OST positively affects treatment adherence for people who inject drugs

People living with HIV who inject drugs have a 68% increase in the odds of refilling their antiretroviral treatment (ART) prescriptions after being exposed to opioid substitution therapy (OST). The research, published ahead of print in the journal AIDS, gives further evidence to the benefits of OST, particularly for ART adherence.

The researchers conducted a retrospective cohort study in British Colombia, Canada. They identified 1,852 people living with HIV, who had not yet started treatment, and who had received OST, or who had a history of injecting drug use. Using OST and ART dispensation records, they sought to determine the causal effect of OST exposure on ART refill adherence. They found that the OST had a positive and statistically significant effect of ART. Increased ART adherence leads directly to improved mortality and morbidity rates, and reduces new infections through viral suppression.

The results support a wide breadth of research confirming the positive association between OST and ART adherence. However, the authors note that applying the results to other settings may be difficult. British Colombia has free universal and comprehensive access to HIV treatment and OST, with OST available office-based, and in community pharmacy-based dispensation. Nonetheless, they state: “There is a priority to expand access to OST particularly within HIV-positive populations, to optimise HIV treatment uptake and adherence and its subsequent individual and population health and economic benefits.”