2024
Integrating methadone into primary care settings in Ukraine: effects on provider stigma and knowledge
Bromberg D, Machavariani E, Madden L, Dumchev K, LaMonaca K, Earnshaw V, Pykalo I, Filippovych M, Haddad M, Dvoriak S, Altice F. Integrating methadone into primary care settings in Ukraine: effects on provider stigma and knowledge. Journal Of The International AIDS Society 2024, 27: e26202. PMID: 38379179, PMCID: PMC10879646, DOI: 10.1002/jia2.26202.Peer-Reviewed Original ResearchConceptsPrimary care clinicsStigma reduction interventionsOpioid agonist therapyClinicians' attitudesStigma constructsHIV preventionReduction interventionsEvidence-based HIV preventionCluster randomized controlled trialEvidence-based carePrimary care settingIntegrated care sitesDirect providersRandomized controlled trialsProvider stigmaCare clinicsCare sitesHIV careCare settingsHealth outcomesClinical staffSubstance use disordersLinear mixed-effects modelsTreatment continuumImprove attitudes
2022
Impact of prerelease methadone on mortality among people with HIV and opioid use disorder after prison release: results from a randomized and participant choice open-label trial in Malaysia
Bazazi A, Culbert G, Wegman M, Heimer R, Kamarulzaman A, Altice F. Impact of prerelease methadone on mortality among people with HIV and opioid use disorder after prison release: results from a randomized and participant choice open-label trial in Malaysia. BMC Infectious Diseases 2022, 22: 837. PMID: 36368939, PMCID: PMC9652918, DOI: 10.1186/s12879-022-07804-6.Peer-Reviewed Original ResearchConceptsOpioid use disorderOpioid agonist therapyInfectious etiologyMost deathsUse disordersSample of menPrison releaseOpen-label trialT-lymphocyte countsPredictors of mortalityNational death recordsCrude mortality rateProportional hazards modelCovariate-adjusted modelsLow CD4Methadone initiationModified intentionAgonist therapySurvival benefitTreat analysisMethodsThis studyHIVHazards modelMortality rateMethadoneInterest without uptake: A mixed-methods analysis of methadone utilization in Kyrgyz prisons
Liberman AR, Bromberg DJ, Litz T, Kurmanalieva A, Galvez S, Rozanova J, Azbel L, Meyer JP, Altice FL. Interest without uptake: A mixed-methods analysis of methadone utilization in Kyrgyz prisons. PLOS ONE 2022, 17: e0276723. PMID: 36282864, PMCID: PMC9595522, DOI: 10.1371/journal.pone.0276723.Peer-Reviewed Original ResearchConceptsKyrgyz prisonsCriminal justice systemDepth qualitative interviewsMethadone utilizationMethadone treatmentMixed-method analysisBrief interventionJustice systemPrison systemCriminal subcultureQualitative interviewsEastern EuropeEvidence-based HIV prevention strategiesCentral AsiaKyrgyz RepublicQualitative findingsPrison releaseHIV prevention strategiesPrisonInjection drug useMedication-assisted therapyMethadone uptakeInterpersonal relationshipsAttitudesHealth-related concernsA pilot implementation study to scale-up methadone in incarcerated persons with opioid use disorder and retain them on treatment after release in Moldova
Dorgay CE, Bromberg DJ, Doltu S, Litz T, Galvez S, Polonsky M, Dvoryak S, Altice FL. A pilot implementation study to scale-up methadone in incarcerated persons with opioid use disorder and retain them on treatment after release in Moldova. International Journal Of Drug Policy 2022, 104: 103683. PMID: 35417790, PMCID: PMC9827420, DOI: 10.1016/j.drugpo.2022.103683.Peer-Reviewed Original ResearchConceptsMethadone maintenance treatmentOpioid use disorderUse disordersBrief interventionPilot implementation studySBIRT interventionTreatment initiationMaintenance treatmentMethadonePotential implementation strategiesIncarcerated personsInterventionImplementation studyTreatment proceduresBaselineDisordersTreatmentParticipantsDays of releaseReleaseImplementation strategiesPre-trial detention facilitySessionsHIVReferral
