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Prescription Opioid Injection Among HIV-Positive People Who Inject Drugs in a Canadian Setting

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Abstract

Prescription opioids (POs) are commonly prescribed to patients living with HIV/AIDS, while the illicit use of POs remains a major public health concern throughout Canada and the United States. We sought to identify the prevalence and correlates of PO injection among HIV-positive people who inject drugs (PWID) in Vancouver, Canada, where HIV/AIDS treatment and care is offered at no cost. We examined data from 634 individuals from an ongoing prospective cohort of HIV-positive PWID. Between December 2005 and November 2013, the median prevalence of recent PO injection was 24.2 % [interquartile range (IQR): 21.5–25.8 %]. In a multivariable generalized estimating equation model, Caucasian ethnicity, heroin injection, and drug dealing were positively associated with PO injection, while older age and methadone maintenance treatment were negatively associated with PO injection (all p < 0.05). Engagement on antiretroviral therapy was inversely associated with PO injection in a bivariable analysis, but did not remain significant after adjusting for heroin injection. These findings describe a particularly vulnerable sub-group of PWID who may benefit from targeted efforts to both minimize drug-related risk behaviors and support HIV/AIDS treatment.

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Acknowledgments

We would like to thank the ACCESS participants for their contribution to this research. We would also like to thank past researchers and staff, particularly Tricia Collingham, Carmen Rock, Kristie Starr, Deborah Graham, Peter Vann, Jennifer Matthews, and Steve Kain for their administrative assistance with this research. This study was supported by the US National Institutes of Health (R01-DA021525). This research was undertaken, in part, thanks to funding from the Canada Research Chairs Program through a Tier 1 Research Chair in Inner City Medicine (Dr. Wood). Dr. Milloy is supported in part by the United States National Institutes of Health R01-DA021525.

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Authors and Affiliations

  1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, University of British Columbia, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada

    Stephanie Lake, Thomas Kerr, Silvia Guillemi, Surita Parashar, Julio Montaner, Evan Wood & M.-J. Milloy

  2. School of Population and Public Health, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, V6T 1Z3, Canada

    Stephanie Lake & Jane Buxton

  3. Department of Medicine, St. Paul’s Hospital, University of British Columbia, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada

    Thomas Kerr, Julio Montaner, Evan Wood & M.-J. Milloy

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  1. Stephanie Lake
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  2. Thomas Kerr
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  4. Silvia Guillemi
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Correspondence to M.-J. Milloy.

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Dr. Montaner has received educational grants from, served an ad hoc advisor to, or spoken at various events sponsored by: Abbott Laboratories, Agouron Pharmaceuticals Inc., Boehringer Ingelheim Pharmaceuticals Inc., Borean Pharma AS, Bristol-Myers Squibb, DuPont Pharma, Gilead Sciences, GlaxoSmithKline, Hoffman-La Roche, Immune Response Corporation, Incyte, Janssen-Ortho Inc., Kucera Pharmaceutical Company, Merck Frosst Laboratories, Pfizer Canada Inc., Sanofi Pasteur, Shire Biochem Inc., Tibotec Pharmaceuticals Ltd., and Trimeris Inc.

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Lake, S., Kerr, T., Buxton, J. et al. Prescription Opioid Injection Among HIV-Positive People Who Inject Drugs in a Canadian Setting. AIDS Behav 20, 2941–2949 (2016). https://doi.org/10.1007/s10461-016-1369-y

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