Background and Seeks For HIV-positive individuals who use illicit opioids engagement

Background and Seeks For HIV-positive individuals who use illicit opioids engagement in methadone maintenance therapy (MMT) can contribute to improved HIV treatment outcomes. of engagement in MMT. Participants 297 ART-exposed individuals on MMT were recruited between December 2005 and May 2013 and followed for a median of 42.1 months. Measurements We measured methadone dose at ≥ 100 vs < 100 mg/day and the likelihood of ≥ 95% adherence to ART. Findings In adjusted generalized estimating equation (GEE) analyses MMT dose ≥ 100 mg/day was independently associated with optimal adherence SU14813 to ART (adjusted odds ratio [AOR] = 1.38; 95% confidence interval [CI]: 1.08 - 1.77 p = 0.010). In a sub-analysis we observed a dose-response relationship between increasing MMT dose and ART adherence (AOR = 1.06 per 20 mg/day increase 95 CI: 1.00 - 1.12 p = 0.041). Conclusion Among HIV-positive individuals in methadone maintenance therapy those receiving higher doses of methadone (≥ 100 mg/day) are more likely to achieve ≥ 95% adherence to antiretroviral therapy than those receiving lower doses. (2014) demonstrated that many individuals on MMT remain under-dosed. Using 23 years of longitudinal data SU14813 from MMT programs across the United States they observed that while the proportion of patients receiving ≥ 60 mg/day of methadone has increased as of 2011 23 of patients remained on sub-therapeutic doses (< 60 mg/day) and only 59% of patients on methadone received doses of at least 80 mg/day (30). While there is a growing body of evidence evaluating the effect of high-dose methadone (≥ 100 mg/day) on drug use outcomes we are unaware of any study that has investigated the result of methadone dosage within the framework of HIV treatment. As a result this research sought to check whether people on high-dose methadone (i.e. ≥ 100 mg/time) exhibited higher degrees of optimum Artwork adherence (i.e. ≥ 95%) in multivariable versions altered for relevant confounders using longitudinal data from a long-running observational cohort of HIV-positive illicit medication users. METHODS Research Participants Data because of this research was drawn through the AIDS Treatment Cohort to judge Exposure to Success Services (Gain access to) a continuing potential cohort of HIV-positive people who make use of illicit medications in Vancouver Canada which includes previously been referred to at length (25 36 The individuals are recruited through snowball sampling and intensive street outreach from 2005 in the city’s SU14813 Downtown Eastside community a location with an open up medication market high degrees of shot medication make use of poverty and HIV infections (37-39). Folks are qualified to receive enrolment in ACCESS if they are HIV-positive aged ≥ 18 years have a history of illicit drug use other than cannabis in the previous month and provide written informed consent. At baseline and at SU14813 every six-month follow-up interview participants answer a standardized interviewer-administered questionnaire and provide blood samples for serologic analysis. The questionnaire elicits detailed demographic data as well as information pertaining to drug use patterns and related exposures. All participants are remunerated $30 (CAD) for each study visit and when appropriate Mouse monoclonal to MTHFR are referred to additional healthcare services including dependency treatment. Ethical approval is usually provided annually by the University of British Columbia/Providence Health Care Research Ethics Board. In this study we included participants who were ART-exposed at recruitment and individuals who initiated ART during the study period and included all interview periods from study entry or ART initiation forward respectively. In addition we restricted our analytic sample to individuals with at least one CD4+ and plasma HIV-1 RNA viral load (VL) measurement within ± 180 days of their baseline interview. To focus on the effect of MMT dose on ART adherence we only included 180-day periods during which individuals reported any dispensation of methadone. HIV/AIDS Drug Treatment Program The information obtained from the semi-annual questionnaire is usually augmented with data on HIV treatment and clinical outcomes from the British Columbia Centre for Excellence in HIV/AIDS (BC-CfE) Drug Treatment Programme as described previously (36). In brief a province-wide centralized ART pharmacy SU14813 provides complete.