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Mortality among HIV‐infected intravenous drug addicts in Stockholm in relation to methadone treatment
Author(s) -
FUGELSTAD ANNA,
RAJS JOVAN,
BÖTTIGER MARGARETA,
VERDIER MARIA GERHARDSSON
Publication year - 1995
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1046/j.1360-0443.1995.90571112.x
Subject(s) - medicine , methadone , methadone maintenance , confidence interval , substance abuse , relative risk , cause of death , mortality rate , demography , pediatrics , emergency medicine , psychiatry , disease , sociology
The aim of the study was to estimate the mortality rate and evaluate the causes of death in all diagnosed HIV‐positive IDUs in the Stockholm area, 1986–90, and to compare the risk of death of those who received methadone treatment with that of those never admitted to or discharged from the programme. Data were collected from the Swedish National Bacteriological Laboratory, the Methadone Maintenance Programme (MMTP) and the Department of Forensic Medicine, as well as from hospitals in the Stockholm region. In Sweden 90% of all IDUs are HIV‐tested. Most deceased IDUs are examined forensically. This examination always includes HIV‐testing. During the observation period, 472 HIV‐infected IDUs were reported from the Stockholm area. Of these addicts 135 participated in the methadone maintenance programme for a shorter or longer time during the study period. Most of them had received the HIV‐diagnosis more than 1 year before first entering the programme. Sixty‐nine subjects died during the observation period. A majority, 52 persons, died from violence or poisoning. Seventeen died from somatic complications of drug abuse. Nine of them were diagnosed as suffering from AIDS. Eight of the deceased had participated in the MMTP. The relative risk of death from external violence and poisoning was 0.25 (95% confidence interval 0.1–1.0) when participants in the MMTP were compared with HIV‐infected IDUs never attending the programme. When all causes of death are compared the relative risk was 0.8. Those patients discharged from the programme have a higher mortality rate than those who never participated. It is concluded that the programme probably contributes to a higher survival rate than for patients outside the MMTP by offering them social support, medical care and control of their drug abuse.