ArticleJournal of acquired immune deficiency syndromes (1999)2015
Implementation and Operational Research: Linkage to Care Among Methadone Clients Living With HIV in Dar es Salaam, Tanzania.
Article in Journal of acquired immune deficiency syndromes (1999), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Prevalence and epidemiological distribution of substance use among people living with HIV in the East African region: a meta-analysis.Frontiers in psychiatry · 2025Pooled it
- Integrating HIV and substance use services: a systematic review.Journal of the International AIDS Society · 2017Pooled it
- Impact of scaling up harm reduction interventions on injecting risk behaviours, ART outcomes and HIV incidence among people who inject drugs in Kenya.The International journal on drug policy · 2025Article
- Depression and its associated factors among people who use drugs attending the Methadone Treatment Clinic at Tumbi Hospital in Pwani, Tanzania: A cross-sectional study.PLOS mental health · 2025Article
- Barriers and facilitators of HIV and hepatitis C care among people who inject drugs in Nairobi, Kenya: a qualitative study with peer educators.Harm reduction journal · 2021Article
- Modelling the impact of HIV and HCV prevention and treatment interventions for people who inject drugs in Dar es Salaam, Tanzania.Journal of the International AIDS Society · 2021Article
- Overview of the epidemiological conditions of HIV among key populations in Africa.Journal of the International AIDS Society · 2021Review
- Effectiveness of health care workers and peer engagement in promoting access to health services among population at higher risk for HIV in Tanzania (KPHEALTH): study protocol for a quasi experimental trial.BMC health services research · 2019Article
- Evaluating the Integrated Methadone and Anti-Retroviral Therapy Strategy in Tanzania Using the RE-AIM Framework.International journal of environmental research and public health · 2019Article
- Patient and provider perspectives on implementation barriers and facilitators of an integrated opioid treatment and HIV care intervention.Addiction science & clinical practice · 2019Article
- The Opioid Epidemic in Africa And Its Impact.Current addiction reports · 2018Article
- Substance use and universal access to HIV testing and treatment in sub-Saharan Africa: implications and research priorities.Journal of virus eradication · 2018Article
- The becoming of methadone in Kenya: How an intervention's implementation constitutes recovery potential.Social science & medicine (1982) · 2018Article
- Convenience without disclosure: a formative research study of a proposed integrated methadone and antiretroviral therapy service delivery model in Dar es Salaam, Tanzania.Addiction science & clinical practice · 2017Article
- Prevalence and predictors of HCV among a cohort of opioid treatment patients in Dar es Salaam, Tanzania.The International journal on drug policy · 2017Article
- Public health and international drug policy.Lancet (London, England) · 2016Review
- Improvements in health-related quality of life among methadone maintenance clients in Dar es Salaam, Tanzania.The International journal on drug policy · 2016Article
- Generating trust: Programmatic strategies to reach women who inject drugs with harm reduction services in Dar es Salaam, Tanzania.The International journal on drug policy · 2016Article
- "Can't you initiate me here?": Challenges to timely initiation on antiretroviral therapy among methadone clients in Dar es Salaam, Tanzania.The International journal on drug policy · 2016Article
- Service integration: opportunities to expand access to antiretroviral therapy for people who inject drugs in Tanzania.Journal of the International AIDS Society · 2015Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundThe first methadone maintenance treatment clinic in Tanzania was launched in February 2011 to address an emerging HIV epidemic among people who inject drugs. We conducted a retrospective cohort study to understand factors associated with linkage to HIV care and explore how a methadone maintenance treatment clinic can serve as a platform for integrated HIV care and treatment.
methodsThis study used routine programmatic and clinical data on clients enrolled in methadone at Muhimbili National Hospital from February 2011 to January 2013. Multivariable proportional hazards regression model was used to examine time to initial CD4 count.
resultsFinal analyses included 148 HIV-positive clients, contributing 31.7 person-years. At 30, 60, and 90 days, the probability of CD4 screening was 40% [95% confidence interval (CI): 32% to 48%], 55% (95% CI: 47% to 63%), and 63% (95% CI: 55% to 71%), respectively. Clients receiving high methadone doses (≥ 85 mg/d) [adjusted hazard ratio (aHR): 1.68, 95% CI: 1.03 to 2.74] had higher likelihood of CD4 screening than those receiving low doses (<85 mg/d). Clients with primary education or lower (aHR: 1.62, 95% CI: 1.05 to 2.51) and self-reported poor health (aHR: 1.96, 95% CI: 1.09 to 3.51) were also more likely to obtain CD4 counts. Clients with criminal arrest history (aHR: 0.56, 95% CI: 0.37 to 0.85]) were less likely to be linked to care. Among 17 antiretroviral therapy eligible clients (CD4 ≤ 200), 12 (71%) initiated treatment, of which 7 (41%) initiated within 90 days.
conclusionsLevels of CD4 screening and antiretroviral therapy initiation were similar to Sub-Saharan programs caring primarily for people who do not inject drugs. Adequate methadone dosing is important in retaining clients to maximize HIV treatment benefits and allow for successful linkage to services.
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