Recent incarceration and buprenorphine maintenance treatment outcomes among human immunodeficiency virus–positive patients

Daniel P. Riggins, Chinazo O. Cunningham, Yuming Ning, Aaron D. Fox

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Opioid use disorder is a common cause of morbidity and mortality among people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Buprenorphine maintenance treatment (BMT) is an effective means of therapy, but patients with recent criminal justice involvement may need more support during BMT than other patients. The authors hypothesized that recently incarcerated BMT patients who initiated treatment in primary care would have poorer treatment outcomes than those who were not recently incarcerated. Methods: Investigators analyzed data from a multisite cohort study of BMT integrated into HIV care. Patients were stratified by self-reported incarceration in the 30 days before initiation of BMT. The outcomes of interest were 6- and 12-month treatment retention and self-reported opioid use. Investigators used multivariable logistic regression and hierarchical linear model, respectively, to evaluate the association between recent incarceration and these outcomes while adjusting for potential confounding variables. Results: Among 305 BMT patients living with HIV/AIDS, 39 (13%) reported recent incarceration. Patients with recent incarceration (vs. without) were more likely to be homeless, unemployed, and previously diagnosed with mental illness. Recent incarceration was not significantly associated with differences in 6-month (odds ratio [OR] = 0.95; 95% confidence interval [CI] = 0.46–1.98) and 12-month (OR = 0.57; 95% CI = 0.27–1.18) treatment retention or in self-reported opioid use (OR = 0.99; 95% CI = 0.51–1.92) after adjustment for potential confounding variables. Conclusions: Those with incarceration in the 30 days prior to BMT initiation were more likely to be homeless, unemployed, and previously diagnosed with mental illness than those without recent incarceration. However, no significant difference in self-reported opioid use or 6-month or 12-month retention in treatment was detected between those with and without recent incarceration. Future studies should confirm these findings with larger sample sizes. Encouraging formerly incarcerated individuals with opioid use disorder to initiate evidence-based treatments, including BMT, should be part of efforts to confront the opioid addiction epidemic in the United States.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalSubstance Abuse
DOIs
StateAccepted/In press - Dec 9 2016

Fingerprint

Buprenorphine
Opioid Analgesics
Therapeutics
Confounding Factors (Epidemiology)
Odds Ratio
HIV
Confidence Intervals
Acquired Immunodeficiency Syndrome
Research Personnel
Criminal Law
Sample Size

Keywords

  • Buprenorphine
  • criminal justice
  • HIV
  • incarceration
  • opiate addiction
  • opiate substitution treatment
  • opioid-related disorders

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health

Cite this

@article{78a9e7d9bca34faca9aace6a2e27cb29,
title = "Recent incarceration and buprenorphine maintenance treatment outcomes among human immunodeficiency virus–positive patients",
abstract = "Background: Opioid use disorder is a common cause of morbidity and mortality among people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Buprenorphine maintenance treatment (BMT) is an effective means of therapy, but patients with recent criminal justice involvement may need more support during BMT than other patients. The authors hypothesized that recently incarcerated BMT patients who initiated treatment in primary care would have poorer treatment outcomes than those who were not recently incarcerated. Methods: Investigators analyzed data from a multisite cohort study of BMT integrated into HIV care. Patients were stratified by self-reported incarceration in the 30 days before initiation of BMT. The outcomes of interest were 6- and 12-month treatment retention and self-reported opioid use. Investigators used multivariable logistic regression and hierarchical linear model, respectively, to evaluate the association between recent incarceration and these outcomes while adjusting for potential confounding variables. Results: Among 305 BMT patients living with HIV/AIDS, 39 (13{\%}) reported recent incarceration. Patients with recent incarceration (vs. without) were more likely to be homeless, unemployed, and previously diagnosed with mental illness. Recent incarceration was not significantly associated with differences in 6-month (odds ratio [OR] = 0.95; 95{\%} confidence interval [CI] = 0.46–1.98) and 12-month (OR = 0.57; 95{\%} CI = 0.27–1.18) treatment retention or in self-reported opioid use (OR = 0.99; 95{\%} CI = 0.51–1.92) after adjustment for potential confounding variables. Conclusions: Those with incarceration in the 30 days prior to BMT initiation were more likely to be homeless, unemployed, and previously diagnosed with mental illness than those without recent incarceration. However, no significant difference in self-reported opioid use or 6-month or 12-month retention in treatment was detected between those with and without recent incarceration. Future studies should confirm these findings with larger sample sizes. Encouraging formerly incarcerated individuals with opioid use disorder to initiate evidence-based treatments, including BMT, should be part of efforts to confront the opioid addiction epidemic in the United States.",
keywords = "Buprenorphine, criminal justice, HIV, incarceration, opiate addiction, opiate substitution treatment, opioid-related disorders",
author = "Riggins, {Daniel P.} and Cunningham, {Chinazo O.} and Yuming Ning and Fox, {Aaron D.}",
year = "2016",
month = "12",
day = "9",
doi = "10.1080/08897077.2016.1220443",
language = "English (US)",
pages = "1--6",
journal = "Substance Abuse",
issn = "0889-7077",
publisher = "Routledge",

}

TY - JOUR

T1 - Recent incarceration and buprenorphine maintenance treatment outcomes among human immunodeficiency virus–positive patients

AU - Riggins, Daniel P.

