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Research Summary

Entering Methadone Maintenance Treatment Has Little Impact on HIV Sex-Risk Behaviors in Heroin-Addicted Adults

Entry into methadone maintenance treatment (MMT) has been shown to reduce drug-related HIV risk behaviors, but the impact on HIV sex-risk behaviors is less clear. In this observational study in Baltimore, MD, 351 subjects with heroin dependence newly admitted to MMT were compared with 164 out-of-treatment subjects recruited from the street. The main outcome measures were the 10 sex-risk items on the AIDS Risk Assessment administered at baseline and at 6 and 12 months.

  • The demographic characteristics of the 2 groups were similar, and there were no significant differences in age, gender, or race.
  • The out-of-treatment group reported having a higher number of sexual partners than those entering MMT at baseline and at 6 and 12 months, and higher frequency of sex at baseline (but not at 6 and 12 months). Results on the other measures were not significantly different.
  • Those entering MMT reported a significant reduction in 1 measured risk behavior after 6 months (but not at 12 months): frequency of unprotected sex while high or with someone who was high. Results on the other measures were not significantly different.


It is not surprising that heroin-dependent individuals who are not in treatment engage in more risky sexual behaviors, but it is disappointing that those entering treatment showed only modest changes in sexual-risk behavior. Results suggest that entry into drug treatment alone is not sufficient to change these behaviors, and that we need to pay more attention to heroin-dependent people who are not in treatment and to develop effective interventions to reduce HIV risk behaviors. Darius A. Rastegar, MD


Mitchell SG, Kelly SM, Brown BS, et al. HIV sex-risk behaviors among in- versus out-of-treatment heroin-addicted adults. Am J Drug Alcohol Abuse. 2012;38(4):328–333.