2021
Methadone within prison and linkage to and retention in treatment upon community release for people with opioid use disorder in Kyrgyzstan: Evaluation of a national program
Bachireddy C, Shrestha R, Bromberg DJ, Azbel L, Kurmanalieva A, Wegman M, Shumskaya N, Rozanova J, Meyer JP, Altice FL. Methadone within prison and linkage to and retention in treatment upon community release for people with opioid use disorder in Kyrgyzstan: Evaluation of a national program. International Journal Of Drug Policy 2021, 101: 103558. PMID: 34915426, PMCID: PMC9998103, DOI: 10.1016/j.drugpo.2021.103558.Peer-Reviewed Original ResearchConceptsHIV statusMean treatment durationOpioid use disorderPositive HIV statusDuration of treatmentMethadone doseHIV incidenceMethadone servicesMethadone treatmentIndependent correlatesHIV preventionUse disordersTreatment durationMethadoneNational programTreatmentHIVAdministrative dataCommunity releaseMonthsKyrgyz prisonsFirst evaluationIncarcerated peopleDurationReleaseMulti-level implementation factors that influence scale-up of methadone maintenance treatment in Moldovan prisons: A qualitative study
O'Hara GL, Liberman AR, Polonsky M, Azbel L, Marcus R, Doltu S, Cugut S, Altice FL. Multi-level implementation factors that influence scale-up of methadone maintenance treatment in Moldovan prisons: A qualitative study. Journal Of Substance Use And Addiction Treatment 2021, 136: 108660. PMID: 34801282, PMCID: PMC10879837, DOI: 10.1016/j.jsat.2021.108660.Peer-Reviewed Original ResearchConceptsMethadone maintenance treatmentCentral Asian regionNegative personal attitudesPrison hierarchySocial forcesInformal hierarchyMaintenance treatmentThematic barriersQualitative interviewsPrison populationInterview dataAsian regionPrisonPrison settingQualitative studyQuantitative surveyKey barriersNew HIV infectionsOpioid use disorderContent analysisComplete interview dataQualitative analysisDistrustPersonal attitudesPrisonersDecisional considerations for methadone uptake in Kyrgyz prisons: The importance of understanding context and providing accurate information
Liberman AR, Bromberg DJ, Azbel L, Rozanova J, Madden L, Meyer JP, Altice FL. Decisional considerations for methadone uptake in Kyrgyz prisons: The importance of understanding context and providing accurate information. International Journal Of Drug Policy 2021, 94: 103209. PMID: 33838398, PMCID: PMC8373625, DOI: 10.1016/j.drugpo.2021.103209.Peer-Reviewed Original ResearchConceptsKyrgyz prisonsInformal governance systemSecondary thematic analysisMethadone uptakePrison governanceGovernance systemPrison economyPrison administrationQualitative interviewsInterrelated themesSocial risksPrison contextEastern EuropePrisonCentral AsiaKyrgyz RepublicUnderstanding contextThematic analysisDecisional considerationsContent analysisMethadone treatmentRespondents' perceptionsHIV preventionMethadone utilizationInterviewsWillingness to initiate pre-exposure prophylaxis (PrEP) and its use among opioid-dependent individuals in drug treatment
Ni Z, Altice FL, Wickersham JA, Copenhaver MM, DiDomizio EE, Nelson LE, Shrestha R. Willingness to initiate pre-exposure prophylaxis (PrEP) and its use among opioid-dependent individuals in drug treatment. Drug And Alcohol Dependence 2021, 219: 108477. PMID: 33422864, PMCID: PMC7946167, DOI: 10.1016/j.drugalcdep.2020.108477.Peer-Reviewed Original ResearchConceptsOpioid-dependent individualsPre-exposure prophylaxisPrEP useHIV riskHealthcare providersSex-related risk behaviorsMultivariable logistic regression analysisAwareness of PrEPUrban methadone clinicMultiple logistic regressionDisproportionate HIV burdenLogistic regression analysisCross-sectional surveyHIV burdenHIV infectionHIV testingIndependent correlatesMethadone clinicsDrug treatmentRisk behaviorsLogistic regressionPrEPPrevious useHigher likelihoodProphylaxis
