Maintenance of HIV risk reduction among injection opioid users: a 12 month posttreatment follow-up

Study objectives were to examine HIV risk behaviors 12 months following methadone maintenance (MM) treatment termination, and to assess the effects of treatment tenure, cocaine use, and gender on posttreatment HIV risk. Injection and sex risk behaviors were measured at treatment entry and 12 months after leaving treatment among 435 injection opioid users. Multi-way contingency tables for treatment tenure and HIV risk at treatment intake and at 12 month follow-up were analyzed using the GSK weighted least-squares estimation procedure. The effects of treatment tenure, gender, and cocaine use on risk behavior at follow-up, while controlling for intake risk and background variables were tested using: a series of multiple logistic regression analyses. Results showed that injection and sex risk behaviors were significantly lower at 12 month follow-up than at treatment entry. Additionally, increased tenure was related to risk reductions, while cocaine use was related to increased risk-taking. Gender was generally unrelated to risk changes. These findings support broader use of MM in helping reduce HIV risks among injection drug users and highlight the need to explore ways to encourage treatment compliance in order to reduce risky practices. (C) 1997 Elsevier Science Ireland Ltd.