Evidence map›Paper›PMID 31359615›Full record

Observational studyHIV medicine2019

Dispensation of antiretroviral therapy and methadone maintenance therapy at the same facility in a low-barrier setting linked to optimal adherence to HIV treatment.

N A Mohd Salleh, N Fairbairn, S Nolan, R Barrios, J Shoveller, L Richardson, M-J Milloy

Abstract readObservational Study
In one paragraph

Observational study in HIV medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

N A Mohd SallehInterdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, BC, Canada.
N FairbairnBC Centre on Substance Use, Vancouver, BC, Canada.
S NolanBC Centre on Substance Use, Vancouver, BC, Canada.
R BarriosBC Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, BC, Canada.ORCID 0000-0003-3642-5986
J ShovellerBC Centre on Substance Use, Vancouver, BC, Canada.
L RichardsonBC Centre on Substance Use, Vancouver, BC, Canada.ORCID 0000-0001-6376-8891
M-J MilloyBC Centre on Substance Use, Vancouver, BC, Canada.ORCID 0000-0003-3821-6221

Funding

Impacts of universal access to HIV/AIDS care among HIV+ injection drug usersU01DA021525 · NIDA · UNIVERSITY OF BRITISH COLUMBIA · PI MILLOY, M-J · 2017 to 2024
$4.3M
Mentoring the next generation of addiction clinician scientists while responding to the opioid epidemicR25DA037756 · NIDA · UNIVERSITY OF BRITISH COLUMBIA · PI FAIRBAIRN, NADIA · 2014 to 2023
$3.6M
NIDA NIH HHS R25 DA037756NIDA NIH HHS U01 DA021525
6 · The paper itself

Abstract

objectivesWe sought to examine the association between dispensation of methadone maintenance therapy (MMT) and antiretroviral therapy (ART) at the same facility, across multiple low-barrier dispensing outlets, and achieving optimal adherence to ART among people who use illicit drugs (PWUD).

methodsWe used data from the AIDS Care Cohort to Evaluate Exposure to Survival Services (ACCESS) study, a long-running study of a community-recruited cohort of HIV-positive PWUD, linked to comprehensive HIV clinical records in Vancouver, Canada, a setting of no-cost, universal access to HIV care. The longitudinal relationship between MMT-ART dispensation at the same facility and the odds of ≥ 95% ART adherence was analysed using multivariable generalized linear mixed-effects modelling. We conducted a further analysis using a marginal structural mode with inverse probability of treatment weights as a sensitivity analysis.

resultsThis study included data on 1690 interviews of 345 ART- and MMT-exposed participants carried out between June 2012 and December 2017. In the final multivariable model, MMT-ART dispensation, compared with nondispensation at the same facility, was associated with greater odds of achieving ≥ 95% adherence [adjusted odds ratio (AOR) 1.56; 95% confidence interval (CI) 1.26-1.96]. A marginal structural model estimated a 1.48 (95% CI 1.15-1.80) greater odds of ≥ 95% adherence among participants who reported MMT-ART dispensation at the same facility compared with those who did not.

conclusionsThe odds of achieving optimal adherence to ART were 56% higher during periods in which MMT and ART medications were dispensed at the same facility, in a low-barrier setting. Our findings highlight the need to consider a simpler integrated approach with medication dispensation at the same facility in low-threshold settings.

Indexed as

Drug MonitoringAdultAnalgesics, OpioidAnti-HIV AgentsCanadaDelivery of Health CareDrug UsersFemaleHIV InfectionsHumansMaleMethadoneMiddle AgedOpiate Substitution TreatmentProspective StudiesSubstance-Related DisordersAnalgesics, OpioidAnti-HIV AgentsMethadoneantiretroviral therapy, highly activeHIVmedication adherencemethadonepeople who use illicit drugs

Identifiers

PMID31359615
PMCPMC6764845

What OpenQuestion holds

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Registered trials

None linked

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.