Search tips
Search criteria 


Logo of pubhealthrepPublic Health Reports
Public Health Rep. 1998 June; 113(Suppl 1): 97–106.
PMCID: PMC1307732

Drug abuse treatment as AIDS prevention.


OBJECTIVE: As the acquired immunodeficiency syndrome (AIDS) epidemic among drug users enters its third decade in the United States, it is important to consider the role playing by substance abuse treatment in the prevention of human immunodeficiency virus (HIV) infection. METHODS: The authors review the research literature, examining findings from studies with behavioral and serologic measures on the association among treatment participation, HIV risk reduction, and HIV infection. RESULTS: Numerous studies have now documented that significantly lower rates of drug use and related risk behaviors are practiced by injecting drug users (IDUs) who are in treatment. Importantly, these behavioral differences, based primarily on self-report, are consistent with studies that have examined HIV seroprevalence and seroincidence among drug users. CONCLUSION: The underlying mechanism of action suggested by the collective findings of the available literature is rather simple-- individuals who enter and remain in treatment reduce their drug use, when leads to fewer instances of drug-related risk behavior. This lower rate of exposure results in fewer infections with HIV. The protective effects of treatment, however, can only be achieved when programs are accessible and responsive to the changing needs of drug users. Future research needs to be directed at developing a better understanding of the factors that enhance treatment entry and retention.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (3.0M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Des Jarlais DC, Friedman SR, Hopkins W. Risk reduction for the acquired immunodeficiency syndrome among intravenous drug users. Ann Intern Med. 1985 Nov;103(5):755–759. [PubMed]
  • Booth RE, Watters JK. How effective are risk-reduction interventions targeting injecting drug users? AIDS. 1994 Nov;8(11):1515–1524. [PubMed]
  • Cooper JR. Methadone treatment and acquired immunodeficiency syndrome. JAMA. 1989 Sep 22;262(12):1664–1668. [PubMed]
  • Orr MF, Glebatis D, Friedmann P, des Jarlais DC, Prevots DR. Incidence of HIV infection in a New York City methadone maintenance treatment program. JAMA. 1996 Jul 10;276(2):99–99. [PubMed]
  • Hubbard RL, Marsden ME, Cavanaugh E, Rachal JV, Ginzburg HM. Role of drug-abuse treatment in limiting the spread of AIDS. Rev Infect Dis. 1988 Mar-Apr;10(2):377–384. [PubMed]
  • McCusker J, Stoddard AM, Hindin RN, Garfield FB, Frost R. Changes in HIV risk behavior following alternative residential programs of drug abuse treatment and AIDS education. Ann Epidemiol. 1996 Mar;6(2):119–125. [PubMed]
  • Kozel NJ, Adams EH. Epidemiology of drug abuse: an overview. Science. 1986 Nov 21;234(4779):970–974. [PubMed]
  • Hahn RA, Onorato IM, Jones TS, Dougherty J. Prevalence of HIV infection among intravenous drug users in the United States. JAMA. 1989 May 12;261(18):2677–2684. [PubMed]
  • Marmor M, Des Jarlais DC, Cohen H, Friedman SR, Beatrice ST, Dubin N, el-Sadr W, Mildvan D, Yancovitz S, Mathur U, et al. Risk factors for infection with human immunodeficiency virus among intravenous drug abusers in New York City. AIDS. 1987 May;1(1):39–44. [PubMed]
  • Greenfield L, Brady JV, Besteman KJ, De Smet A. Patient retention in mobile and fixed-site methadone maintenance treatment. Drug Alcohol Depend. 1996 Oct;42(2):125–131. [PubMed]
  • Ball JC, Lange WR, Myers CP, Friedman SR. Reducing the risk of AIDS through methadone maintenance treatment. J Health Soc Behav. 1988 Sep;29(3):214–226. [PubMed]
