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April 26, 1995

Tuberculosis Transmission in Methadone Maintenance Programs

Author Affiliations

University of California, San Francisco
National Institutes of Health Rockville, Md

JAMA. 1995;273(16):1260. doi:10.1001/jama.1995.03520400030039

To the Editor.  —We recently reported1 that among homeless injection drug users in San Francisco, Calif, there was an increased risk for tuberculosis (TB) infection among those who had ever been in a methadone program. At that time we were unable to distinguish subjects who had been in methadone maintenance programs from those who had been in short-term (≤21 days) methadone detoxification only.We have now reexamined this question in a large group of 2774 homeless and unstably housed persons. A total of 632 subjects had skin test results, were negative for the human immunodeficiency virus (HIV), and had used injection drugs. One hundred of these had been in methadone treatment programs. We grouped the 632 subjects as follows: (1) those who had never been in any methadone treatment programs, (2) those who had ever been in methadone detoxification programs only, and (3) those who had ever been in

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