Beverly L. Richman

HIV risks of men in methadone maintenance treatment programs who abuse their intimate partners: a forgotten issue.

Accumulating findings suggest a relationship between partner violence and HIV risk among women, however, this issue has yet to be adequately researched among men. This study examines the relationship between perpetrating intimate partner violence and HIV risk behavior among a sample of men in methadone maintenance treatment programs (MMTPs). Data were collected on 273 sexually active men, who were recruited from four inner-city MMTP clinics. More than a third of the sample reported perpetrating intimate physical abuse and 15% reported severe physical abuse in the past 12 months. Results from multiple logistic regression analyses indicate that after adjusting for demographic, poverty, and drug-use factors, men who abused an intimate partner were almost 4 times more likely to have more than one intimate partner, almost 3 times more likely to have unprotected anal sex, and 2.6 times more likely to have sex with a drug-injecting sexual partner than their counterparts. This study showed that men who perpetrated partner violence were at higher risk for HIV transmission. HIV prevention interventions need to consider the complex relationship between partner violence and HIV risk.

The medical status of methadone maintenance patients in treatment for 11 - 18 years

To assess the safety and potential health consequences of long-term methadone maintenance treatment, we identified 111 male patients admitted to methadone maintenance treatment between 1965 and 1968, still enrolled in 1980 and in continuous treatment for at least 10 years. We were able, between 1980 and 1985, to examine patients or review records of 110 patients (99%). Most medical diagnoses, symptomatic complaints, physical examination findings and laboratory test results occurred with similar frequency in the long-term methadone maintenance patients and in a group of 56 long-term heroin addicts. These data suggest that prolonged methadone maintenance treatment is safe and is not associated with unexpected adverse effects.

Physical and sexual intimate partner violence among women in methadone maintenance treatment

Although several studies have examined the relationship between intimate partner violence (IPV) and drug use among women in drug treatment programs, more information is needed to delineate differences, as a function of the specific drug used. Data from a random sample of 416 women attending methadone programs were analyzed to elucidate the differential associations between IPV and use of the following: marijuana only, cocaine only, heroin only, or cocaine and heroin. Prevalence of IPV among this sample far exceeded estimates from the general population. After adjusting for sociodemographic variables, use of cocaine only was significantly associated with an increased likelihood of experiencing IPV compared with no drug use. Similar results were found for women using both cocaine and heroin.