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February 24, 1999

Use of Antiretroviral Therapy by Intravenous Drug Users With HIV—Reply

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(8):699-701. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-8-jbk0224

In Reply: In response to Dr Anderson's request, we calculated the odds of not receiving ART for IDUs according to enrollment in methadone maintenance programs. In univariate analysis, IDUs not enrolled in methadone maintenance programs were more than 3 times more likely to not receive ART (OR, 3.75; 95% CI, 1.77-7.97). This OR was virtually identical to the OR associated with nonenrollment in any drug or alcohol treatment program. In multivariate analyses, controlling for sex, age, physician HIV experience and both CD4 cell count and HIV-1 RNA at eligibility, the adjusted OR (AOR) associated with nonenrollment in a methadone program was also similar to our previous results (AOR, 4.01; 95% CI, 1.47-10.89). Small numbers precluded a subanalysis of ART use by attendance at other substance abuse programs. We have no data to assess the relationship between physician methadone prescribing and ART experience.