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dc.contributor.authorKlimas, Jan
dc.contributor.authorDong, Huiru
dc.contributor.authorFairbairn, Nadia
dc.contributor.authorSocías, Eugenia
dc.contributor.authorBarrios, Rolando
dc.contributor.authorWood, Evan
dc.contributor.authorKerr, Thomas
dc.contributor.authorMontaner, Julio
dc.contributor.authorMilloy, M-J
dc.date.accessioned2020-03-10T10:30:30Z
dc.date.available2020-03-10T10:30:30Z
dc.date.issued2018-02-07
dc.identifier.pmid29409539
dc.identifier.doi10.1186/s13722-017-0104-y
dc.identifier.urihttp://hdl.handle.net/10147/627275
dc.descriptionObjectives: A growing body of evidence supports the effectiveness of injectable diacetylmorphine (i.e., heroin) for individuals with treatment-refractory opioid use disorder. Despite this evidence, and the increasing toll of opioid-associated morbidity and mortality, it remains controversial in some settings. To investigate the possible contribution of heroin-assisted treatment (HAT) to HIV treatment-related outcomes, we sought to estimate the proportion and characteristics of HIV-positive people who inject opioids that might be eligible for HAT in Vancouver, Canada. Methods: We used data from a prospective cohort of people living with HIV who use illicit drugs in Vancouver, Canada. Using generalized estimating equations (GEE), we assessed the longitudinal relationships between eligibility for HAT, using criteria from previous clinical trials and guidelines, with behavioural, social, and clinical characteristics. Results: Between 2005 and 2014, 478 participants were included in these analyses, contributing 1927 person-years of observation. Of those, 94 (19.7%) met eligibility for HAT at least once during the study period. In a multivariable GEE model, after adjusting for clinical characteristics, being eligible for HAT was positively associated with homelessness, female gender, high-intensity illicit drug use, drug dealing and higher CD4 count. Conclusions: In our study of HIV-positive people with a history of injection drug use, approximately 20% of participants were eligible for HAT at ≥ 1 follow-up period. Eligibility was linked to risk factors for sub-optimal HIV/AIDS treatment outcomes, such as homelessness and involvement in the local illicit drug trade, suggesting that scaling-up access to HAT might contribute to achieving optimal HIV treatment in this setting.en_US
dc.language.isoenen_US
dc.subjectHIV/AIDSen_US
dc.subjectHeroinen_US
dc.subjectIllicit drug useen_US
dc.subjectOpioid agonist treatmenten_US
dc.subjectSubstance-related disordersen_US
dc.titleEligibility for heroin-assisted treatment (HAT) among people who inject opioids and are living with HIV in a Canadian setting.en_US
dc.typeArticleen_US
dc.typeOtheren_US
dc.identifier.eissn1940-0640
dc.identifier.journalAddiction science & clinical practiceen_US
dc.source.journaltitleAddiction science & clinical practice
dc.source.volume13
dc.source.issue1
dc.source.beginpage3
dc.source.endpage
refterms.dateFOA2020-03-10T10:30:31Z
dc.source.countryInternational
dc.source.countryUnited States
dc.source.countryUnited States
dc.source.countryInternational
dc.source.countryUnited States
dc.source.countryUnited States
dc.source.countryCanada
dc.source.countryEngland


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