Document 0770
 DOCN  M9480770
 TI    Predictors of outcome in methadone programs: effect of HIV counseling
       and testing.
 DT    9410
 AU    Farley TA; Cartter ML; Wassell JT; Hadler JL; Division of Field
       Services, Centers for Disease Control, Atlanta,; Georgia.
 SO    Conn Med. 1994 Mar;58(3):165-71. Unique Identifier : AIDSLINE
       MED/94313846
 AB    OBJECTIVE: To identify predictors of treatment outcomes in methadone
       maintenance programs and to determine whether HIV counseling and testing
       influenced these outcomes. DESIGN: Retrospective record review. SETTING:
       Four methadone maintenance programs in four cities in Connecticut, USA.
       PARTICIPANTS: Five hundred and ninety-four clients, who began treatment
       over an 18-month period and for whom records were available, took part.
       INTERVENTIONS: HIV counseling and testing. MAIN OUTCOME MEASURES: Risk
       of treatment discontinuation and persistent in-treatment illicit drug
       use. RESULTS: The most important predictor of treatment discontinuation
       and of persistent in-treatment illicit drug use was self-reported
       pretreatment cocaine use. After controlling for this and demographic
       risk factors, clients who received initial HIV counseling, when compared
       with clients who did not, had a similar 12-month discontinuation risk
       (54% vs 59%; P = 0.08) but were less likely to show persistent illicit
       drug use (46% vs 53%; P = 0.01). Among counseled entrants who were
       tested for HIV antibodies, those receiving positive results had a
       12-month discontinuation risk similar to those receiving negative
       results (50% vs 52%), but more often showed persistent illicit drug use
       (57% vs 44%), although this difference may have been due to chance (P =
       0.28). The majority of clients who discontinued treatment did so because
       they were discharged for noncompliance with clinic rules, usually for
       failing to pay fees. CONCLUSIONS: HIV counseling and testing do not have
       a substantial adverse effect on methadone treatment outcomes. In the
       clinics under study, failure to pay clinic fees was an important factor
       contributing to discontinuation of treatment.
 DE    Adult  *AIDS Serodiagnosis/PSYCHOLOGY  Connecticut  Female  Human  HIV
       Infections/*PREVENTION & CONTROL/TRANSMISSION  Male
       Methadone/*THERAPEUTIC USE  Narcotic
       Dependence/PSYCHOLOGY/*REHABILITATION  Outcome and Process Assessment
       (Health Care)  Patient Dropouts/PSYCHOLOGY  *Patient Education
       Substance Abuse Detection/PSYCHOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).