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Impact of Opioid Substitution Therapy on Antiretroviral Therapy Outcomes: A Systematic Review and Meta-Analysis

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ABSTRACT

This meta-analysis provides strong evidence that opioid substitution therapy improves several key outcomes of the HIV care continuum among people who inject drugs, including recruitment onto antiretroviral therapy, retention in care, adherence, and viral suppression.

No MeSH data available.


Forest plot of the effect of opioid substitution therapy on coverage of antiretroviral therapy (ART) among people who inject drugs (PWID), defined as the proportion of PWID on ART at a given time point. I2 and P value are measures of between-study heterogeneity. Abbreviations: CI, confidence interval; N, total sample size of PWID; OR, odds ratio.
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CIW416F1: Forest plot of the effect of opioid substitution therapy on coverage of antiretroviral therapy (ART) among people who inject drugs (PWID), defined as the proportion of PWID on ART at a given time point. I2 and P value are measures of between-study heterogeneity. Abbreviations: CI, confidence interval; N, total sample size of PWID; OR, odds ratio.

Mentions: Ten studies reported on ART coverage, including 3 cross-sectional studies, 1 case-control study, 4 longitudinal studies, and 2 surveillance studies presenting coverage at baseline or a fixed time point (Supplementary Table 1). OST use was associated with a 54% increase in the odds of being on ART (OR, 1.54; 95% CI, 1.17–2.03; P = .002; Figure 1; Supplementary Table 2) with moderate heterogeneity (I2 = 67%; P = .001). In the meta-regression analysis, 28% of the between-study variance was explained by the different regions (North America vs Europe), with a larger effect in North America (OR, 1.84; 95% CI, 1.40–2.43; I2 = 37%) than Europe (OR, 1.19; 95% CI, .75–1.88; I2 = 74%).Figure 1.


Impact of Opioid Substitution Therapy on Antiretroviral Therapy Outcomes: A Systematic Review and Meta-Analysis
Forest plot of the effect of opioid substitution therapy on coverage of antiretroviral therapy (ART) among people who inject drugs (PWID), defined as the proportion of PWID on ART at a given time point. I2 and P value are measures of between-study heterogeneity. Abbreviations: CI, confidence interval; N, total sample size of PWID; OR, odds ratio.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC5036913&req=5

CIW416F1: Forest plot of the effect of opioid substitution therapy on coverage of antiretroviral therapy (ART) among people who inject drugs (PWID), defined as the proportion of PWID on ART at a given time point. I2 and P value are measures of between-study heterogeneity. Abbreviations: CI, confidence interval; N, total sample size of PWID; OR, odds ratio.
Mentions: Ten studies reported on ART coverage, including 3 cross-sectional studies, 1 case-control study, 4 longitudinal studies, and 2 surveillance studies presenting coverage at baseline or a fixed time point (Supplementary Table 1). OST use was associated with a 54% increase in the odds of being on ART (OR, 1.54; 95% CI, 1.17–2.03; P = .002; Figure 1; Supplementary Table 2) with moderate heterogeneity (I2 = 67%; P = .001). In the meta-regression analysis, 28% of the between-study variance was explained by the different regions (North America vs Europe), with a larger effect in North America (OR, 1.84; 95% CI, 1.40–2.43; I2 = 37%) than Europe (OR, 1.19; 95% CI, .75–1.88; I2 = 74%).Figure 1.

View Article: PubMed Central - PubMed

ABSTRACT

This meta-analysis provides strong evidence that opioid substitution therapy improves several key outcomes of the HIV care continuum among people who inject drugs, including recruitment onto antiretroviral therapy, retention in care, adherence, and viral suppression.

No MeSH data available.