Methadone maintenance therapy and viral suppression among HIV-infected opioid users: The impacts of crack and injection cocaine use

- The effect of methadone maintenance therapy (MMT) on viral suppression varied according to distinct patterns of cocaine use.
- MMT was associated with increased odds of viral suppression among less than daily cocaine injectors.
- Daily cocaine injectors did not experience the beneficial impact of MMT on viral suppression.
- MMT was associated with increased odds of viral suppression regardless of crack cocaine use.

BackgroundMethadone maintenance therapy (MMT) is associated with improved HIV treatment outcomes among people who use drugs (PWUD). The extent to which these benefits are sustained in the context of ongoing cocaine use is unclear. We assessed differential impacts of MMT on HIV viral load (VL) suppression in relation to discrete patterns of cocaine use.MethodsData was drawn from ACCESS, a prospective cohort of HIV-positive PWUD in Vancouver, Canada. Generalized linear mixed-effects were used to model the independent effect of MMT on VL suppression across strata of frequency of cocaine injection and crack smoking (≥daily versus