Opiate Substitution Therapy Can Lower HIV Risk
October 6, 2012

Opiate Substitution Therapy Can Lower HIV Risk Amongst Drug Users

redOrbit Staff & Wire Reports — Your Universe Online

Opiate substitution therapies (OST) can reduce a person's risk of contracting HIV through injected drugs, according to a new study published Friday in the online edition of the British Medical Journal.

In an October 5 statement, Dr. Julie Bruneau of the CHUM Research Centre (CRCHUM) and the Department of Family Medicine at the Université de Montréal said there was "good evidence" that OST can "reduce drug-related mortality, morbidity and some of the injection risk behaviors" amongst people who inject drugs (PWID).

"This new study provides solid evidence demonstrating the link between these treatments and a reduced risk of HIV transmission,” Dr. Bruneau added. “These results are important given that increases in HIV incidence have been reported among PWID in a number of countries in recent years, where opiate substitution therapies are illegal or severely restricted."

Researchers from the U.S., Canada, Australia, and Italy, including Dr. Bruneau, conducted a meta-analysis of multiple published and unpublished studies from multiple countries in an attempt to find a connection between OST treatment and HIV transmission amongst injected drug users.

They selected nine studies involving primarily 26- to 39-year-old men, with more than 800 total incidences of HIV infection and 23,000-plus person-years of follow up, according to the CHUM statement.

Dr. Bruneau and colleagues found that OST treatment using methadone and buprenorphine was associated with a 54% reduction in infection risk for PWID, although differences in the studies meant it was not possible to "calculate an 'absolute risk reduction' for HIV infection that would translate to all settings."

CHUM statistics indicate that between 5% and 10% of all global HIV infections are linked to injected drug use. To treat those addicted to injected drugs, methadone, buprenorphine, and on occasion, other forms of drugs can be prescribed as opiate substitution therapies to help curb their addictions, the organization added.

“These therapies can reduce HIV transmission among PWID not only in countries in which there is a high incidence of this disease, but also in Quebec where there has been an increase in the use of illicit opiates intravenously, particularly among youths, and where access to OST is problematic," the doctor said.

"Our study provides strong quantitative evidence of an association between opiate substitution treatment and reduced risk of HIV transmission among people who inject drugs," the authors said in their study. Their findings, they said, "further support studies showing a range of benefits of opiate substitution treatment, and support calls for the global increase of harm reduction interventions to reduce the transmission of HIV between people who inject drugs and between people who inject drugs and the wider community"