Buprenorphine/Naloxone Treatment in Primary Care is Associated with Decreased Human Immunodeficiency Virus Risk Behaviors

Untreated opioid dependence increases HIV transmission globally. Although previous research has shown that methadone treatment can reduce HIV risk behavior and seroconversion, little data exist on whether office-based treatment with buprenorphine/ naloxone can have the same effects. This study attempts to address this data gap.

The authors conducted a longitudinal analysis of 166 opiod-dependent people receiving buprenorphine/naloxone treatment in a primary care clinic. After 12 and 24 weeks, drug-related and sex-related HIV risk behaviors were compared with baseline using the AIDS/HIV Risk Inventory.

Key Findings:

  • Primary care clinic buprenorphine/naloxone treatment was associated with significant reductions in overall and drug-related HIV risk behaviors. Sex-related risk behaviors were lower at 24 weeks, but not at 12 weeks, compared to baseline.
  • Reduction in overall risk was driven mainly by decrease in injection drug use and decrease in having sex while on drugs or alcohol.
  • The rate of noncondom use was not affected by the treatment.
  • These findings are, in general, similar to those from methadone studies.

A primary limitation of this study is the use of self-reported data, as study participants commonly underreport high-risk behaviors. Further efforts to combine buprenorphine treatment programs with counseling aimed specifically at reducing high-risk HIV-transmitting behaviors would likely show even greater effects.