Integration of methadone maintenance treatment and HIV care for injecting drug users: a cohort study in Bandung, Indonesia. (1/268)

AIM: to know the effectiveness of antiretroviral treatment (ART) among methadone clients and patients who started ART outside the methadone program during the same period. METHODS: uptake of HIV testing and treatment were evaluated in a cohort of IDUs starting MMT. Effectiveness of anti-retroviral treatment (ART) was compared with matched 175 HIV-patients with a history of IDU outside MMT. RESULTS: overall, 223 patients were enrolled in MMT between May 2006 and January 2009, of whom 44% were tested for HIV, with an HIV prevalence of 73%. Screening of MMT clients was responsible for diagnosing HIV and starting ART in 31.9%, respectively 45.7%. Two year retention (100% vs 97.1%; p=0.23) and survival (93.9% vs 92.3%; p=0.76) during ART were not significantly different for 35 patients who combined ART with methadone, and the control group (n=175). Virological failure was found in one patient (3.7%) in MMT compared to 10.5% of the control group. CONCLUSION: providing HIV testing and treatment is a feasible and effective way to increase detection and treatment of HIV among clients enrolled in MMT. HIV- treatment integrated with methadone maintenance can be very effective. These results support wider application of integrated HIV care and opioid substitution.  (+info)

HIV and injecting drug use in Indonesia: epidemiology and national response. (2/268)

Indonesia is facing one of the most rapidly growing HIV-epidemics in Asia. Risk behaviour associated with injecting drug use, such as sharing contaminated needles, is the main risk factor for HIV infection. Among the general population the prevalence of HIV-infection is still low (0.2%), but up to 50% or more of the estimated 145.000 - 170.000 injecting drug users are already HIV-positive. Overrepresentation of injecting drug users and continued risk behavior inside Indonesian prisons contribute to spread of HIV. Through sexual contacts, HIV is transmitted from current or previous injecting drug users to their non-injecting sexual partners; 10-20% of this group may already be infected. The national response targeted to limit spread of HIV through injecting drug use has included needle and syringe program (NSP), methadone maintenance treatment (MMT), voluntary counseling and testing (VCT), and outreach program as priority programs. However coverage and utilization of the harm reduction services is still limited, but effective integration with HIV testing and treatment is expanding. By 2008, there were 110 service points for NSP and 24 operational MMT clinics. Nevertheless, utilization of these services has been less satisfactory and their effectiveness has been questioned. Besides effective prevention, HIV- testing and earlier treatment of HIV-seropositve individuals, including those with a history of injecting drug use, will help control the growing HIV-epidemic in Indonesia.  (+info)

A longitudinal study of incarceration and HIV risk among methadone maintained men and their primary female partners. (3/268)

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Methadone deaths: risk factors in pain and addicted populations. (4/268)

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A transitional opioid program to engage hospitalized drug users. (5/268)

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The Physician Clinical Support System-Buprenorphine (PCSS-B): a novel project to expand/improve buprenorphine treatment. (6/268)

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Methadone maintenance and the cost and utilization of health care among individuals dependent on opioids in a commercial health plan. (7/268)

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Methadone disposition in oral fluid during pharmacotherapy for opioid-dependence. (8/268)

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