Scolaris Content Display Scolaris Content Display

Comparison 1 Drug use and risk outcomes (follow‐up studies), Outcome 1 Proportion reporting injecting use.
Figures and Tables -
Analysis 1.1

Comparison 1 Drug use and risk outcomes (follow‐up studies), Outcome 1 Proportion reporting injecting use.

Comparison 1 Drug use and risk outcomes (follow‐up studies), Outcome 2 Proportion sharing injecting equipment.
Figures and Tables -
Analysis 1.2

Comparison 1 Drug use and risk outcomes (follow‐up studies), Outcome 2 Proportion sharing injecting equipment.

Comparison 1 Drug use and risk outcomes (follow‐up studies), Outcome 3 Opioid use (proportion reporting use or with positive urine samples).
Figures and Tables -
Analysis 1.3

Comparison 1 Drug use and risk outcomes (follow‐up studies), Outcome 3 Opioid use (proportion reporting use or with positive urine samples).

Comparison 1 Drug use and risk outcomes (follow‐up studies), Outcome 4 Cocaine use (proportion using or with positive urine screens).
Figures and Tables -
Analysis 1.4

Comparison 1 Drug use and risk outcomes (follow‐up studies), Outcome 4 Cocaine use (proportion using or with positive urine screens).

Comparison 2 Sex‐related risk outcomes (follow‐up studies), Outcome 1 Proportion reporting multiple sex partners.
Figures and Tables -
Analysis 2.1

Comparison 2 Sex‐related risk outcomes (follow‐up studies), Outcome 1 Proportion reporting multiple sex partners.

Comparison 2 Sex‐related risk outcomes (follow‐up studies), Outcome 2 Proportion reporting unprotected sex (or use of condoms in half or less of occasions).
Figures and Tables -
Analysis 2.2

Comparison 2 Sex‐related risk outcomes (follow‐up studies), Outcome 2 Proportion reporting unprotected sex (or use of condoms in half or less of occasions).

Comparison 2 Sex‐related risk outcomes (follow‐up studies), Outcome 3 Proportion reporting exchanges of sex for drugs or money.
Figures and Tables -
Analysis 2.3

Comparison 2 Sex‐related risk outcomes (follow‐up studies), Outcome 3 Proportion reporting exchanges of sex for drugs or money.

Comparison 3 Overall risk assessments (follow‐up studies), Outcome 1 Proportion at risk.
Figures and Tables -
Analysis 3.1

Comparison 3 Overall risk assessments (follow‐up studies), Outcome 1 Proportion at risk.

Comparison 4 Drug use and risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 1 Proportion reporting injecting use.
Figures and Tables -
Analysis 4.1

Comparison 4 Drug use and risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 1 Proportion reporting injecting use.

Comparison 4 Drug use and risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 2 Frequency of injecting use.
Figures and Tables -
Analysis 4.2

Comparison 4 Drug use and risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 2 Frequency of injecting use.

Comparison 4 Drug use and risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 3 Proportion sharing injecting equipment.
Figures and Tables -
Analysis 4.3

Comparison 4 Drug use and risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 3 Proportion sharing injecting equipment.

Comparison 4 Drug use and risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 4 Frequency of opioid use.
Figures and Tables -
Analysis 4.4

Comparison 4 Drug use and risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 4 Frequency of opioid use.

Comparison 4 Drug use and risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 5 Frequency of cocaine use.
Figures and Tables -
Analysis 4.5

Comparison 4 Drug use and risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 5 Frequency of cocaine use.

Comparison 4 Drug use and risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 6 Drug risk scores.
Figures and Tables -
Analysis 4.6

Comparison 4 Drug use and risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 6 Drug risk scores.

Comparison 5 Sex‐related risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 1 Sex‐related risk score.
Figures and Tables -
Analysis 5.1

Comparison 5 Sex‐related risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 1 Sex‐related risk score.

Comparison 5 Sex‐related risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 2 Number of sex partners.
Figures and Tables -
Analysis 5.2

Comparison 5 Sex‐related risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 2 Number of sex partners.

Comparison 5 Sex‐related risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 3 Proportion reporting unprotected sex (or use of condoms in half or less of occasions).
Figures and Tables -
Analysis 5.3

Comparison 5 Sex‐related risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 3 Proportion reporting unprotected sex (or use of condoms in half or less of occasions).

