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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.

Comments:

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

Reference:

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.

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