HIV risk behavior in treatment-seeking opioid-dependent youth: results from a NIDA clinical trials network multisite study

• Published in: Journal of acquired immune deficiency syndromes (1999) Vol. 55; no. 1; pp. 65 - 72
• Main Authors: Meade, Christina S, Weiss, Roger D, Fitzmaurice, Garrett M, Poole, Sabrina A, Subramaniam, Geetha A, Patkar, Ashwin A, Connery, Hilary S, Woody, George E
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins Ovid Technologies 01-09-2010
• Subjects: Adolescent; Analgesics, Opioid - adverse effects; Antiretroviral drugs; Behavior modification; Buprenorphine - therapeutic use; Children & youth; Clinical trials; Drug addiction; Drug therapy; Female; HIV; HIV Infections - transmission; Human immunodeficiency virus; Humans; Male; Naloxone - therapeutic use; Narcotic Antagonists - therapeutic use; Patient Acceptance of Health Care; Risk Assessment; Risk-Taking; Sexual behavior; Sexual Behavior - statistics & numerical data; Substance Abuse, Intravenous - complications; Substance-Related Disorders - drug therapy; Young Adult
• ISSN: 1525-4135; 1944-7884
• DOI: 10.1097/QAI.0b013e3181d916db

To assess baseline rates of and changes in HIV drug and sexual risk behavior as a function of gender and treatment in opioid-dependent youth.
One hundred fifty participants were randomly assigned to extended buprenorphine/naloxone therapy (BUP) for 12 weeks or detoxification for 2 weeks; all received drug counseling for 12 weeks. HIV risk was assessed at baseline and 4-week, 8-week, and 12-week follow-ups. Behavioral change was examined using generalized estimating equations.
Baseline rates of past-month HIV risk for females/males were 51%/45% for injection drug use (IDU) (ns), 77%/35% for injection risk (P < 0.001), 82%/74% for sexual activity (ns), 14%/24% for multiple partners (ns), and 68%/65% for unprotected intercourse (ns). IDU decreased over time (P < 0.001), with greater decreases in BUP versus detoxification (P < 0.001) and females versus males in BUP (P < 0.05). Injection risk did not change for persistent injectors. Sexual activity decreased in both genders and conditions (P < 0.01), but sexual risk did not.
Overall, IDU and sexual activity decreased markedly, particularly in BUP patients and females, but injection and sexual risk behaviors persisted. Although extended BUP seems to have favorable effects on HIV risk behavior in opioid-dependent youth, risk reduction counseling may be necessary to extend its benefits.