmission: the role of expanding access to opioid agonist therapies for injection drug users. Addiction. 2005;100(2):150–8.

    Article  PubMed  Google Scholar 

  25. Sullivan LE, Moore BA, Chawarski MC, Pantalon MV, Barry D, O’Connor PG, et al. Buprenorphine/naloxone treatment in primary care is associated with decreased human immunodeficiency virus risk behaviors. J Subst Abuse Treat. 2008;35(1):87–92.

    Article  PubMed  Google Scholar 

  26. Meade CS, Weiss RD, Fitzmaurice GM, Poole SA, Subramaniam GA, Patkar AA, et al. HIV risk behavior in treatment-seeking opioid-dependent youth: results from a NIDA clinical trials network multisite study. J Acquir Immune Defic Syndr. 2010;55(1):65–72. doi:10.1097/QAI.0b013e3181d916db..

    Article  PubMed  Google Scholar 

  27. Woody GE, Poole SA, Subramaniam G, Dugosh K, Bogenschutz M, Abbott P et al. Extended vs short-term buprenorphine-naloxone for treatment of opioid-addicted youth a randomized trial. JAMA-J Am Med Assoc. 2008;300(17):2003–11.

    Article  Google Scholar 

  28. Schackman BR, Merrill JO, McCarty D, Levi J, Lubinski C. Overcoming policy and financing barriers to integrated buprenorphine and HIV primary care. Clin Infect Dis. 2006;43:S247–53.

    PubMed  Google Scholar 

  29. Doran CM, Shanahan M, Mattick RP, Ali R, White J, Bell J. Buprenorphine versus methadone maintenance: a cost-effectiveness analysis. Drug Alcohol Depend. 2003;71(3):295–302.

    Article  PubMed  CAS  Google Scholar 

  30. Schottenfeld RS, Chawarski MC, Mazlan M. Maintenance treatment with buprenorphine and naltrexone for heroin dependence in Malaysia: a randomised, double-blind, placebo-controlled trial. Lancet. 2008;371(9631):2192–200.

    Article  PubMed  CAS  Google Scholar 

  31. Lucas GM, Beauchamp G, Aramrattana A, Shao YM, Liu W, Fu LP, et al. Short-term safety of buprenorphine/naloxone in HIV-seronegative opioid-dependent Chinese and Thai drug injectors enrolled in HIV prevention trials network 058. Int J Drug Policy. 2012;23(2):162–5.

    Article  PubMed  Google Scholar 

  32. Fram DH, Marmo J, Holden R. Naltrexone treatment—the problem of patient acceptance. J Subst Abuse Treat. 1989;6(2):119–22.

    Article  PubMed  CAS  Google Scholar 

  33. Tucker TK, Ritter AJ. Naltrexone in the treatment of heroin dependence: a literature review. Drug Alcohol Rev. 2000;19(1):73–82.

    Article  Google Scholar 

  34. Minozzi S, Amato L, Vecchi S, Davoli M, Kirchmayer U, Verster A. Oral naltrexone maintenance treatment for opioid dependence. Cochrane Database Syst Rev. 2006;(1).

    Google Scholar 

  35. Krupitsky E, Woody GE, Zvartau E, O’Brien CP. Addiction treatment in Russia. Lancet. 2010;376(9747):1145.

    Article  PubMed  Google Scholar 

  36. Krupitsky EM, Zvartau EE, Masalov DV, Tsoi MV, Burakov AM, Egorova VY, et al. Naltrexone for heroin dependence treatment in St. Petersburg, Russia. J Subst Abuse Treat. 2004;26(4):285–94.

    Article  PubMed  Google Scholar 

  37. Krupitsky E, Zvartau E, Masalov D, Tsoi M, Egorova V, Burakov A et al. A double-blind, placebo controlled trial of naltrexone and fluoxetine for heroin addiction treatment. Eur Neuropsychopharmacol. 2005;15:S284.

    Article  Google Scholar 

  38. Krupitsky EM, Zvartau EE, Masalov DV, Tsoi MV, Burakov AM, Egorova VY, et al. Naltrexone with or without fluoxetine for preventing relapse to heroin addiction in St. Petersburg, Russia. J Subst Abuse Treat. 2006;31(4):319–28.

    Article  PubMed  Google Scholar 

  39. Krupitsky E, Nunes EV, Ling W, Illeperuma A, Gastfriend DR, Silverman BL. Injectable extended-release naltrexone for opioid dependence: a double-blind, placebo-controlled, multicentre randomised trial. Lancet. 2011;377(9776):1506–13.

