Sexually transmitted and blood-borne infection risk reduction with methadone and buprenorphine/naloxone among people with prescription-type opioid use disorder: Findings from a Canadian pragmatic randomized trial

M.E. Socias; Z. Cui; B. Le Foll; J. Lei; S. Stewart; R. Anand; D. Jutras-Aswad

doi:10.1111/hiv.13636

Sexually transmitted and blood-borne infection risk reduction with methadone and buprenorphine/naloxone among people with prescription-type opioid use disorder: Findings from a Canadian pragmatic randomized trial

M.E. Socias
, Z. Cui
, B. Le Foll
, J. Lei
, S. Stewart
, R. Anand
, D. Jutras-Aswad

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

2 Downloads (Pure)

Abstract

Introduction
People who use drugs are disproportionally affected by sexually transmitted and blood-borne infections (STBBIs). While the benefits of methadone in reducing injecting-risk behaviours are well documented, less is known on its impacts on sexual-related risks, as well as its comparative effectiveness to buprenorphine/naloxone, particularly in the context of highly potent opioids. The aim of this study was to estimate the relative effects of buprenorphine/naloxone and methadone on injecting and STBBI risks among people with prescription-type opioid use disorder (POUD).

Methods
Secondary analysis of a pan-Canadian pragmatic 24-week randomized clinical trial comparing methadone and buprenorphine/naloxone models of care among 272 people with POUD (including licit or illicit opioid analgesics, fentanyl). The Risk Behaviour Survey was used to collect injecting and sexual risks at baseline, and weeks 12 and 24.

Results
In total, 210 participants initiated treatment (103 buprenorphine/naloxone and 107 methadone). At baseline, 113/205 (55.1%) participants reported recently injecting drugs, 37/209 (17.7%) unsafe injection practices and 67/162 (41.4%) high-risk sex. Both methadone and buprenorphine/naloxone were associated with reductions in the prevalence of injection drug use and high-risk sex at weeks 12 and 24 with no interactions between treatment arm and time.

Conclusion
Methadone and buprenorphine/naloxone were similarly effective in reducing injecting and sexual risk behaviours among people with POUD.

Original language	English
Pages (from-to)	817-825
Number of pages	9
Journal	HIV Medicine
Volume	25
Issue number	7
Early online date	20 Mar 2024
DOIs	https://doi.org/10.1111/hiv.13636
Publication status	Published online - 20 Mar 2024

Bibliographical note

Clinical Trials Registration
clinicaltrials.gov NCT03033732.

Funding

This study was financially supported by the Canadian Institutes of Health Research (CIHR; grant numbers SMN-139148, SMN-139149, SMN-139150, SMN-139151) through the Canadian Research Initiative on Substance Misuse (grant numbers CIS-144301, CIS-144302, CIS-144303, CIS-144304). MES is supported by a Michael Smith Foundation for Health Research and St. Paul's Foundation Scholar Award. DJA holds a research scholar award from the Fonds de Recherche du Québec en Santé. BLF is supported by a clinician scientist award from the Department of Family and Community Medicine and by the Addiction Psychiatry Chair of the Department of Psychiatry, University of Toronto.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

buprenorphine
fentanyl
HIV prevention
medications for opioid use disorder
methadone
sexually transmitted and blood-born infections

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Socias, M. E., Cui, Z., Le Foll, B., Lei, J., Stewart, S., Anand, R., & Jutras-Aswad, D. (2024). Sexually transmitted and blood-borne infection risk reduction with methadone and buprenorphine/naloxone among people with prescription-type opioid use disorder: Findings from a Canadian pragmatic randomized trial. HIV Medicine, 25(7), 817-825. Advance online publication. https://doi.org/10.1111/hiv.13636

@article{deb183a825e4481e973ffb712c8dcc5b,

title = "Sexually transmitted and blood-borne infection risk reduction with methadone and buprenorphine/naloxone among people with prescription-type opioid use disorder: Findings from a Canadian pragmatic randomized trial",

abstract = "Introduction People who use drugs are disproportionally affected by sexually transmitted and blood-borne infections (STBBIs). While the benefits of methadone in reducing injecting-risk behaviours are well documented, less is known on its impacts on sexual-related risks, as well as its comparative effectiveness to buprenorphine/naloxone, particularly in the context of highly potent opioids. The aim of this study was to estimate the relative effects of buprenorphine/naloxone and methadone on injecting and STBBI risks among people with prescription-type opioid use disorder (POUD). Methods Secondary analysis of a pan-Canadian pragmatic 24-week randomized clinical trial comparing methadone and buprenorphine/naloxone models of care among 272 people with POUD (including licit or illicit opioid analgesics, fentanyl). The Risk Behaviour Survey was used to collect injecting and sexual risks at baseline, and weeks 12 and 24. Results In total, 210 participants initiated treatment (103 buprenorphine/naloxone and 107 methadone). At baseline, 113/205 (55.1\%) participants reported recently injecting drugs, 37/209 (17.7\%) unsafe injection practices and 67/162 (41.4\%) high-risk sex. Both methadone and buprenorphine/naloxone were associated with reductions in the prevalence of injection drug use and high-risk sex at weeks 12 and 24 with no interactions between treatment arm and time. Conclusion Methadone and buprenorphine/naloxone were similarly effective in reducing injecting and sexual risk behaviours among people with POUD.",