Comparison 5 Sex‐related risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 4 Frequency of condom use.
Figures and Tables -
Analysis 5.4

Comparison 5 Sex‐related risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 4 Frequency of condom use.

Comparison 5 Sex‐related risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 5 Proportion reporting exchanges of sex for drugs or money.
Figures and Tables -
Analysis 5.5

Comparison 5 Sex‐related risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 5 Proportion reporting exchanges of sex for drugs or money.

Comparison 5 Sex‐related risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 6 Frequency of exchanges of sex for drugs or money.
Figures and Tables -
Analysis 5.6

Comparison 5 Sex‐related risk outcomes ‐ substitution treatment versus no substitution treatment, Outcome 6 Frequency of exchanges of sex for drugs or money.

Table 1. Nature of substitution treatment

Study

Substitute agent

Av. dose/day

Setting

Abbott 1998

Methadone

About 70mg

Specialist drug & alcohol program

Avants 1998

Methadone

About 80mg

Specialist drug & alcohol program

Baker 1995

Methadone

About 66mg

Not reported

Batki 1989

Methadone

Not reported

Specialist AIDS program

Britton 1994

Methadone

Not reported

Specialist drug & alcohol program

Brooner 1998

Methadone

70mg

Specialist drug & alcohol program

Camacho 1996

Methadone

About 40mg

Specialist drug & alcohol program

Chatham 1999

Methadone

About 40mg

Specialist drug & alcohol program

Dolan 2003

Methadone

61mg

Prison methadone program

Finch 1995

Methadone

About 50mg

Specialist drug & alcohol program

Gossop 2000

Methadone

About 50mg

Specialist drug & alcohol program & primary health

Grella 1996

Methadone

Not reported

Specialist drug & alcohol program

Iguchi 1998

Methadone

40mg/day (taper)

Specialist drug & alcohol program

King 2000

Methadone

50mg/day

Specialist drug & alcohol program

Kwiatkowski 2001

Methadone

70mg/day

Specialist drug & alcohol program

Maddux 1997

Methadone

Not reported

Specialist drug & alcohol program

Magura 1991

Methadone

Not reported

Specialist drug & alcohol program

Margolin 2003

Methadone

˜80mg/day

Specialist drug & alcohol program

Meandzija 1994

Methadone

Not reported

Not reported

Metzger 1993

Methadone

About 44mg

Specialist drug & alcohol program

Sees 2000

Methadone

Not reported

Not reported

Moss 1994

Methadone

About 85mg

Not reported

Serpelloni 1994

Methadone

Not reported

Specialist drug & alcohol program

Simpson 1995

Methadone

Not reported

Specialist drug & alcohol program

Stark 1996

Methadone

80‐100mg/day

Not reported

Strang 2000

Methadone

57mg/day

Specialist drug & alcohol program

Thiede 2000

Methadone

Not reported

Specialist drug & alcohol program

Williams 1992

Methadone

70mg/day

Specialist drug & alcohol program

Figures and Tables -
Table 1. Nature of substitution treatment
Table 2. Risk of confounding and bias

