Sexually transmitted and blood-borne infection risk reduction with methadone and buprenorphine/naloxone among people with prescription-type opioid use disorder: Findings from a Canadian pragmatic randomized trial

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine Pub Date : 2024-03-20 DOI:10.1111/hiv.13636

M. Eugenia Socias, Zishan Cui, Bernard Le Foll, Jingxin Lei, Sherry Stewart, Rohan Anand, Didier Jutras-Aswad

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引用次数: 0

Abstract

Introduction

People who use drugs are disproportionally affected by sexually transmitted and blood-borne infections (STBBIs). While the benefits of methadone in reducing injecting-risk behaviours are well documented, less is known on its impacts on sexual-related risks, as well as its comparative effectiveness to buprenorphine/naloxone, particularly in the context of highly potent opioids. The aim of this study was to estimate the relative effects of buprenorphine/naloxone and methadone on injecting and STBBI risks among people with prescription-type opioid use disorder (POUD).

Methods

Secondary analysis of a pan-Canadian pragmatic 24-week randomized clinical trial comparing methadone and buprenorphine/naloxone models of care among 272 people with POUD (including licit or illicit opioid analgesics, fentanyl). The Risk Behaviour Survey was used to collect injecting and sexual risks at baseline, and weeks 12 and 24.

Results

In total, 210 participants initiated treatment (103 buprenorphine/naloxone and 107 methadone). At baseline, 113/205 (55.1%) participants reported recently injecting drugs, 37/209 (17.7%) unsafe injection practices and 67/162 (41.4%) high-risk sex. Both methadone and buprenorphine/naloxone were associated with reductions in the prevalence of injection drug use and high-risk sex at weeks 12 and 24 with no interactions between treatment arm and time.

Conclusion

Methadone and buprenorphine/naloxone were similarly effective in reducing injecting and sexual risk behaviours among people with POUD.

Clinical Trials Registration

clinicaltrials.gov NCT03033732.

Abstract Image

查看原文本刊更多论文

用美沙酮和丁丙诺啡/纳洛酮降低处方类阿片使用障碍患者的性传播和血液传播感染风险：加拿大实用随机试验的结果。

导言：吸毒者受到性传播和血液传播感染（STBBIs）的影响尤为严重。尽管美沙酮在减少注射风险行为方面的益处有据可查，但人们对它对性相关风险的影响以及它与丁丙诺啡/纳洛酮的比较效果却知之甚少，尤其是在强效阿片类药物方面。本研究旨在估算丁丙诺啡/纳洛酮和美沙酮对处方类阿片使用障碍（POUD）患者注射和STBBI风险的相对影响：对一项为期 24 周的泛加拿大实用随机临床试验进行二次分析，该试验比较了美沙酮和丁丙诺啡/纳洛酮对 272 名处方类阿片使用障碍患者（包括合法或非法阿片类镇痛药、芬太尼）的护理模式。风险行为调查用于收集基线、第12周和第24周的注射风险和性风险：共有 210 人开始接受治疗（103 人使用丁丙诺啡/纳洛酮，107 人使用美沙酮）。在基线时，113/205（55.1%）名参与者报告最近注射过毒品，37/209（17.7%）人有不安全注射行为，67/162（41.4%）人有高风险性行为。在第12周和第24周，美沙酮和丁丙诺啡/纳洛酮都能降低注射吸毒和高危性行为的发生率，治疗方法和时间之间没有相互作用：美沙酮和丁丙诺啡/纳洛酮在减少POUD患者注射吸毒和高危性行为方面的效果相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.