AU - Cunningham, Chinazo O.

AU - Ning, Yuming

AU - Fox, Aaron D.

PY - 2016/12/9

Y1 - 2016/12/9

N2 - Background: Opioid use disorder is a common cause of morbidity and mortality among people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Buprenorphine maintenance treatment (BMT) is an effective means of therapy, but patients with recent criminal justice involvement may need more support during BMT than other patients. The authors hypothesized that recently incarcerated BMT patients who initiated treatment in primary care would have poorer treatment outcomes than those who were not recently incarcerated. Methods: Investigators analyzed data from a multisite cohort study of BMT integrated into HIV care. Patients were stratified by self-reported incarceration in the 30 days before initiation of BMT. The outcomes of interest were 6- and 12-month treatment retention and self-reported opioid use. Investigators used multivariable logistic regression and hierarchical linear model, respectively, to evaluate the association between recent incarceration and these outcomes while adjusting for potential confounding variables. Results: Among 305 BMT patients living with HIV/AIDS, 39 (13%) reported recent incarceration. Patients with recent incarceration (vs. without) were more likely to be homeless, unemployed, and previously diagnosed with mental illness. Recent incarceration was not significantly associated with differences in 6-month (odds ratio [OR] = 0.95; 95% confidence interval [CI] = 0.46–1.98) and 12-month (OR = 0.57; 95% CI = 0.27–1.18) treatment retention or in self-reported opioid use (OR = 0.99; 95% CI = 0.51–1.92) after adjustment for potential confounding variables. Conclusions: Those with incarceration in the 30 days prior to BMT initiation were more likely to be homeless, unemployed, and previously diagnosed with mental illness than those without recent incarceration. However, no significant difference in self-reported opioid use or 6-month or 12-month retention in treatment was detected between those with and without recent incarceration. Future studies should confirm these findings with larger sample sizes. Encouraging formerly incarcerated individuals with opioid use disorder to initiate evidence-based treatments, including BMT, should be part of efforts to confront the opioid addiction epidemic in the United States.

AB - Background: Opioid use disorder is a common cause of morbidity and mortality among people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Buprenorphine maintenance treatment (BMT) is an effective means of therapy, but patients with recent criminal justice involvement may need more support during BMT than other patients. The authors hypothesized that recently incarcerated BMT patients who initiated treatment in primary care would have poorer treatment outcomes than those who were not recently incarcerated. Methods: Investigators analyzed data from a multisite cohort study of BMT integrated into HIV care. Patients were stratified by self-reported incarceration in the 30 days before initiation of BMT. The outcomes of interest were 6- and 12-month treatment retention and self-reported opioid use. Investigators used multivariable logistic regression and hierarchical linear model, respectively, to evaluate the association between recent incarceration and these outcomes while adjusting for potential confounding variables. Results: Among 305 BMT patients living with HIV/AIDS, 39 (13%) reported recent incarceration. Patients with recent incarceration (vs. without) were more likely to be homeless, unemployed, and previously diagnosed with mental illness. Recent incarceration was not significantly associated with differences in 6-month (odds ratio [OR] = 0.95; 95% confidence interval [CI] = 0.46–1.98) and 12-month (OR = 0.57; 95% CI = 0.27–1.18) treatment retention or in self-reported opioid use (OR = 0.99; 95% CI = 0.51–1.92) after adjustment for potential confounding variables. Conclusions: Those with incarceration in the 30 days prior to BMT initiation were more likely to be homeless, unemployed, and previously diagnosed with mental illness than those without recent incarceration. However, no significant difference in self-reported opioid use or 6-month or 12-month retention in treatment was detected between those with and without recent incarceration. Future studies should confirm these findings with larger sample sizes. Encouraging formerly incarcerated individuals with opioid use disorder to initiate evidence-based treatments, including BMT, should be part of efforts to confront the opioid addiction epidemic in the United States.

KW - Buprenorphine

KW - criminal justice

KW - HIV

KW - incarceration

KW - opiate addiction

KW - opiate substitution treatment

KW - opioid-related disorders

UR - http://www.scopus.com/inward/record.url?scp=85006165426&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85006165426&partnerID=8YFLogxK

U2 - 10.1080/08897077.2016.1220443

DO - 10.1080/08897077.2016.1220443

M3 - Article

SP - 1

EP - 6

JO - Substance Abuse

JF - Substance Abuse

SN - 0889-7077

ER -