2020
Rapid transitional response to the COVID-19 pandemic by opioid agonist treatment programs in Ukraine
Meteliuk A, Galvez de Leon SJ, Madden LM, Pykalo I, Fomenko T, Filippovych M, Farnum SO, Dvoryak S, Islam ZM, Altice FL. Rapid transitional response to the COVID-19 pandemic by opioid agonist treatment programs in Ukraine. Journal Of Substance Use And Addiction Treatment 2020, 121: 108164. PMID: 33191004, PMCID: PMC7769928, DOI: 10.1016/j.jsat.2020.108164.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyTake-home dosingInterim guidanceShort-term overall mortalityOpioid agonist treatment programPerson clinical encountersOAT deliveryAgonist therapyOverall mortalityCOVID-19 transmissionPatient dropoutOAT patientsNaloxone distributionOverdose educationClinical practiceClinic interactionsTreatment programClinical encountersPatientsCliniciansCOVID-19COVID-19 pandemicOverdosesDosingPrevious yearThe real‐world impact of dosing of methadone and buprenorphine in retention on opioid agonist therapies in Ukraine
Farnum SO, Makarenko I, Madden L, Mazhnaya A, Marcus R, Prokhorova T, Bojko MJ, Rozanova J, Dvoriak S, Islam Z, Altice FL. The real‐world impact of dosing of methadone and buprenorphine in retention on opioid agonist therapies in Ukraine. Addiction 2020, 116: 83-93. PMID: 32428276, PMCID: PMC7674222, DOI: 10.1111/add.15115.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyOAT discontinuationAgonist therapyTreatment retentionIndependent predictorsHIV epidemicCost-effective HIV prevention strategyMethadone maintenance treatment patientsObservational longitudinal cohort studySpecialty addictions treatmentBuprenorphine maintenance treatmentHigh dosageHIV prevention strategiesLongitudinal cohort studyOpioid-dependent peopleTreatment discontinuationCohort studyMaintenance treatmentMale sexTreatment patientsPrevention strategiesDiscontinuationYounger ageCenter settingAddiction treatmentAdherence to and Retention in Medications for Opioid Use Disorder Among Adolescents and Young Adults
Viera A, Bromberg DJ, Whittaker S, Refsland BM, Stanojlović M, Nyhan K, Altice FL. Adherence to and Retention in Medications for Opioid Use Disorder Among Adolescents and Young Adults. Epidemiologic Reviews 2020, 42: 41-56. PMID: 32239206, PMCID: PMC8087870, DOI: 10.1093/epirev/mxaa001.Peer-Reviewed Original ResearchConceptsOpioid use disorderUse disordersYoung adultsAssociation of ageFull-text reviewRetention of adolescentsConcurrent substance useNegative health outcomesMOUD retentionOpioid epidemicInclusion criteriaHealth outcomesYounger ageAge groupsMOUDSubstance useAdherenceGood evidenceAdultsMedicationsDisordersAdolescentsSearch criteriaAgeOutcomes
2019
HIV-Related Stigma, Motivation to Adhere to Antiretroviral Therapy, and Medication Adherence Among HIV-Positive Methadone-Maintained Patients
Shrestha R, Altice FL, Copenhaver MM. HIV-Related Stigma, Motivation to Adhere to Antiretroviral Therapy, and Medication Adherence Among HIV-Positive Methadone-Maintained Patients. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2019, 80: 166-173. PMID: 30383588, PMCID: PMC6331231, DOI: 10.1097/qai.0000000000001891.Peer-Reviewed Original ResearchConceptsOptimal ART adherenceAntiretroviral therapyMethadone-maintained patientsMethadone maintenance treatmentART adherenceMaintenance treatmentHIV treatment outcomesHIV-positive patientsOpioid agonist therapyMultivariable logistic regressionHIV risk behaviorsExplanatory pathwaysAgonist therapySuboptimal adherenceMedication adherenceHIV treatmentTreatment outcomesHIV stigmaPatientsLogistic regressionHIVPrevention initiativesTherapyAdherenceSignificant correlatesRetention in clinical trials after prison release: results from a clinical trial with incarcerated men with HIV and opioid dependence in Malaysia
