Methadone maintenance and other factors associated with intraindividual temporal trends in injection-drug use

FRANÇAIS :
Cette étude évalue les différences de fréquence d'injection de drogue, sur une période de plus de 43 mois, sur des toxicomanes newyorkais séronégatifs, qui bénéficient de conseils de prévention des risques du VIH et de dépistage à chaque visite dans un centre médical. Certains de ces toxicomanes suivent un traitement de maintenance à la méthadone. Les résultats montrent que les personnes suivant régulièrement le traitement ont le plus diminué leur fréquence d'injection. Mais cette baisse n'est pas uniforme, il faut tenir compte de l'environnement initial et de l'influence négative des toxicomanes extérieurs au programme. En fait la méthode paraît inefficace car la majorité des sujets n'ont pas vaiment changé leur fréquence d'injection.
ENGLISH :
The objective of this study was to determine what sociodemographic, lifestyle, or drug-related characteristics predict temporal changes in self-reported drug injection frequencies among HIV-seronegative injection-drug users (IDUs) who were being given HIV testing and risk reduction counseling. The 277 subjects were given 4-11 quartely interviews including a detailed history of drug use and other HIV risk factors, HIV risk reduction counseling, and venipuncture for HIV antibody testing. Only 44% of subjects decreased their drug injection frequencies despite repetitive HIV testing and counseling. In multivariate logistic analyses, decreasing temporal trends were associated with consistent enrollment in methadone maintenance (p<.1) whereas increasing trends conversely were associated with inconsistent enrollment (p<.01) and also with an absence of crack use (p<.01). Relapses were significantly associated with needle sharing with multiple partners and a low frequency of smoking. The data suggest that methadone maintenance facilitates a positive response to HIV risk reduction counseling. (From authors' abstract)