Heroin use outcomes for integrated HIV/buprenorphine treatment programs

Background: Integration of buprenorphine treatment of opioid dependence into HIV care settings provides an opportunity to expand treatment access and improve outcomes. There are little data available describing effectiveness of integrated programs. Methods: We analyzed data on 321 HIV+ opioid dependent patients who received office-based buprenorphine treatment in a HRSA/SPNS project studying integration of buprenorphine treatment into HIV care (BHIVES). Data included self-reported socio-demographics, general health measures, and substance use. We compared substance use outcomes at baseline and after 1-year. Results: Most patients were over 40 years old (71%); unemployed (74%); and HIV+ for >10 years (61%). There were significant decreases in heroin and other opioid use over time. Compared to baseline, after 1-year in an integrated program participants were significantly less likely to report using heroin (OR=0.17, p<.001) and other opioids (OR=0.35, p<.001). Those that reported using heroin for 5 years or fewer were twice as likey to report non heroin use after 1-year compared to participants reporting 16+ heroin using years (OR=0.45, p<.001). Gender, ethnicity, and age were not associated with self-reported heroin use at 1-year. Discussion: Buprenorphine treatment provided in HIV care settings results in reduced heroin and other substance use over time.