Methadone Maintenance as HIV Risk Reduction With Street-Recruited Injecting Drug Users

Abstract

Objective: To compare changes in HIV risk behaviors between street-recruited opiate injectors who entered and remained in methadone maintenance treatment and those who did not. Methods: Three hundred sixteen participants were interviewed at baseline, received outreach interventions, and were interviewed again 6 months later. Results: Significant (p < .001) reductions in HIV-related risk behaviors, including frequency of injecting, injecting with used (dirty) needles, and sharing injection paraphernalia, were demonstrated. Participants (31%) who entered and remained in methadone maintenance treatment for at least 90 days before follow-up showed a signifi cantly greater reduction in heroin injections than those who did not. They did not show a greater reduction in using dirty needles or sharing other injection paraphernalia. Conclusions: These findings suggest that although methadone maintenance may reduce injection frequency, it does not reduce other HIV-related risk behaviors above and beyond what can be accomplished through outreach interventions. Treatment facilities and outreach intervention programs should collaborate to provide a compre hensive approach to reducing HIV risk behaviors among drug injectors both in and out of drug treatment.