Home > Eligibility for heroin-assisted treatment (HAT) among people who inject opioids and are living with HIV in a Canadian setting.

Klimas, Jan and Dong, Huiru and Fairbairn, Nadia and Socías, Eugenia and Barrios, Rolando and Wood, Evan and Kerr, Thomas and Montaner, Julio and Milloy, M-J . (2018) Eligibility for heroin-assisted treatment (HAT) among people who inject opioids and are living with HIV in a Canadian setting. Addiction Science & Clinical Practice, 13 (1)

URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC58120...

OBJECTIVES: 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.


Item Type:Evidence resource
Drug Type:Opioid
Intervention Type:AOD disorder, AOD disorder drug therapy, AOD disorder treatment method, AOD disorder harm reduction
Date:7 February 2018
Page Range:p. 3
Volume:13
Number:1
EndNote:View
Subjects:B Substances > Opioids (opiates)
B Substances > Opioids (opiates) > Heroin
G Health and disease > Disorder by cause > Communicable disease > HIV
J Health care, prevention and rehabilitation > Substance use prevention > Substance use harm reduction
J Health care, prevention and rehabilitation > Treatment and maintenance > Treatment factors
T Demographic characteristics > Person who injects drugs (Intravenous / injecting)
VA Geographic area > Canada

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