HIV rapid testing in drug treatment: comparison across treatment modalities.

Filed under: Methadone Clinics

J Subst Abuse Treat. 2012 Sep 26;
Schwartz RP, Stitzer ML, Feaster DJ, Korthuis PT, Alvanzo AA, Winhusen TM, Donnard L, Snead N, Metsch LR

Despite high rates of risky behavior among patients, many drug abuse treatment programs do not provide on-site HIV testing. This secondary analysis examined differences in outcome by program modality from a multi-site trial in which 1281 HIV-negative patients in three methadone programs, seven non-methadone outpatient programs, and three residential programs were randomly assigned to: (1) off-site referral for HIV risk reduction counseling and testing; or on-site rapid testing (2) with or (3) without risk reduction counseling. The parent study using generalized estimating equations with site as a cluster variable found significantly higher rates of HIV testing and feedback of results by 1month post-enrollment for the combined on-site conditions compared to the offsite condition [RR=4.52, 97.5% CI (3.57, 5.72)]. Utilizing the same statistical approach, we found neither significant treatment modality nor significant treatment modality by testing condition interaction effects either for receipt of HIV test results at 1month or for sexual or drug use HIV-risk behaviors at 6-month follow-up. On-site HIV testing is effective across treatment modalities for achieving high rates of testing and results feedback. All programs should be encouraged to adopt or expand this service.
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Factors associated with mortality among heroin users after seeking treatment with methadone: A population-based cohort study in Taiwan.

Filed under: Methadone Clinics

J Subst Abuse Treat. 2012 Sep 25;
Huang CL, Chung-Wei L

Data concerning factors associated with mortality among heroin users under methadone maintenance treatment (MMT) in the Han Chinese population are limited. This study examined mortality risk among heroin users after seeking treatment with methadone in a catchment area using a cohort of 1616 Taiwanese heroin users between October 2006 and December 2008. During the study period, 26 (1.6%) people died, with an all-cause mortality rate per 100 person years of 3.42. The primary cause of death among our patients was accidents, followed by suicide and drug overdose. Older age, HIV infection, psychiatric treatment history, and alcohol abuse/dependence were risk factors for all-cause mortality; remaining on MMT was protective for survival. Our findings suggest that although mortality is mainly associated with medical and psychiatric comorbidities, continuing with the MMT program is still an important predictor for survival.
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