HIV risk behaviors during pharmacologic treatment for opioid dependence: a comparison of levomethadyl acetate [corrected] buprenorphine, and methadone

J Subst Abuse Treat. 2006 Sep;31(2):187-94. doi: 10.1016/j.jsat.2006.04.005. Epub 2006 Jul 18.

Abstract

The efficacies of three opioid substitution medications for reducing HIV risk behaviors in opioid-dependent patients were assessed in a randomized double-blind clinical trial comparing levomethadyl acetate [corrected] (LAAM), buprenorphine (BUP), and methadone (METH). Individually optimized flexible dosing was used for each group, with weekly possible doses of 255-391 mg of LAAM, 56-112 mg of BUP, and 420-700 mg of METH. An interview regarding specific HIV risk behaviors, including injecting, equipment sharing, and sexual activity, yielded data for pretreatment and four in-study time points for 137 subjects. Declines in risk behaviors during treatment were evident in all groups for most measures of injecting and equipment sharing. Only the METH group showed consistent declines in measures of sexual behaviors. These results demonstrate that all three medications can be highly effective in decreasing HIV risk behaviors when the dose is optimized. Reductions in sexual behaviors for the METH group are consistent with known METH side effects.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Buprenorphine / therapeutic use*
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • HIV Infections / transmission*
  • Humans
  • Male
  • Methadone / therapeutic use*
  • Methadyl Acetate / therapeutic use*
  • Narcotic Antagonists / therapeutic use*
  • Narcotics / therapeutic use*
  • Opioid-Related Disorders / drug therapy*
  • Risk-Taking*

Substances

  • Narcotic Antagonists
  • Narcotics
  • Buprenorphine
  • Methadyl Acetate
  • Methadone