HIV risk reduction with buprenorphine-naloxone or methadone

Findings from a randomized trial

George E. Woody, Douglas Bruce, Philip (Todd) Korthuis, Sumedha Chhatre, Sabrina Poole, Maureen Hillhouse, Petra Jacobs, James Sorensen, Andrew J. Saxon, David Metzger, Walter Ling

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Objectives: Compare HIV injecting and sex risk in patients being treated with methadone (MET) or buprenorphine-naloxone (BUP). Methods: Secondary analysis from a study of liver enzyme changes in patients randomized to MET or BUP who completed 24 weeks of treatment and had 4 or more blood draws. The initial 1:1 randomization was changed to 2:1 (BUP:MET) after 18 months due to higher dropout in BUP. The Risk Behavior Survey measured HIV risk before 30 days at baseline and weeks 12 and 24. Results: Among 529 patients randomized to MET, 391 (74%) were completers; among 740 randomized to BUP, 340 (46%) were completers; 700 completed the Risk Behavior Survey. There were significant reductions in injecting risk (P <0.0008) with no differences between groups in mean number of times reported injecting heroin, speedball, other opiates, and number of injections; or percent who shared needles; did not clean shared needles with bleach; shared cookers; or engaged in front/back loading of syringes. The percent having multiple sex partners decreased equally in both groups (P <0.03). For males on BUP, the sex risk composite increased; formales onMET, the sex risk decreased resulting in significant group differences over time (P <0.03). For females, there was a significant reduction in sex risk (P <0.02) with no group differences. Conclusions: Among MET and BUP patients who remained in treatment, HIV injecting risk was equally and markedly reduced; however, MET retained more patients. Sex risk was equally and significantly reduced among females in both treatment conditions, but it increased for males on BUP and decreased for males on MET.

Original languageEnglish (US)
Pages (from-to)288-293
Number of pages6
JournalJournal of Acquired Immune Deficiency Syndromes
Volume66
Issue number3
StatePublished - Jul 1 2014

Fingerprint

Methadone
Risk Reduction Behavior
HIV
Risk-Taking
Needles
Opiate Alkaloids
Naloxone Drug Combination Buprenorphine
Sexual Partners
Heroin
Syringes
Random Allocation
Therapeutics
Injections
Liver
Enzymes

Keywords

  • Buprenorphine
  • HIV
  • Methadone
  • Risk reduction

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)
  • Medicine(all)

Cite this

Woody, G. E., Bruce, D., Korthuis, P. T., Chhatre, S., Poole, S., Hillhouse, M., ... Ling, W. (2014). HIV risk reduction with buprenorphine-naloxone or methadone: Findings from a randomized trial. Journal of Acquired Immune Deficiency Syndromes, 66(3), 288-293.

HIV risk reduction with buprenorphine-naloxone or methadone : Findings from a randomized trial. / Woody, George E.; Bruce, Douglas; Korthuis, Philip (Todd); Chhatre, Sumedha; Poole, Sabrina; Hillhouse, Maureen; Jacobs, Petra; Sorensen, James; Saxon, Andrew J.; Metzger, David; Ling, Walter.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 66, No. 3, 01.07.2014, p. 288-293.

Research output: Contribution to journalArticle

Woody, GE, Bruce, D, Korthuis, PT, Chhatre, S, Poole, S, Hillhouse, M, Jacobs, P, Sorensen, J, Saxon, AJ, Metzger, D & Ling, W 2014, 'HIV risk reduction with buprenorphine-naloxone or methadone: Findings from a randomized trial', Journal of Acquired Immune Deficiency Syndromes, vol. 66, no. 3, pp. 288-293.
Woody, George E. ; Bruce, Douglas ; Korthuis, Philip (Todd) ; Chhatre, Sumedha ; Poole, Sabrina ; Hillhouse, Maureen ; Jacobs, Petra ; Sorensen, James ; Saxon, Andrew J. ; Metzger, David ; Ling, Walter. / HIV risk reduction with buprenorphine-naloxone or methadone : Findings from a randomized trial. In: Journal of Acquired Immune Deficiency Syndromes. 2014 ; Vol. 66, No. 3. pp. 288-293.
@article{0733585d58064753bb61941ec8f03062,
title = "HIV risk reduction with buprenorphine-naloxone or methadone: Findings from a randomized trial",
abstract = "Objectives: Compare HIV injecting and sex risk in patients being treated with methadone (MET) or buprenorphine-naloxone (BUP). Methods: Secondary analysis from a study of liver enzyme changes in patients randomized to MET or BUP who completed 24 weeks of treatment and had 4 or more blood draws. The initial 1:1 randomization was changed to 2:1 (BUP:MET) after 18 months due to higher dropout in BUP. The Risk Behavior Survey measured HIV risk before 30 days at baseline and weeks 12 and 24. Results: Among 529 patients randomized to MET, 391 (74{\%}) were completers; among 740 randomized to BUP, 340 (46{\%}) were completers; 700 completed the Risk Behavior Survey. There were significant reductions in injecting risk (P <0.0008) with no differences between groups in mean number of times reported injecting heroin, speedball, other opiates, and number of injections; or percent who shared needles; did not clean shared needles with bleach; shared cookers; or engaged in front/back loading of syringes. The percent having multiple sex partners decreased equally in both groups (P <0.03). For males on BUP, the sex risk composite increased; formales onMET, the sex risk decreased resulting in significant group differences over time (P <0.03). For females, there was a significant reduction in sex risk (P <0.02) with no group differences. Conclusions: Among MET and BUP patients who remained in treatment, HIV injecting risk was equally and markedly reduced; however, MET retained more patients. Sex risk was equally and significantly reduced among females in both treatment conditions, but it increased for males on BUP and decreased for males on MET.",
keywords = "Buprenorphine, HIV, Methadone, Risk reduction",
author = "Woody, {George E.} and Douglas Bruce and Korthuis, {Philip (Todd)} and Sumedha Chhatre and Sabrina Poole and Maureen Hillhouse and Petra Jacobs and James Sorensen and Saxon, {Andrew J.} and David Metzger and Walter Ling",
year = "2014",
month = "7",
day = "1",
language = "English (US)",
volume = "66",
pages = "288--293",
journal = "Journal of Acquired Immune Deficiency Syndromes",
issn = "1525-4135",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - HIV risk reduction with buprenorphine-naloxone or methadone