Chandra DK, Bazazi AR, Solim M, Kamarulzaman A, Altice FL, Culbert GJ. Retention in clinical trials after prison release: results from a clinical trial with incarcerated men with HIV and opioid dependence in Malaysia. HIV Research & Clinical Practice 2019, 20: 12-23. PMID: 31303149, PMCID: PMC6698147, DOI: 10.1080/15284336.2019.1603433.Peer-Reviewed Original ResearchConceptsClinical trialsStudy visitHIV clinical trialsOpioid dependenceMethadone initiationStudy retentionHolistic Health Recovery ProgramPrison releaseHIV risk reduction interventionsRisk reduction interventionsIncarcerated menStandard careMethadone treatmentReduction interventionsStudy participantsFactorial trialHIVBehavioral interventionsTrialsVisitsMost participantsInterventionMenCommunity reentryRecovery program
2018
Adherence to Antiretroviral Therapy Among Incarcerated Persons with HIV: Associations with Methadone and Perceived Safety
Culbert GJ, Waluyo A, Wang M, Putri TA, Bazazi AR, Altice FL. Adherence to Antiretroviral Therapy Among Incarcerated Persons with HIV: Associations with Methadone and Perceived Safety. AIDS And Behavior 2018, 23: 2048-2058. PMID: 30465106, PMCID: PMC6698149, DOI: 10.1007/s10461-018-2344-6.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyART adherenceART utilizationMethadone utilizationHIV status disclosureHealth service satisfactionStatus disclosureMedical treatmentDrug dependencyPWHAdherenceMost participantsHIVMethadoneTherapyChance locusSafetyAdequate supportHigh levelsPerceived SafetyPersonal safetyOpioid Agonist Treatment and Improved Outcomes at Each Stage of the HIV Treatment Cascade in People Who Inject Drugs in Ukraine
Mazhnaya A, Marcus R, Bojko MJ, Zelenev A, Makarenko I, Pykalo I, Filippovych S, Dvoriak S, Altice FL. Opioid Agonist Treatment and Improved Outcomes at Each Stage of the HIV Treatment Cascade in People Who Inject Drugs in Ukraine. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2018, 79: 288-295. PMID: 30312275, PMCID: PMC8215524, DOI: 10.1097/qai.0000000000001827.Peer-Reviewed Original ResearchConceptsOpioid agonist treatmentHIV treatment cascadeTreatment cascadeAgonist treatmentIndependent factorsHepatitis C virus testingOpioid-dependent PWIDOpioid use disorderClinical care settingsLogistic regression modelsOAT coverageAntiretroviral therapyHIV careUNAIDS 90HIV preventionImproved outcomesTreatment strategiesCare settingsVirus testingNationwide studyPWIDUse disordersOAT expansionHIVCareDrug injection within prison in Kyrgyzstan: elevated HIV risk and implications for scaling up opioid agonist treatments
Azbel L, Wegman MP, Polonsky M, Bachireddy C, Meyer J, Shumskaya N, Kurmanalieva A, Dvoryak S, Altice FL. Drug injection within prison in Kyrgyzstan: elevated HIV risk and implications for scaling up opioid agonist treatments. International Journal Of Prison Health 2018, 14: 175-187. PMID: 30274558, PMCID: PMC6447033, DOI: 10.1108/ijph-03-2017-0016.Peer-Reviewed Original ResearchConceptsMethadone maintenance treatmentNeedle syringe programsDrug injectionDrug injectorsHigh HIV risk behaviorElevated HIV riskPrison drug injectionHepatitis C infectionOpioid agonist treatmentHIV risk behaviorsC infectionHIV incidenceAgonist treatmentMaintenance treatmentIndependent correlatesBiobehavioral surveysHIV riskOnly examinationRisk behaviorsMMT useLow uptakeCurrent incarcerationInjectionLogit linkHigh-risk environmentsIntegrated Bio-behavioral Approach to Improve Adherence to Pre-exposure Prophylaxis and Reduce HIV Risk in People Who Use Drugs: A Pilot Feasibility Study