    Article  PubMed  CAS  Google Scholar 

  40. Tross S, Hanner J, Hu M-C, Pavlicova M, Campbell A, Nunes EV. Substance use and high risk sexual behaviors among women in psychosocial outpatient and methadone maintenance treatment programs. Am J Drug Alcohol Abuse. 2009;35(5):368–74.

    Article  PubMed  Google Scholar 

  41. Rudy ET, Shoptaw S, Lazzar M, Bolan RK, Tilekar SD, Kerndt PR. Methamphetamine use and other club drug use differ in relation to HIV status and risk behavior among gay and bisexual men. Sex Transm Dis. 2009;36(11):693–5.

    Article  PubMed  CAS  Google Scholar 

  42. Meader N, Li R, Des Jarlais DC, Pilling S. Psychosocial interventions for reducing injection and sexual risk behaviour for preventing HIV in drug users. Cochrane Database Syst Rev. 2010(1):CD007192.

    Google Scholar 

  43. Shoptaw S, Reback CJ, Peck JA, Yang XW, Rotheram-Fuller E, Larkins S, et al. Behavioral treatment approaches for methamphetamine dependence and HIV-related sexual risk behaviors among urban gay and bisexual men. Drug Alcohol Depend. 2005;78(2):125–34.

    Article  PubMed  Google Scholar 

  44. Tross S, Campbell ANC, Cohen LR, Calsyn D, Pavlicova M, Miele GM et al. Effectiveness of HIV/STD sexual risk reduction groups for women in substance abuse treatment programs: results of NIDA clinical trials network trial. JAIDS-J Acquir Immune Defic Syndr. 2008;48(5):581–9.

    Article  Google Scholar 

  45. Calsyn DA, Hatch-Maillette M, Tross S, Doyle SR, Crits-Christoph P, Song YS, et al. Motivational and skills training HIV/sexually transmitted infection sexual risk reduction groups for men. J Subst Abuse Treat. 2009;37(2):138–50.

    Article  PubMed  Google Scholar 

  46. Calsyn DA, Crits-Christoph P, Hatch-Maillette MA, Doyle SR, Song YS, Coyer S, et al. Reducing sex under the influence of drugs or alcohol for patients in substance abuse treatment. Addiction. 2010;105(1):100–8.

    Article  PubMed  Google Scholar 

  47. Chang LW, Serwadda D, Quinn TC, Wawer MJ, Gray RH, Reynolds SJ. Combination implementation for HIV prevention: moving from clinical trial evidence to population-level effects. Lancet Infect Dis. 2013;13(1):65–76.

    Article  PubMed  Google Scholar 

  48. Shoptaw S, Reback CJ, Larkins S, Wang PC, Rotheram-Fuller E, Dang J, et al. Outcomes using two tailored behavioral treatments for substance abuse in urban gay and bisexual men. J Subst Abuse Treat. 2008;35(3):285–93.

    Article  PubMed  Google Scholar 

  49. Volkow ND, Montaner J. Enhanced HIV testing, treatment, and support for HIV-infected substance users. JAMA-J Am Med Assoc. 2010;303(14):1423–4.

    Article  CAS  Google Scholar 

  50. Granich RM, Gilks CF, Dye C, De Cock KM, Williams BG. Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Lancet. 2009;373(9657):48–57.

    Article  PubMed  Google Scholar 

  51. De Cock KM, Crowley SP, Lo Y-R, Granich RM, Williams BG. Preventing HIV transmission with antiretrovirals. Bull World Health Organ. 2009;87(7):488–A.

    Article  PubMed  Google Scholar 

  52. Lima VD, Johnston K, Hogg RS, Levy AR, Harrigan PR, Anema A, et al. Expanded access to highly active antiretroviral therapy: a potentially powerful strategy to curb the growth of the HIV epidemic. J Infect Dis. 2008;198(1):59–67.

    Article  PubMed  CAS  Google Scholar 

  53. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Eng J Med. 2011;365(6):493–505.

    Article  CAS  Google Scholar 

  54. Chander G, Himelhoch S, Fleishman JA, Hellinger J, Gaist P, Moore RD et al. HAART receipt and viral suppression among HIV-infected patients with co-occurring mental illness and illicit drug use. AIDS Care-Psychol Socio-Med Asp AIDS/HIV. 2009;21(5):655–63.

    Article  Google Scholar 

  55. Krusi A, Wood E, Montaner J, Kerr T. Social and structural determinants of HAART access and adherence among injection drug users. Int J Drug Policy. 2010;21(1):4–9.

