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Randomized Controlled Trial
. 2010 Jul;87(4):592-602.
doi: 10.1007/s11524-010-9438-4.

Improved HIV and substance abuse treatment outcomes for released HIV-infected prisoners: the impact of buprenorphine treatment

Sandra Ann Springer  1 , Shu Chen, Frederick L Altice
Affiliations
Randomized Controlled Trial

Improved HIV and substance abuse treatment outcomes for released HIV-infected prisoners: the impact of buprenorphine treatment

Sandra Ann Springer et al. J Urban Health. 2010 Jul.

Abstract

HIV-infected prisoners fare poorly after release. Though rarely available, opioid agonist therapy (OAT) may be one way to improve HIV and substance abuse treatment outcomes after release. Of the 69 HIV-infected prisoners enrolled in a randomized controlled trial of directly administered antiretroviral therapy, 48 (70%) met DSM-IV criteria for opioid dependence. Of these, 30 (62.5%) selected OAT, either as methadone (N = 7, 14.5%) or buprenorphine/naloxone (BPN/NLX; N = 23, 48.0%). Twelve-week HIV and substance abuse treatment outcomes are reported as a sub-study for those selecting BPN/NLX. Retention was high: 21 (91%) completed BPN/NLX induction and 17 (74%) remained on BPN/NLX after 12 weeks. Compared with baseline, the proportion with a non-detectable viral load (61% vs 63% log(10) copies/mL) and mean CD4 count (367 vs 344 cells/mL) was unchanged at 12 weeks. Opiate-negative urine testing remained 83% for the 21 who completed induction. Using means from 10-point Likert scales, opioid craving was reduced from 6.0 to 1.8 within 3 days of BPN/NLX induction and satisfaction remained high at 9.5 throughout the 12 weeks. Adverse events were few and mild. BPN/NLX therapy was acceptable, safe and effective for both HIV and opioid treatment outcomes among released HIV-infected prisoners. Future randomized controlled trials are needed to affirm its benefit in this highly vulnerable population.

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Figures

FIGURE 1.
FIGURE 1.
Subject allocation.
FIGURE 2.
FIGURE 2.
HIV treatment outcomes.
FIGURE 3.
FIGURE 3.
Opiate craving and satisfaction with buprenorphine treatment.
FIGURE 4.
FIGURE 4.
Percent of positive urine toxicology tests over time.
See this image and copyright information in PMC

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References

    1. Spaulding AC, Seals RM, Page MJ, Brzozowski AK, Rhodes W, Hammett TM. HIV/AIDS among inmates of and releasees from US correctional facilities, 2006: declining share of epidemic but persistent public health opportunity. PLoS ONE. 2009;4(11):e7558. doi: 10.1371/journal.pone.0007558. - DOI - PMC - PubMed
    1. Hammett TM, Harmon MP, Rhodes W. The burden of infectious disease among inmates of and releasees from US correctional facilities, 1997. Am J Public Health. 2002;92(11):1789–1794. doi: 10.2105/AJPH.92.11.1789. - DOI - PMC - PubMed
    1. Centers for Disease Control (CDC) Decrease in AIDS-related mortality in a state correctional system—New York, 1995–1998. MMWR Morb Mortal Wkly Rep. 1999;47(51–52):1115–1117. - PubMed
    1. Springer S, Friedland G, Doros G, Pesanti E, Altice FL. Antiretroviral treatment regimen outcomes among HIV-infected prisoners. New Haven: Yale AIDS Program; 2007. - PMC - PubMed
    1. Levasseur L, Marzo J, Ross N, Blatier C. Frequency of re-incarcerations in the same detention center: role of substitution therapy. A preliminary retrospective analysis. Ann Med Interne. 2002;153(3 Suppl):1S14–1S19. - PubMed

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