Linda Beatrice Mlunde1, Bruno Fokas Sunguya2, Jessie Kazeni Kilonzo Mbwambo3, Omary Said Ubuguyu4, Junko Yasuoka5, Masamine Jimba6. 1. Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. Electronic address: lindasozy@gmail.com. 2. Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65015, Dar es Salaam, Tanzania. Electronic address: sunguya@gmail.com. 3. Department of Psychiatry and Mental Health, Muhimbili National Hospital, P.O. Box 65000, Dar es Salaam, Tanzania. Electronic address: jmbwambo@gmail.com. 4. Department of Psychiatry and Mental Health, Muhimbili National Hospital, P.O. Box 65000, Dar es Salaam, Tanzania. Electronic address: oubuguyu@yahoo.com. 5. Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. Electronic address: jyasuoka@post.harvard.edu. 6. Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. Electronic address: mjimba@m.u-tokyo.ac.jp.
Abstract
OBJECTIVES: People who inject drugs are at high risk of HIV infection but often face barriers in accessing medical care including access to antiretroviral therapy (ART). Evidence is available about the effectiveness of opioid agonist therapy on drug dependency and risk behaviors. However, it remains scattered regarding access to ART among HIV-positive people who inject drugs. We conducted a systematic review to examine the association of opioid agonist therapy with ART initiation among HIV-positive people who inject drugs. METHODS: We searched the literature for evidence from seven databases. We conducted a narrative synthesis and meta-analysis to examine the association of opioid agonist therapy with ART initiation. RESULTS: Five out of 2,901 identified studies met the inclusion criteria. Three out of five studies reported that, HIV-positive people receiving opioid agonist therapy initiated ART more than those not receiving opioid agonist therapy. In meta-analysis, opioid agonist therapy was associated with ART initiation among HIV positive people who inject drugs (pooled odds ratio: 1.68; 95% confidence interval: 1.03-2.73). CONCLUSIONS: Opioid agonist therapy is positively associated with ART initiation among HIV-positive people who inject drugs. It is important to scale up opioid agonist therapy among people who inject drugs to improve their ART initiation.
OBJECTIVES:People who inject drugs are at high risk of HIV infection but often face barriers in accessing medical care including access to antiretroviral therapy (ART). Evidence is available about the effectiveness of opioid agonist therapy on drug dependency and risk behaviors. However, it remains scattered regarding access to ART among HIV-positive people who inject drugs. We conducted a systematic review to examine the association of opioid agonist therapy with ART initiation among HIV-positive people who inject drugs. METHODS: We searched the literature for evidence from seven databases. We conducted a narrative synthesis and meta-analysis to examine the association of opioid agonist therapy with ART initiation. RESULTS: Five out of 2,901 identified studies met the inclusion criteria. Three out of five studies reported that, HIV-positive people receiving opioid agonist therapy initiated ART more than those not receiving opioid agonist therapy. In meta-analysis, opioid agonist therapy was associated with ART initiation among HIV positive people who inject drugs (pooled odds ratio: 1.68; 95% confidence interval: 1.03-2.73). CONCLUSIONS: Opioid agonist therapy is positively associated with ART initiation among HIV-positive people who inject drugs. It is important to scale up opioid agonist therapy among people who inject drugs to improve their ART initiation.
Authors: Anh T Vo; Christopher Magana; Matthew Hickman; Annick Borquez; Leo Beletsky; Natasha K Martin; Javier A Cepeda Journal: Int J Drug Policy Date: 2021-08-11
Authors: Maxim Polonsky; Lyuba Azbel; Martin P Wegman; Jacob M Izenberg; Chethan Bachireddy; Jeffrey A Wickersham; Sergii Dvoriak; Frederick L Altice Journal: J Int AIDS Soc Date: 2016-07-18 Impact factor: 5.396