Longitudinal analysis of HIV-risk behaviors of participants in a randomized trial of prison-initiated buprenorphine
Abstract Background It has been estimated that approximately 15% of people who are incarcerated in the US have histories of opioid use disorder. Relapse to opioid use after release from prison poses a serious risk of HIV infection. Prison-initiated buprenorphine may help to reduce HIV infection give...
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| Format: | Article |
| Language: | English |
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BMC
2019-12-01
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| Series: | Addiction Science & Clinical Practice |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13722-019-0172-2 |
| _version_ | 1818602647061528576 |
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| author | Thomas R. Blue Michael S. Gordon Robert P. Schwartz Kathryn Couvillion Frank J. Vocci Terrence T. Fitzgerald Kevin E. O’Grady |
| author_facet | Thomas R. Blue Michael S. Gordon Robert P. Schwartz Kathryn Couvillion Frank J. Vocci Terrence T. Fitzgerald Kevin E. O’Grady |
| author_sort | Thomas R. Blue |
| collection | DOAJ |
| description | Abstract Background It has been estimated that approximately 15% of people who are incarcerated in the US have histories of opioid use disorder. Relapse to opioid use after release from prison poses a serious risk of HIV infection. Prison-initiated buprenorphine may help to reduce HIV infection given the association between opioid use and HIV-risk behaviors. Methods The present study is a secondary analysis of longitudinal data gathered from a randomized controlled trial of buprenorphine-naloxone for people who were incarcerated (N = 211) between 2008 and 2012. It compares the impact of assignment to initiate buprenorphine in prison (N = 106 randomized, N = 104 analyzed) versus in the community (N = 107 randomized, N = 107 analyzed) and whether or not participants entered community treatment on the frequency of HIV-risk behaviors in the 12 months following release from prison. Data were analyzed hierarchically and for each outcome variable, a multilevel, over-dispersed Poisson model was fit to the data. Outcome variables were the number of times the following behaviors occurred in the last 30 days: (1) having sex without a condom (2) injecting drugs (3) using unsterilized needles, and (4) sharing injection paraphernalia. Results Participants assigned to begin buprenorphine in the community experienced a greater decrease in injection drug use over time compared to participants assigned to begin buprenorphine in prison. There were no significant associations between treatment assignment or community treatment entry and instances of having sex without a condom, sharing injection paraphernalia, or using unsterilized needles. Conclusions Overall, the present study did not find support for the initiation of buprenorphine in prison (as opposed to the community) as a means to reduce incidences of HIV-risk behaviors. Avenues for future research in the nexus of HIV-risk reduction, criminal justice, and pharmacotherapy are discussed. Trial registration This study was supported by the National Institute on Drug Abuse (NIDA), Buprenorphine for Prisoners (PI: Kinlock; R01DA021579). ClinicalTrials.gov identifier: NCT 00574067 |
| first_indexed | 2024-12-16T13:10:36Z |
| format | Article |
| id | doaj.art-af5c80c2ac184096ae0b2f232f790460 |
| institution | Directory Open Access Journal |
| issn | 1940-0640 |
| language | English |
| last_indexed | 2024-12-16T13:10:36Z |
| publishDate | 2019-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Addiction Science & Clinical Practice |
| spelling | doaj.art-af5c80c2ac184096ae0b2f232f7904602022-12-21T22:30:38ZengBMCAddiction Science & Clinical Practice1940-06402019-12-0114111110.1186/s13722-019-0172-2Longitudinal analysis of HIV-risk behaviors of participants in a randomized trial of prison-initiated buprenorphineThomas R. Blue0Michael S. Gordon1Robert P. Schwartz2Kathryn Couvillion3Frank J. Vocci4Terrence T. Fitzgerald5Kevin E. O’Grady6Friends Research Institute Inc.Friends Research Institute Inc.Friends Research Institute Inc.Friends Research Institute Inc.Friends Research Institute Inc.Glenwood Life Counseling CenterDepartment of Psychology, University of Maryland, College ParkAbstract Background It has been estimated that approximately 15% of people who are incarcerated in the US have histories of opioid use disorder. Relapse to opioid use after release from prison poses a serious risk of HIV infection. Prison-initiated buprenorphine may help to reduce HIV infection given the association between opioid use and HIV-risk behaviors. Methods The present study is a secondary analysis of longitudinal data gathered from a randomized controlled trial of buprenorphine-naloxone for people who were incarcerated (N = 211) between 2008 and 2012. It compares the impact of assignment to initiate buprenorphine in prison (N = 106 randomized, N = 104 analyzed) versus in the community (N = 107 randomized, N = 107 analyzed) and whether or not participants entered community treatment on the frequency of HIV-risk behaviors in the 12 months following release from prison. Data were analyzed hierarchically and for each outcome variable, a multilevel, over-dispersed Poisson model was fit to the data. Outcome variables were the number of times the following behaviors occurred in the last 30 days: (1) having sex without a condom (2) injecting drugs (3) using unsterilized needles, and (4) sharing injection paraphernalia. Results Participants assigned to begin buprenorphine in the community experienced a greater decrease in injection drug use over time compared to participants assigned to begin buprenorphine in prison. There were no significant associations between treatment assignment or community treatment entry and instances of having sex without a condom, sharing injection paraphernalia, or using unsterilized needles. Conclusions Overall, the present study did not find support for the initiation of buprenorphine in prison (as opposed to the community) as a means to reduce incidences of HIV-risk behaviors. Avenues for future research in the nexus of HIV-risk reduction, criminal justice, and pharmacotherapy are discussed. Trial registration This study was supported by the National Institute on Drug Abuse (NIDA), Buprenorphine for Prisoners (PI: Kinlock; R01DA021579). ClinicalTrials.gov identifier: NCT 00574067https://doi.org/10.1186/s13722-019-0172-2Hiv-risk behaviorBuprenorphinePrisonOpioid use disorderCorrectional settings |
| spellingShingle | Thomas R. Blue Michael S. Gordon Robert P. Schwartz Kathryn Couvillion Frank J. Vocci Terrence T. Fitzgerald Kevin E. O’Grady Longitudinal analysis of HIV-risk behaviors of participants in a randomized trial of prison-initiated buprenorphine Addiction Science & Clinical Practice Hiv-risk behavior Buprenorphine Prison Opioid use disorder Correctional settings |
| title | Longitudinal analysis of HIV-risk behaviors of participants in a randomized trial of prison-initiated buprenorphine |
| title_full | Longitudinal analysis of HIV-risk behaviors of participants in a randomized trial of prison-initiated buprenorphine |
| title_fullStr | Longitudinal analysis of HIV-risk behaviors of participants in a randomized trial of prison-initiated buprenorphine |
| title_full_unstemmed | Longitudinal analysis of HIV-risk behaviors of participants in a randomized trial of prison-initiated buprenorphine |
| title_short | Longitudinal analysis of HIV-risk behaviors of participants in a randomized trial of prison-initiated buprenorphine |
| title_sort | longitudinal analysis of hiv risk behaviors of participants in a randomized trial of prison initiated buprenorphine |
| topic | Hiv-risk behavior Buprenorphine Prison Opioid use disorder Correctional settings |
| url | https://doi.org/10.1186/s13722-019-0172-2 |
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