T2 - Findings from a randomized trial

AU - Woody, George E.

AU - Bruce, Douglas

AU - Korthuis, Philip (Todd)

AU - Chhatre, Sumedha

AU - Poole, Sabrina

AU - Hillhouse, Maureen

AU - Jacobs, Petra

AU - Sorensen, James

AU - Saxon, Andrew J.

AU - Metzger, David

AU - Ling, Walter

PY - 2014/7/1

Y1 - 2014/7/1

N2 - Objectives: Compare HIV injecting and sex risk in patients being treated with methadone (MET) or buprenorphine-naloxone (BUP). Methods: Secondary analysis from a study of liver enzyme changes in patients randomized to MET or BUP who completed 24 weeks of treatment and had 4 or more blood draws. The initial 1:1 randomization was changed to 2:1 (BUP:MET) after 18 months due to higher dropout in BUP. The Risk Behavior Survey measured HIV risk before 30 days at baseline and weeks 12 and 24. Results: Among 529 patients randomized to MET, 391 (74%) were completers; among 740 randomized to BUP, 340 (46%) were completers; 700 completed the Risk Behavior Survey. There were significant reductions in injecting risk (P <0.0008) with no differences between groups in mean number of times reported injecting heroin, speedball, other opiates, and number of injections; or percent who shared needles; did not clean shared needles with bleach; shared cookers; or engaged in front/back loading of syringes. The percent having multiple sex partners decreased equally in both groups (P <0.03). For males on BUP, the sex risk composite increased; formales onMET, the sex risk decreased resulting in significant group differences over time (P <0.03). For females, there was a significant reduction in sex risk (P <0.02) with no group differences. Conclusions: Among MET and BUP patients who remained in treatment, HIV injecting risk was equally and markedly reduced; however, MET retained more patients. Sex risk was equally and significantly reduced among females in both treatment conditions, but it increased for males on BUP and decreased for males on MET.

AB - Objectives: Compare HIV injecting and sex risk in patients being treated with methadone (MET) or buprenorphine-naloxone (BUP). Methods: Secondary analysis from a study of liver enzyme changes in patients randomized to MET or BUP who completed 24 weeks of treatment and had 4 or more blood draws. The initial 1:1 randomization was changed to 2:1 (BUP:MET) after 18 months due to higher dropout in BUP. The Risk Behavior Survey measured HIV risk before 30 days at baseline and weeks 12 and 24. Results: Among 529 patients randomized to MET, 391 (74%) were completers; among 740 randomized to BUP, 340 (46%) were completers; 700 completed the Risk Behavior Survey. There were significant reductions in injecting risk (P <0.0008) with no differences between groups in mean number of times reported injecting heroin, speedball, other opiates, and number of injections; or percent who shared needles; did not clean shared needles with bleach; shared cookers; or engaged in front/back loading of syringes. The percent having multiple sex partners decreased equally in both groups (P <0.03). For males on BUP, the sex risk composite increased; formales onMET, the sex risk decreased resulting in significant group differences over time (P <0.03). For females, there was a significant reduction in sex risk (P <0.02) with no group differences. Conclusions: Among MET and BUP patients who remained in treatment, HIV injecting risk was equally and markedly reduced; however, MET retained more patients. Sex risk was equally and significantly reduced among females in both treatment conditions, but it increased for males on BUP and decreased for males on MET.

KW - Buprenorphine

KW - HIV

KW - Methadone

KW - Risk reduction

UR - http://www.scopus.com/inward/record.url?scp=84922394197&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84922394197&partnerID=8YFLogxK

M3 - Article

VL - 66

SP - 288

EP - 293

JO - Journal of Acquired Immune Deficiency Syndromes

JF - Journal of Acquired Immune Deficiency Syndromes

SN - 1525-4135

IS - 3

ER -