Evidence map›Paper›PMID 18425898›Full record

SynthesisThe Cochrane database of systematic reviews2008

Substitution treatment of injecting opioid users for prevention of HIV infection.

L Gowing, M Farrell, R Bornemann, L Sullivan, R Ali

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01108614 (A Randomized Community Intervention Trial on Reducing HIV Infection Among Drug Users Attending Methadone Maintenance Treatment), which is not on this map. Cited by 90 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
90citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01108614 phase3unknown statusnot on this mapstarted 2009, after this paper: background citation

A Randomized Community Intervention Trial on Reducing HIV Infection Among Drug Users Attending Methadone Maintenance Treatment(MMT) and Preventing Secondary Transmission From HIV Positive Clients to Their Sexual Partners in China

TypeinterventionalSponsorNational Center for AIDS/STD Control and Prevention, China CDCRan2009 to 2011Enrolled12,000ConditionsHIV, Hepatitis C, Syphilis, HSV-2ArmsIntervention
3 · Its place in the literature

Who cites it

90 citing papers in PubMed, 10 syntheses or guidelines pooled it.

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30 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

L GowingUniversity of Adelaide, Department of Clinical and Experimental Pharmacology, DASC Evidence-Bsed Practice Unit, Adelaide, Australia, 5005. linda.gowing@adelaide.edu.au
M Farrell
R Bornemann
L Sullivan
R Ali

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInjecting drug users are vulnerable to infection with HIV and other blood borne viruses as a result of collective use of injecting equipment as well as sexual behaviour.

objectivesTo assess the effect of oral substitution treatment for opioid dependent injecting drug users on rates of HIV infections, and high risk behaviours. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and PsycINFO to March 2007. We also searched reference lists of articles, reviews and conference abstracts SELECTION CRITERIA: Studies were required to consider the incidence of risk behaviours, or the incidence of HIV infection related to substitution treatment of opioid dependence. All types of original studies were considered. Two reviewers independently assessed studies for inclusion. DATA COLLECTION AND ANALYSIS: One reviewer extracted data from included studies, assessed quality and confirmed decisions by consulting with all other reviewers. MAIN

resultsThirty-three studies, involving 10,400 participants, were included. The majority were not randomised controlled studies and there were problems of confounding and bias. The studies varied in several aspects limiting the extent of quantitative analysis. Studies consistently show that oral substitution treatment for opioid-dependent injecting drug users is associated with statistically significant reductions in illicit opioid use, injecting use and sharing of injecting equipment. It is also associated with reductions in the proportion of injecting drug users reporting multiple sex partners or exchanges of sex for drugs or money, but has little effect on condom use. It appears that the reductions in risk behaviours related to drug use do translate into reductions in cases of HIV infection. AUTHORS'

conclusionsOral substitution treatment for injecting opioid users reduces drug-related behaviours with a high risk of HIV transmission, but has less effect on sex-related risk behaviours. The lack of data from randomised controlled studies limits the strength of the evidence presented in this review.

Indexed as

Sexual BehaviorAdministration, OralHIV InfectionsHumansNarcoticsOpioid-Related DisordersRandomized Controlled Trials as TopicRisk-TakingSubstance Abuse, IntravenousNarcotics

Identifiers

PMID18425898

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.