Predictors of Treatment Retention in Enhanced and Standard Methadone Maintenance Treatment for HIV Risk Reduction

Survival analysis was used to determine the predictors of discharge from a methadone maintenance treatment program for heroin addicts at high-risk for HIV infection and/or transmission. A consistent set of predictors was identified that was associated with treatment discharge at 90 days, 12 months,...

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Bibliographic Details
Published in:Journal of drug issues 1997-04, Vol.27 (2), p.203-224
Main Authors: Grella, Christine E., Wugalter, Stuart E., Anglin, M. Douglas
Format: Article
Language:English
Subjects:
Acquired Immune Deficiency Syndrome
Addicts
Attrition
Biological and medical sciences
Client Characteristics
Drug Addiction
Health risk assessment
Heroin
HIV
Human immunodeficiency virus
Los Angeles, California
Medical sciences
Methadone
Methadone Maintenance
Miscellaneous
Predictors
Public health. Hygiene
Public health. Hygiene-occupational medicine
Retention
Risk reduction
Substance abuse treatment
Treatment
Treatment Outcomes
Treatment Programs
USA
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Summary:Survival analysis was used to determine the predictors of discharge from a methadone maintenance treatment program for heroin addicts at high-risk for HIV infection and/or transmission. A consistent set of predictors was identified that was associated with treatment discharge at 90 days, 12 months, 18 months, and 24 months. Individuals who, at intake, were HIV seropositive, were younger, used cocaine, drank alcohol daily, and scored high on measures of depression and interpersonal problems were at a higher risk for discharge. Receipt of enhanced methadone treatment, which included case management services, group participation, psychiatric services, contingency-based reinforcers, and transportation assistance, was associated with a higher probability of retention, particularly in the first 90 days. These findings can be used to target individuals who are vulnerable to early discharge from treatment and to provide adjunctive services that may improve retention. Several of these predictors, particularly cocaine use and psychological problems, have also been associated with HIV risk among methadone clients. Increasing retention in methadone treatment will not only improve treatment efficacy but will also address the public health imperative to limit the transmission of HIV.
ISSN:0022-0426
1945-1369
DOI:10.1177/002204269702700202