Evidence map›Paper›PMID 36368939›Full record

Trial reportBMC infectious diseases2022

Impact of prerelease methadone on mortality among people with HIV and opioid use disorder after prison release: results from a randomized and participant choice open-label trial in Malaysia.

Alexander R Bazazi, Gabriel J Culbert, Martin P Wegman, Robert Heimer, Adeeba Kamarulzaman, Frederick L Altice

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02396979 (Intervention of HIV, Drug Use and the Criminal Justice System in Malaysia), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.6field-weighted citation impact, top 31% 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.

NCT02396979 phase4completednot on this map

Intervention of HIV, Drug Use and the Criminal Justice System in Malaysia

TypeinterventionalSponsorYale UniversityRan2010 to 2014Enrolled300ConditionsHuman Immunodeficiency Virus, Acquired Immunodeficiency Syndrome, Opiate Addiction, Drug DependenceArmsMethadone, Holistic Health Recovery Program
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 6 citations in OpenAlex.

  1. Trial
  2. Observational
  3. Article
  4. Article
  5. 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

6 authors at 3 institutions in 2 countries.

Alexander R BazaziDepartment of Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine, 135 College Street, Suite 323, New Haven, CT, 06510-228, USA. alexander.bazazi@ucsf.edu.
Gabriel J CulbertPopulation Health Nursing Science, University of Illinois at Chicago, Chicago, IL, USA.
Martin P WegmanDepartment of Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine, 135 College Street, Suite 323, New Haven, CT, 06510-228, USA.
Robert HeimerDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
Adeeba KamarulzamanDepartment of Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine, 135 College Street, Suite 323, New Haven, CT, 06510-228, USA.
Frederick L AlticeDepartment of Medicine, Section of Infectious Diseases, AIDS Program, Yale School of Medicine, 135 College Street, Suite 323, New Haven, CT, 06510-228, USA.
Yale University · USUniversity of Illinois Chicago · USUniversity of Malaya · MY

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
MEDICAL SCIENTIST TRAINING PROGRAMT32GM007205 · NIGMS · YALE UNIVERSITY · PI KAZMIERCZAK, BARBARA I · 1985 to 2019
$42.9M
TRAINING THE NEXT GENERATION OF MENTAL HEALTH RESEARCHERSR25MH060482 · NIMH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI DANIEL H MATHALON, Susan M. Voglmaier · 2000 to 2026
$5.2M
Intervention of HIV, Drug Use and the Criminal Justice System in MalaysiaR01DA025943 · NIDA · YALE UNIVERSITY · PI ALTICE, FREDERICK LEWIS · 2008 to 2012
$2.7M
Training in Nursing Interventions for HIV and Addiction in Criminal Justice SettingsK23DA041988 · NIDA · UNIVERSITY OF ILLINOIS AT CHICAGO · PI CULBERT, GABRIEL JOHN · 2017 to 2020
$827k
Comparative effect of managed care on quality and costs of care for Medicaid adulF30MH105153 · NIMH · UNIVERSITY OF FLORIDA · PI WEGMAN, MARTIN P · 2014 to 2018
$145k
Improving HIV and substance use disorder treatment research by integrating randomized and nonrandomized studies: an evaluation of methadone for HIV-infected opioid-dependent Malaysian prisoners.F30DA039716 · NIDA · YALE UNIVERSITY · PI BAZAZI, ALEXANDER REZA · 2015 to 2017
$123k
NCATS NIH HHS UL1 TR001863NIDA NIH HHS F30 DA039716NIDA NIH HHS F30DA039716NIDA NIH HHS K23 DA041988NIDA NIH HHS K23DA041988NIDA NIH HHS R01 DA025943NIDA NIH HHS R01DA025943NIGMS NIH HHS T32 GM007205NIGMS NIH HHS T32GM07205NIMH NIH HHS F30 MH105153NIMH NIH HHS F30MH105153NIMH NIH HHS R25 MH060482NIMH NIH HHS R25MH060482Universiti Malaya High Impact Research Grant UM.C/625/1/HIR/MOHE/MED01
6 · The paper itself

Abstract

introductionMortality is elevated after prison release and may be higher in people with HIV and opioid use disorder (OUD). Maintenance with opioid agonist therapy (OAT) like methadone or buprenorphine reduces mortality in people with OUD and may confer benefits to people with OUD and HIV leaving prison. Survival benefits of OAT, however, have not been evaluated prospectively in people with OUD and HIV leaving prison.

methodsThis study prospectively evaluated mortality after prison release and whether methadone initiated before release increased survival after release in a sample of men with HIV and OUD (n = 291). We linked national death records to data from a controlled trial of prerelease methadone initiation conducted from 2010 to 2014 with men with HIV and OUD imprisoned in Malaysia. Vital statistics were collected through 2015. Allocation to prerelease methadone was by randomization (n = 64) and participant choice (n = 246). Cox proportional hazards models were used to estimate treatment effects of prerelease methadone on postrelease survival.

resultsOverall, 62 deaths occurred over 872.5 person-years (PY) of postrelease follow-up, a crude mortality rate of 71.1 deaths per 1000 PY (95% confidence interval [CI] 54.5-89.4). Most deaths were of infectious etiology, mostly related to HIV. In a modified intention-to-treat analysis, the impact of prerelease methadone on postrelease mortality was consistent with a null effect in unadjusted (hazard ratio [HR] 1.3, 95% CI 0.6-3.1) and covariate-adjusted (HR 1.2, 95% CI 0.5-2.8) models. Predictors of mortality were educational level (HR 1.4, 95% CI 1.0-1.8), pre-incarceration alcohol use (HR 2.0, 95% CI 1.1-3.9), and lower CD4

conclusionsPostrelease mortality in this sample of men with HIV and OUD was extraordinarily high, and most deaths were likely of infectious etiology. No effect of prerelease methadone on postrelease mortality was observed, which may be due to study limitations or an epidemiological context in which inadequately treated HIV, and not inadequately treated OUD, is the main cause of death after prison release.

trial registrationNCT02396979. Retrospectively registered 24/03/2015.

Indexed as

HIV InfectionsOpioid-Related DisordersPrisonersAnalgesics, OpioidHumansMalaysiaMaleMethadoneOpiate Substitution TreatmentPrisonsAnalgesics, OpioidMethadoneHIVMethadoneMortalityOpioid use disorderPrison

Identifiers

PMID36368939
PMCPMC9652918
OpenAlexW4308804785

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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.