Optimizing care for HIV-positive drug users

In March 2011, JAIDS (Journal of Acquired Immune Deficiency Syndromes, 2011:56;S1) devotes an entire supplement on the integration of buprenorphine, an opiate substitution therapy, and HIV treatment for HIV-positive injection drug users. Drs. Gerald Friedland and David Vlahov, both of whom worked on the studies, note that buprenorphine has an improved safety profile compared with methadone, including fewer adverse interactions with antiretroviral therapies. 

To test the effectiveness of an integrated methadone/antiretroviral therapy, scientists across the United States participated in a multi-site evaluation of the potential for this new comprehensive approach, the results of which have clear implications worldwide. Led by the US Health Services and Resources Administration, the project is entitled, ‘‘The Buprenorphine Initiative: An Evaluation of Innovative Methods for Integrating Buprenorphine Opioid Abuse Treatment in HIV Primary Care’’. It is a national multisite demonstration project evaluating buprenorphine and HIV integrated treatment in 10 HIV primary care sites, involving over 300 patients and supported by an evaluation and technical assistance site. As is evident from the findings, an increased investment in the integration and expansion of these dual therapies seems likely to pay dividends down the road in terms of increased adherence, lower levels of illicit opioid dependence, and other health-related outcomes.

You can read the entire supplement issue here.

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