Evidence map›Paper›PMID 23038795›Full record

SynthesisBMJ (Clinical research ed.)2012

Opiate substitution treatment and HIV transmission in people who inject drugs: systematic review and meta-analysis.

Georgie J MacArthur, Silvia Minozzi, Natasha Martin, Peter Vickerman, Sherry Deren, Julie Bruneau, Louisa Degenhardt, Matthew Hickman

Registry-linked trialOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07148206 (Dronabinol and Epidiolex to Manage Uncontrolled Residual Symptoms of Buprenorphine Initiation Trial), which is not on this map. Cited by 275 papers, 21 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
275citing papers in PubMed, 21 pooled it
20.3field-weighted citation impact, top 1% of its field
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.

NCT07148206 phase3not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Dronabinol and Epidiolex to Manage Uncontrolled Residual Symptoms of Buprenorphine Initiation Trial

TypeinterventionalSponsorMontefiore Medical CenterRan2026 to 2028Enrolled40ConditionsOpioid Use DisorderArmsDronabinol Capsules, Epidiolex 100 mg/mL Oral Solution, Placebo Dronabinol, Placebo Epidiolex
3 · Its place in the literature

Who cites it

275 citing papers in PubMed, 21 syntheses or guidelines pooled it, 494 citations in OpenAlex.

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 4 countries.

Georgie J MacArthurSchool of Social and Community Medicine, University of Bristol, Bristol BS8 2PS, UK.
Silvia Minozzi
Natasha Martin
Peter Vickerman
Sherry Deren
Julie Bruneau
Louisa Degenhardt
Matthew Hickman
London School of Hygiene & Tropical Medicine · GBUniversity of Bristol · GBCentre Hospitalier de l’Université de Montréal · CANew York University · USUniversity of Melbourne · AU

Funding

British Heart FoundationMedical Research Council G0701627Medical Research Council G1000021Wellcome Trust WT087640MA
6 · The paper itself

Abstract

objectiveTo quantify the effect of opiate substitution treatment in relation to HIV transmission among people who inject drugs.

designSystematic review and meta-analysis of prospective published and unpublished observational studies. DATA SOURCES: Search of Medline, Embase, PsychINFO, and the Cochrane Library from the earliest year to 2011 without language restriction. REVIEW

methodsWe selected studies that directly assessed the impact of opiate substitution treatment in relation to incidence of HIV and studies that assessed incidence of HIV in people who inject drugs and that might have collected data regarding exposure to opiate substitution treatment but not have reported it. Authors of these studies were contacted. Data were extracted by two reviewers and pooled in a meta-analysis with a random effects model.

resultsTwelve published studies that examined the impact of opiate substitution treatment on HIV transmission met criteria for inclusion, and unpublished data were obtained from three additional studies. All included studies examined methadone maintenance treatment. Data from nine of these studies could be pooled, including 819 incident HIV infections over 23,608 person years of follow-up. Opiate substitution treatment was associated with a 54% reduction in risk of HIV infection among people who inject drugs (rate ratio 0.46, 95% confidence interval 0.32 to 0.67; P<0.001). There was evidence of heterogeneity between studies (I(2)=60%, χ(2)=20.12, P=0.010), which could not be explained by geographical region, site of recruitment, or the provision of incentives. There was weak evidence for greater benefit associated with longer duration of exposure to opiate substitution treatment.

conclusionOpiate substitution treatment provided as maintenance therapy is associated with a reduction in the risk of HIV infection among people who inject drugs. These findings, however, could reflect comparatively high levels of motivation to change behaviour and reduce injecting risk behaviour among people who inject drugs who are receiving opiate substitution treatment.

Indexed as

Opiate Substitution TreatmentConfounding Factors, EpidemiologicDisease Transmission, InfectiousHIV InfectionsHumansMethadoneNarcoticsPrimary PreventionProspective StudiesResearch DesignRisk FactorsSubstance Abuse, IntravenousTime FactorsMethadoneNarcotics

Identifiers

PMID23038795
PMCPMC3489107
OpenAlexW2051366813

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.