Evidence map›Paper›PMID 34389218›Full record

SynthesisThe International journal on drug policy2021

Assessing HIV and overdose risks for people who use drugs exposed to compulsory drug abstinence programs (CDAP): A systematic review and meta-analysis.

Anh T Vo, Christopher Magana, Matthew Hickman, Annick Borquez, Leo Beletsky, Natasha K Martin, Javier A Cepeda

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The International journal on drug policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.2field-weighted citation impact, top 21% 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.

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

2 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Review
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 at 5 institutions in 2 countries.

Anh T VoDivision of Infectious Diseases and Global Public Health, University of California San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093, USA. Electronic address: atv013@ucsd.edu.
Christopher MaganaDivision of Infectious Diseases and Global Public Health, University of California San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093, USA.
Matthew HickmanPopulation Health Sciences, University of Bristol, UK.
Annick BorquezDivision of Infectious Diseases and Global Public Health, University of California San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093, USA.
Leo BeletskyDivision of Infectious Diseases and Global Public Health, University of California San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093, USA; Northeastern University School of Law and Bouvé College of Health Sciences, Boston, MA, USA.
Natasha K MartinDivision of Infectious Diseases and Global Public Health, University of California San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093, USA; Population Health Sciences, University of Bristol, UK.
Javier A CepedaDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
University of California, San Diego · USUniversity of California System · USJohns Hopkins University · USNortheastern University · USUniversity of Bristol · GB

Funding

UC San Diego Clinical and Translational Research InstituteUL1TR001442 · NCATS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FIRESTEIN, GARY S, HOGARTH, MICHAEL · 2015 to 2024
$88.3M
VirologyP30AI036214 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SONIA JAIN · 1994 to 2026
$78.4M
Real-time prediction of emerging drug use epidemics in the United StatesDP2DA049295 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI BORQUEZ, ANNICK · 2019 to 2019
$2.4M
Optimizing HIV prevention portfolios targeting people who inject drugs using dynamic economic modelingR01AI147490 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MARTIN, NATASHA · 2019 to 2022
$2.3M
MODELING THE IMPACT OF A POLICE EDUCATION PROGRAM ON HIV INCIDENCE AMONG PEOPLE WHO INJECT DRUGSK01DA043421 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI CEPEDA, JAVIER · 2017 to 2021
$941k
Medical Research Council MR/N00616X/1NCATS NIH HHS UL1 TR001442NIAID NIH HHS P30 AI036214NIAID NIH HHS R01 AI147490NIDA NIH HHS DP2 DA049295NIDA NIH HHS K01 DA043421
6 · The paper itself

Abstract

backgroundEvidence supports integrating drug use treatment, harm reduction, and HIV prevention services to address dual epidemics of drug use disorders and HIV. These dual epidemics have spurred a rise in legally-enforced compulsory drug abstinence programs (CDAP), despite limited evidence on its effectiveness. We conducted a systematic review and meta-analysis evaluating the association between CDAP exposure and HIV and overdose-related risk.

methodsWe searched PubMed, EBSCOhost and Sociological Abstracts for studies that contained an individual-level association between CDAP exposure and related HIV or overdose risks, with no date restrictions. Meta-analyses were conducted on data abstracted from eligible studies, using pooled random-effects models and I-squared statistics. We assessed quality of the studies across 14 criteria for observational studies.

resultsOut of 2,226 abstracts screened, we included 8 studies (5253 individuals/776 events) across China, Mexico, Thailand, Norway, and the United States. All but two were cross-sectional analyses, limiting strength of observed associations. In the two studies that reported association between CDAP and HIV seropositivity or receptive syringe sharing, findings were inconsistent and did not indicate that those with exposure to CDAP had increased odds of HIV or syringe sharing. However, we found the odds of experiencing non-fatal overdose in lifetime and in the last 6-12 months were 2.02 (95% CI 0.22 - 18.86, p = 0.16) to 3.67 times higher (95% CI 0.21 - 62.88, p = 0.39), respectively, among those with CDAP exposure than those without.

conclusionResearch assessing HIV risk associated with CDAP is scant and inconclusive, while evidence of robust associations between CDAP and overdose risk continues to mount. More rigorous, longitudinal studies are needed to evaluate the causal relationships between CDAP and these health outcomes. Aside from the growing evidence base on collateral harms, ethical considerations dictate that voluntary, evidence-based drug treatment should be prioritized to address the drivers of excess morbidity and mortality among people who use drugs.

Indexed as

Drug OverdoseHIV InfectionsPharmaceutical PreparationsSubstance Abuse, IntravenousCross-Sectional StudiesHumansNeedle SharingPharmaceutical PreparationsCivil commitmentCompulsory drug abstinence programDrug treatmentHarm reductionHIVOverdosePWIDPWUD

Identifiers

PMID34389218
PMCPMC9027650
OpenAlexW3183555740

What OpenQuestion holds

Textmetadata
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Registered trials

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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.