Medications for Treatment of Opioid Use Disorder among Persons Living with HIV

Curr HIV/AIDS Rep. 2019 Feb;16(1):1-6. doi: 10.1007/s11904-019-00436-7.


Purpose of review: Recent HIV outbreaks have occurred as a result of the current US opioid epidemic. Providing medications for opioid use disorder (MOUD) with methadone, buprenorphine, and extended-release naltrexone is essential to achieving optimal HIV treatment outcomes including viral suppression and retention in treatment. This review describes the pharmacology of MOUD with specific attention to interactions with antiretroviral therapy, and to the effect of MOUD on HIV treatment outcomes.

Recent findings: Methadone and buprenorphine both improve HIV viral suppression, adherence to antiretroviral therapy, and overall mortality for persons with opioid use disorder (OUD). Extended-release naltrexone has been most extensively studied in persons with HIV leaving incarcerated settings, and improves HIV viral suppression in that context. Strategies that integrate MOUD and HIV treatment are crucial to optimize viral suppression. The differing pharmacokinetic and delivery characteristics of these MOUD offer diverse options. Given the chronic and relapsing nature of both HIV and OUD, long-term approaches are required.

Keywords: Buprenorphine; Extended-release naltrexone; HIV; MAT; Medication for opioid use disorder; Methadone; Opioid addiction; Opioid use disorders.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Buprenorphine / therapeutic use*
  • HIV Infections / drug therapy
  • HIV Infections / etiology
  • Humans
  • Methadone / therapeutic use*
  • Naltrexone / therapeutic use*
  • Opioid-Related Disorders / drug therapy*
  • Treatment Outcome


  • Buprenorphine
  • Naltrexone
  • Methadone