  • Booth RE, Crowley TJ, Zhang Y. Substance abuse treatment entry, retention and effectiveness: out-of-treatment opiate injection drug users. Drug Alcohol Depend. 1996 Sep;42(1):11–20. [PubMed]
  • Caplehorn JR, Ross MW. Methadone maintenance and the likelihood of risky needle-sharing. Int J Addict. 1995 May;30(6):685–698. [PubMed]
  • Meandzija B, O'Connor PG, Fitzgerald B, Rounsaville BJ, Kosten TR. HIV infection and cocaine use in methadone maintained and untreated intravenous drug users. Drug Alcohol Depend. 1994 Oct;36(2):109–113. [PubMed]
  • Avins AL, Lindan CP, Woods WJ, Hudes ES, Boscarino JA, Kay J, Clark W, Hulley SB. Changes in HIV-related behaviors among heterosexual alcoholics following addiction treatment. Drug Alcohol Depend. 1997 Jan 10;44(1):47–55. [PubMed]
  • Amsel Z, Mandell W, Matthias L, Mason C, Hocherman I. Reliability and validity of self-reported illegal activities and drug use collected from narcotic addicts. Int J Addict. 1976;11(2):325–336. [PubMed]
  • Catania JA, Gibson DR, Chitwood DD, Coates TJ. Methodological problems in AIDS behavioral research: influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull. 1990 Nov;108(3):339–362. [PubMed]
  • Brown LS, Jr, Burkett W, Primm BJ. Drug treatment and HIV seropositivity. N Y State J Med. 1988 Mar;88(3):156–156. [PubMed]
  • Novick DM, Joseph H, Croxson TS, Salsitz EA, Wang G, Richman BL, Poretsky L, Keefe JB, Whimbey E. Absence of antibody to human immunodeficiency virus in long-term, socially rehabilitated methadone maintenance patients. Arch Intern Med. 1990 Jan;150(1):97–99. [PubMed]
  • Moss AR, Vranizan K, Gorter R, Bacchetti P, Watters J, Osmond D. HIV seroconversion in intravenous drug users in San Francisco, 1985-1990. AIDS. 1994 Feb;8(2):223–231. [PubMed]
  • Williams AB, McNelly EA, Williams AE, D'Aquila RT. Methadone maintenance treatment and HIV type 1 seroconversion among injecting drug users. AIDS Care. 1992;4(1):35–41. [PubMed]
  • Serpelloni G, Carrieri MP, Rezza G, Morganti S, Gomma M, Binkin N. Methadone treatment as a determinant of HIV risk reduction among injecting drug users: a nested case-control study. AIDS Care. 1994;6(2):215–220. [PubMed]
  • Metzger DS, Woody GE, McLellan AT, O'Brien CP, Druley P, Navaline H, DePhilippis D, Stolley P, Abrutyn E. Human immunodeficiency virus seroconversion among intravenous drug users in- and out-of-treatment: an 18-month prospective follow-up. J Acquir Immune Defic Syndr. 1993 Sep;6(9):1049–1056. [PubMed]
  • Friedman SR, Jose B, Deren S, Des Jarlais DC, Neaigus A. Risk factors for human immunodeficiency virus seroconversion among out-of-treatment drug injectors in high and low seroprevalence cities. The National AIDS Research Consortium. Am J Epidemiol. 1995 Oct 15;142(8):864–874. [PubMed]
  • Schuster CR. Intravenous drug use and AIDS prevention. Public Health Rep. 1988 May-Jun;103(3):261–266. [PMC free article] [PubMed]
  • Siegal HA, Carlson RG, Falck RS, Wang J. Drug abuse treatment experience and HIV risk behaviors among active drug injectors in Ohio. Am J Public Health. 1995 Jan;85(1):105–108. [PubMed]
  • Etheridge RM, Craddock SG, Dunteman GH, Hubbard RL. Treatment services in two national studies of community-based drug abuse treatment programs. J Subst Abuse. 1995;7(1):9–26. [PubMed]
  • McLellan AT, Arndt IO, Metzger DS, Woody GE, O'Brien CP. The effects of psychosocial services in substance abuse treatment. JAMA. 1993 Apr 21;269(15):1953–1959. [PubMed]
  • Yancovitz SR, Des Jarlais DC, Peyser NP, Drew E, Friedmann P, Trigg HL, Robinson JW. A randomized trial of an interim methadone maintenance clinic. Am J Public Health. 1991 Sep;81(9):1185–1191. [PubMed]

Articles from Public Health Reports are provided here courtesy of SAGE Publications