Tetrault, J., M.J. Kozal, J. Chiarella, et al. Journal of Addiction Medicine (February 2013), e-publication ahead of print.
The authors conducted a cross-sectional analysis of 59 HIV-infected persons receiving opioid agonist treatment (OAT) – an effective treatment for reducing injection-related sharing and HIV risk in persons with opioid dependency – to assess the prevalence of risk behaviors, antiretroviral (ARV) resistance, and ARV resistance among persons with risk behaviors. Eighty percent of the participants had been receiving OAT for at least 12 weeks. The findings overall showed a presence of both continued risky behaviors and resistance: 14 percent of individuals receiving OAT engaged in unprotected sex; 7 percent shared injection drug equipment; 32 percent had a measureable viral load; and 15 percent had evidence of ARV resistance. In terms of ARV resistance by evidence of risk behavior, 22 percent of individuals engaging in risk behaviors had ARV resistance, and 14 percent with no risk behavior evidence also had resistance. These findings, which suggest that HIV-positive people on OAT continue to engage in risky behavior, placing partners at risk, show that addressing HIV resistance is essential. The authors concluded that improving HIV prevention and treatment programs for HIV-infected individuals with opioid dependence is necessary, especially in low-resource contexts.