Shrestha R, Altice FL, Karki P, Copenhaver MM. Integrated Bio-behavioral Approach to Improve Adherence to Pre-exposure Prophylaxis and Reduce HIV Risk in People Who Use Drugs: A Pilot Feasibility Study. AIDS And Behavior 2018, 22: 2640-2649. PMID: 29582199, PMCID: PMC6051885, DOI: 10.1007/s10461-018-2099-0.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnalgesics, OpioidBiobehavioral SciencesCondomsFeasibility StudiesFemaleHIV InfectionsHumansMaleMedication AdherenceMethadoneMiddle AgedMotivationOpiate Substitution TreatmentOpioid-Related DisordersPatient Acceptance of Health CarePilot ProjectsPre-Exposure ProphylaxisProspective StudiesRisk Reduction BehaviorSexual BehaviorSexual PartnersSubstance Abuse, IntravenousConceptsPre-exposure prophylaxis adherenceSelf-reported PrEP adherenceSex-related risk behaviorsHIV risk reduction behaviorsBio-behavioral interventionPre-exposure prophylaxisProspective clinical trialsHigh-risk peopleHIV prevention interventionsHIV risk behaviorsPilot feasibility studyPost-intervention assessmentPrEP adherenceProphylaxis adherencePreliminary efficacyClinical trialsIntervention groupHIV riskPrevention interventionsRisk behaviorsBio-behavioral approachAdherenceInterventionHigh acceptabilityPrEPConcurrent drug injection during opioid agonist treatment among people who inject drugs in Ukraine
Makarenko I, Mazhnaya A, Marcus R, Pykalo I, Madden L, Filippovich S, Dvoriak S, Altice FL. Concurrent drug injection during opioid agonist treatment among people who inject drugs in Ukraine. Journal Of Substance Use And Addiction Treatment 2018, 87: 1-8. PMID: 29471921, PMCID: PMC5826566, DOI: 10.1016/j.jsat.2018.01.007.Peer-Reviewed Original ResearchConceptsOpioid agonist treatmentMethadone maintenance treatmentConcurrent illicit drug useOAT patientsIllicit drug useDrug injectionDrug useAgonist treatmentUse disordersMultivariable logistic regressionConcurrent drug useOngoing drug usePolysubstance use disorderAlcohol use disorderMaintenance treatmentIndependent correlatesBMT programSevere opioidDrug injectingPatientsHealth outcomesTreatment dropoutAlcohol dependenceInjection initiationYounger age
2017
Using nominal group technique among clinical providers to identify barriers and prioritize solutions to scaling up opioid agonist therapies in Ukraine
Madden L, Bojko MJ, Farnum S, Mazhnaya A, Fomenko T, Marcus R, Barry D, Ivanchuk I, Kolomiets V, Filippovych S, Dvoryak S, Altice FL. Using nominal group technique among clinical providers to identify barriers and prioritize solutions to scaling up opioid agonist therapies in Ukraine. International Journal Of Drug Policy 2017, 49: 48-53. PMID: 28957756, DOI: 10.1016/j.drugpo.2017.07.025.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyNominal group techniqueAgonist therapyBuprenorphine maintenance treatmentAddiction treatment approachesImplementation science strategiesOAT servicesMaintenance treatmentClinical providersTreatment approachesTreatment servicesNGT discussionRegional controlTherapyCliniciansGroup techniqueStructural barriersWhy People Who Inject Drugs Voluntarily Transition Off Methadone in Ukraine
Rozanova J, Marcus R, Taxman FS, Bojko MJ, Madden L, Farnum SO, Mazhnaya A, Dvoriak S, Altice FL. Why People Who Inject Drugs Voluntarily Transition Off Methadone in Ukraine. Qualitative Health Research 2017, 27: 2057-2070. PMID: 28942704, DOI: 10.1177/1049732317732307.Peer-Reviewed Original Research