    Article  PubMed  Google Scholar 

  56. Wu ES, Metzger DS, Lynch KG, Douglas SD. Association between alcohol use and HIV viral load. JAIDS-J Acquir Immune Defic Syndr. 2011;56(5):E129–30.

    Article  Google Scholar 

  57. Lucas GM, Mullen BA, Weidle PJ, Hader S, McCaul ME, Moore RD. Directly administered antiretroviral therapy in methadone clinics is associated with improved HIV treatment outcomes, compared with outcomes among concurrent comparison groups. Clin Infect Dis. 2006;42(11):1628–35.

    Article  PubMed  CAS  Google Scholar 

  58. Lucas GM, Griswold M, Gebo KA, Keruly J, Chaisson RE, Moore RD. Illicit drug use and HIV-1 disease progression: a longitudinal study in the era of highly active antiretroviral therapy. Am J Epidemiol. 2006;163(5):412–20.

    Article  PubMed  Google Scholar 

  59. Roux P, Carrieri MP, Villes V, Dellamonica P, Poizot-Martin I, Ravaux I, et al. The impact of methadone or buprenorphine treatment and ongoing injection on highly active antiretroviral therapy (HAART) adherence: evidence from the MANIF2000 cohort study. Addiction. 2008;103(11):1828–36.

    Article  PubMed  Google Scholar 

  60. Roux P, Carrieri MP, Cohen J, Ravaux I, Poizot-Martin I, Dellamonica P, et al. Retention in opioid substitution treatment: a major predictor of long-term virological success for HIV-infected injection drug users receiving antiretroviral treatment. Clin Infect Dis. 2009;49(9):1433–40.

    Article  PubMed  Google Scholar 

  61. Spire B, Lucas GM, Carrieri MP. Adherence to HIV treatment among IDUs and the role of opioid substitution treatment (OST). Int J Drug Policy. 2007;18(4):262–70.

    Article  PubMed  Google Scholar 

  62. Centers for Disease Control and P. HIV infection among injection-drug users—34 states, 2004–2007. MMWR Morb Mortal Wkly Rep. 2009;58(46):1291–5.

    Google Scholar 

  63. Pollack HA, D’Aunno T, Lamar B. Outpatient substance abuse treatment and HIV prevention: an update. J Subst Abuse Treat. 2006;30(1):39–47.

    Article  PubMed  Google Scholar 

  64. Knudsen HK, Oser CB. Availability of HIV-related health services in adolescent substance abuse treatment programs. AIDS Care-Psychol Socio-Med Asp AIDS/HIV. 2009;21(10):1238–46.

    Article  CAS  Google Scholar 

  65. Sorensen JL, Haug NA, Delucchi KL, Gruber V, Kletter E, Batki SL, et al. Voucher reinforcement improves medication adherence in HIV-positive methadone patients: a randomized trial. Drug Alcohol Depend. 2007;88(1):54–63.

    Article  PubMed  Google Scholar 

  66. Barnett PG, Sorensen JL, Wong W, Haug NA, Hall SM. Effect of incentives for medication adherence on health care use and costs in methadone patients with HIV. Drug Alcohol Depend. 2009;100(1–2):115–21.

    Article  PubMed  Google Scholar 

  67. Mathers BM, Degenhardt L, Ali H, Wiessing L, Hickman M, Mattick RP, et al. HIV prevention, treatment, and care services for people who inject drugs: a systematic review of global, regional, and national coverage. Lancet. 2010;375(9719):1014–28.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 4000, 19104, Philadelphia, PA, USA

    David S. Metzger Ph.D.

  2. Treatment Research Institute, Independence Mall WestPhiladelphia, 600 Public Ledger Building 150 S., 19106, WestPhiladelphia, PA, USA

    David S. Metzger Ph.D.

Authors
  1. David S. Metzger Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David S. Metzger Ph.D. .

Editor information

Editors and Affiliations

  1. Dept. of Human Develop. & Family Studies, University of Connecticut, Storrs, Connecticut, USA

    Lisa A. Eaton

  2. Ctr for Health Intervention & Prevention, University of Connecticut, Storrs, Connecticut, USA

    Seth C. Kalichman

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Metzger, D. (2014). Substance Use Treatment in the Era of New HIV Prevention Technologies. In: Eaton, L., Kalichman, S. (eds) Biomedical Advances in HIV Prevention. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8845-3_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-8845-3_8

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8844-6

  • Online ISBN: 978-1-4614-8845-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation