METHADONE-MAINTENANCE TREATMENT AND HIV RISK-TAKING BEHAVIOR AMONG INJECTING DRUG-USERS IN BERLIN

Study objective - To determine whether methadone maintenance treatment (MMT) is effective in reducing the levels of HIV risk-taking behaviou r (borrowing and lending of injection equipment, irregular condom use) among injecting drug users (IDUs), and to identify independent predic tors of the borrowing of used syringes. Design - Cross sectional study of IDUs in MMT and not in MMT, using standardised interviews for coll ection of sociodemographic and behavioural data, and laboratory tests for detecting HIV antibodies. Setting and participants - The 612 IDUs were recruited at different services for drug users such as treatment centres, walk in agencies, a hospital, and on the streets. Main result s - Of all IDUs, 41% had borrowed and 34% had passed on used injection equipment in the previous six months. In univariate analysis, IDUs re ceiving MMT had injected less frequently and were significantly less l ikely to borrow and lend syringes. In logistic regression analysis, MM T was protective against the borrowing of syringes (adjusted odds rati o 0.36, 95% confidence interval 0.2, 0.8), but not against syringe len ding nor against sexual risk behaviour (ie, numbers of sex partners, l ack of condom use). Important independent predictors of the borrowing of syringes were injecting drug use in prison, use of sedatives, and s ex with another IDU in the previous six months. Conclusions - MMT may play a significant role in reducing the levels of borrowing of syringe s among IDUs. However, additional prevention measures are needed which should specifically address sexual risk behaviour and target subgroup s of IDUs with high levels of needle sharing, such as IDUs who have be en in prison and and those who are sedative users.