The Impact of Methadone Maintenance Treatment on HIV Risk Behaviors among High-Risk Injection Drug Users: A Systematic Review.

Evidence-based medicine & public health Pub Date : 2016-01-01 Epub Date: 2016-03-22
Pramila Karki, Roman Shrestha, Tania B Huedo-Medina, Michael Copenhaver
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Abstract

Injection drug users (IDUs) are at high risk of acquiring HIV infection through preventable drug- and sex-related HIV risk behaviors. In recent decade, there has been a growing evidence that methadone maintenance treatment (MMT) is associated with a significant decrease in both drug- and sex-related risk behaviors among this high-risk population. The better understanding of the relationship between MMT and HIV-related risk behaviors will help to better inform future HIV prevention strategies, which may have policy implications as well. In this systematic review, we therefore aimed to explore the relevant literature to more clearly examine the possible impact of MMT on HIV risks behaviors among high-risk IDUs. The findings thus far suggest that MMT is associated with a significant decrease in injecting drug use and sharing of injecting equipment. Evidence on sex-related risk behavior is limited, but suggest that MMT is associated with a lower incidence of multiple sex partners and unprotected sex. The literature also suggests that the most significant factor in reducing HIV risks was treatment adherence. As such, more attention needs to be given in future studies to ensure the higher rates of access to MMT as well as to improve the adherence to MMT.

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美沙酮维持治疗对高危注射吸毒者HIV危险行为影响的系统评价
注射吸毒者(IDUs)通过可预防的与药物和性有关的艾滋病毒风险行为感染艾滋病毒的风险很高。近十年来,越来越多的证据表明,美沙酮维持治疗(MMT)与高危人群中药物和性相关危险行为的显著减少有关。更好地了解MMT与艾滋病毒相关风险行为之间的关系将有助于更好地为未来的艾滋病毒预防策略提供信息,这也可能具有政策意义。因此,在本系统综述中,我们旨在探索相关文献,以更清楚地研究MMT对高危注射吸毒者中HIV风险行为的可能影响。迄今为止的研究结果表明,MMT与注射吸毒和共用注射设备的显著减少有关。有关性相关危险行为的证据有限,但表明MMT与多性伴侣和无保护性行为发生率较低有关。文献还表明,降低艾滋病毒风险的最重要因素是治疗依从性。因此,在未来的研究中需要给予更多的关注,以确保更高的获得MMT的比率,并改善对MMT的依从性。
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The Impact of Methadone Maintenance Treatment on HIV Risk Behaviors among High-Risk Injection Drug Users: A Systematic Review. The Impact of Methadone Maintenance Treatment on HIV Risk Behaviors among High-Risk Injection Drug Users: A Systematic Review.
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