by Carolyn Chu, MD, MSc, AAHIVS, AAHIVM Chief Medical Officer
June 29, 2021
Kim J, Lesko CR, Fojo AT, et al. The effect of buprenorphine on HIV viral suppression. Clin Infect Dis. 2021 Jun 25; ciab578. doi: 10.1093/cid/ciab578. PMID: 34171087.
These findings add to existing evidence associating buprenorphine with HIV care engagement as well as ART uptake and adherence, and the association between buprenorphine retention and viral suppression. Authors suggest, based on this analysis, buprenorphine may actually increase prevalence of viral suppression. Such a causal relationship would greatly strengthen the case and recommendations for integrated opioid use disorder treatment (OUD) and HIV care. Incorporation of buprenorphine into HIV care settings represents a uniquely powerful and life-saving opportunity to promote cross-disciplinary collaboration and training (e.g. increasing OUD management skills/knowledge among HIV providers and increasing HIV skills/knowledge among substance use providers). Recent changes in buprenorphine practice guidelines allow for an alternative notification of intent pathway for eligible providers seeking to treat up to 30 patients: now, such providers may forego previously-required federal certification requirements related to training, counseling, and other ancillary services (more information here). HIV clinicians and programs, especially those with limited local/specialty substance use referral networks, should strongly consider integrating substance use disorder treatment—especially OUD treatment—into their practices.
The author has no conflicts of interest to disclose.
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