keywords = "buprenorphine, fentanyl, HIV prevention, medications for opioid use disorder, methadone, sexually transmitted and blood-born infections",

author = "M.E. Socias and Z. Cui and \{Le Foll\}, B. and J. Lei and S. Stewart and R. Anand and D. Jutras-Aswad",

note = "Clinical Trials Registration clinicaltrials.gov NCT03033732.",

year = "2024",

month = mar,

day = "20",

doi = "10.1111/hiv.13636",

language = "English",

volume = "25",

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Socias, ME, Cui, Z, Le Foll, B, Lei, J, Stewart, S, Anand, R & Jutras-Aswad, D 2024, 'Sexually transmitted and blood-borne infection risk reduction with methadone and buprenorphine/naloxone among people with prescription-type opioid use disorder: Findings from a Canadian pragmatic randomized trial', HIV Medicine, vol. 25, no. 7, pp. 817-825. https://doi.org/10.1111/hiv.13636

Sexually transmitted and blood-borne infection risk reduction with methadone and buprenorphine/naloxone among people with prescription-type opioid use disorder: Findings from a Canadian pragmatic randomized trial. / Socias, M.E.; Cui, Z.; Le Foll, B. et al.
In: HIV Medicine, Vol. 25, No. 7, 20.03.2024, p. 817-825.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Sexually transmitted and blood-borne infection risk reduction with methadone and buprenorphine/naloxone among people with prescription-type opioid use disorder: Findings from a Canadian pragmatic randomized trial

AU - Socias, M.E.

AU - Cui, Z.

AU - Le Foll, B.

AU - Lei, J.

AU - Stewart, S.

AU - Anand, R.

AU - Jutras-Aswad, D.

N1 - Clinical Trials Registration clinicaltrials.gov NCT03033732.

PY - 2024/3/20

Y1 - 2024/3/20

N2 - Introduction People who use drugs are disproportionally affected by sexually transmitted and blood-borne infections (STBBIs). While the benefits of methadone in reducing injecting-risk behaviours are well documented, less is known on its impacts on sexual-related risks, as well as its comparative effectiveness to buprenorphine/naloxone, particularly in the context of highly potent opioids. The aim of this study was to estimate the relative effects of buprenorphine/naloxone and methadone on injecting and STBBI risks among people with prescription-type opioid use disorder (POUD). Methods Secondary analysis of a pan-Canadian pragmatic 24-week randomized clinical trial comparing methadone and buprenorphine/naloxone models of care among 272 people with POUD (including licit or illicit opioid analgesics, fentanyl). The Risk Behaviour Survey was used to collect injecting and sexual risks at baseline, and weeks 12 and 24. Results In total, 210 participants initiated treatment (103 buprenorphine/naloxone and 107 methadone). At baseline, 113/205 (55.1%) participants reported recently injecting drugs, 37/209 (17.7%) unsafe injection practices and 67/162 (41.4%) high-risk sex. Both methadone and buprenorphine/naloxone were associated with reductions in the prevalence of injection drug use and high-risk sex at weeks 12 and 24 with no interactions between treatment arm and time. Conclusion Methadone and buprenorphine/naloxone were similarly effective in reducing injecting and sexual risk behaviours among people with POUD.

AB - Introduction People who use drugs are disproportionally affected by sexually transmitted and blood-borne infections (STBBIs). While the benefits of methadone in reducing injecting-risk behaviours are well documented, less is known on its impacts on sexual-related risks, as well as its comparative effectiveness to buprenorphine/naloxone, particularly in the context of highly potent opioids. The aim of this study was to estimate the relative effects of buprenorphine/naloxone and methadone on injecting and STBBI risks among people with prescription-type opioid use disorder (POUD). Methods Secondary analysis of a pan-Canadian pragmatic 24-week randomized clinical trial comparing methadone and buprenorphine/naloxone models of care among 272 people with POUD (including licit or illicit opioid analgesics, fentanyl). The Risk Behaviour Survey was used to collect injecting and sexual risks at baseline, and weeks 12 and 24. Results In total, 210 participants initiated treatment (103 buprenorphine/naloxone and 107 methadone). At baseline, 113/205 (55.1%) participants reported recently injecting drugs, 37/209 (17.7%) unsafe injection practices and 67/162 (41.4%) high-risk sex. Both methadone and buprenorphine/naloxone were associated with reductions in the prevalence of injection drug use and high-risk sex at weeks 12 and 24 with no interactions between treatment arm and time. Conclusion Methadone and buprenorphine/naloxone were similarly effective in reducing injecting and sexual risk behaviours among people with POUD.

KW - buprenorphine

KW - fentanyl

KW - HIV prevention

KW - medications for opioid use disorder

KW - methadone

KW - sexually transmitted and blood-born infections

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U2 - 10.1111/hiv.13636

DO - 10.1111/hiv.13636

M3 - Article

SN - 1464-2662

VL - 25

SP - 817

EP - 825

JO - HIV Medicine

JF - HIV Medicine

IS - 7

ER -

Sexually transmitted and blood-borne infection risk reduction with methadone and buprenorphine/naloxone among people with prescription-type opioid use disorder: Findings from a Canadian pragmatic randomized trial

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

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