Study

Characteristics

Recruitment

Confounders

Follow‐up

Intervention

Data collection

Overall risk

Abbott 1998

0

0

0

0

0

0

0

Avants 1998

0

0

0

0

0

0

0

Baker 1995

1

0

1

0

0

0

2

Batki 1989

0

1

0

1

0

0

2

Britton 1994

1

1

1

0

0

0

3

Brooner 1998

1

1

1

0

0

0

3

Camacho 1996

0

0

0

1

0

0

1

Chatham 1999

0

0

0

1

0

0

1

Dolan 2003

0

0

0

1

0

0

1

Finch 1995

0

1

0

1

0

0

2

Gossop 2002

0

0

0

1

0

0

1

Grella 1996

0

1

0

0

0

1

2

Iguchi 1998

0

0

0

1

0

0

1

King 2000

1

0

0

0

0

0

1

Kwiatkowski 2001

0

0

1

1

0

0

2

Maddux 1997

0

0

1

0

0

0

1

Magura 1991

0

0

0

1

0

0

1

Margolin 2003

1

0

0

1

0

1

3

Meandzija 1994

1

0

1

0

0

0

2

Metzger 1993

0

0

1

0

0

0

1

Moss 1994

1

1

1

0

1

0

4

Sees 2000

0

0

1

1

0

0

2

Serpelloni 1994

1

0

0

0

1

0

2

Simpson 1995

0

0

0

1

0

0

1

Stark 1996

0

0

1

0

0

0

1

Strang 2000

0

0

0

1

0

0

1

Thiede 2000

0

0

1

1

0

0

2

Williams 1992

1

0

1

1

0

1

4

Total studies

9

6

12

15

2

3

Figures and Tables -
Table 2. Risk of confounding and bias
Table 3. Follow‐up period

Study

Interval

Abbott 1998

6 months

Avants 1996

6 months after completion of 12‐week program

Baker 1995

No follow‐up ‐ single interview

Batki 1989

12 months ‐ 3 months also available

Britton 1994

12 months

Brooner 1998

1 month

Camacho 1996

6 months ‐ 3 months also available

Chatham 1999

12 months after leaving study

Dolan 2003

4 months

Finch 1995

2 months

Gossop 2000

1 year (primary data)

Grella 1996

18‐24 months

Iguchi 1998

5‐6 weeks (1‐2 weeks also available)

King 2000

6 months

Kwiatkowski 2001

6 months

Maddux 1997

12 months

Magura 1991

12 months

Margolin 2003

6 and/or 9 months

Meandzija 1994

No follow‐up ‐ single interview

Metzger 1993

18 months

Moss 1994

Not applicable

Sees 2000

6 months (12 months also available)

Serpelloni 1994

Not applicable

Simpson 1995

3 months

Stark 1996

No follow‐up ‐ single interview

Strang 2000

6 months

Thiede 2000

12 months

Williams 1992

Not applicable

Figures and Tables -
Table 3. Follow‐up period
Table 4. Proportion of participants injecting at baseline

Study

Proportion injecting

Abbott 1998

Not reported ‐ 47% new to methadone

Avants 1998

214/291 (73.5%) entering treatment using iv

Baker 1995

Injecting use in prior 6 months a requirement

Batki 1989

All injecting drug users

Britton 1994

All in MMT at baseline ‐ unclear how many injecting

Brooner 1998

Unclear

Camacho 1996

All injected in 30 days prior

Chatham 1999

All injecting at entry

Dolan 2003

50% MMT and 56% control injected in prison prior to baseline interview

Finch 1995

98% injecting drug users

Gossop 2000

62% injecting at intake

Grella 1996

Unclear

Iguchi 1998

Unclear

King 2000

86% injected in 30 days prior to intake

Kwiatkowski 2000

Injecting use in prior 30 days a requirement

Maddux 1997

Unclear

Magura 1991

All injecting users at entry

Margolin 2003

Injecting drug use selection criterion

Meandzija 1994

Injecting drug users selected

Metzger 1993

87% injected in 6 months prior to baseline

Moss 1994

Injecting drug use selection criterion

Sees 2000

Unclear

Serpelloni 1994

Injecting drug users selected

Simpson 1995

Unclear

Stark 1996

Injecting drug use in prior 3 months required

Strang 2000

All injecting users

Thiede 2000

All injecting users

Williams 1992

Unclear (history of injecting use)

Figures and Tables -
Table 4. Proportion of participants injecting at baseline
Table 5. Timeframe for assessment

Study

Timeframe

Abbott 1998

Unclear (possibly 30 days)

Avants 1998

Unclear

Baker 1995

Prior month

Batki 1989

Prior 30 days

Britton 1994

Prior 6 months

Brooner 1998

Prior 30 days

Camacho 1996

Prior 30 days

Chatham 1999

Prior 6 months

Dolan 2003

1 month (3x1 month periods prior to follow‐up)

Finch 1995

Unclear

Gossop 2000

Prior 90 days

Grella 1996

Prior 30 days or prior 12 months

Iguchi 1998

Combination of 2 assessments, each of 1 week

King 2000

Prior 30 days

Kwiatkowski 2001

Prior 30 days

Maddux 1997

Prior 30 days

Magura 1991

Prior 30 days

Margolin 2003

Variable

Meandzija 1994

Prior 30 days

Metzger 1993

Prior 6 months

Moss 1994

Not applicable

Sees 2000

Prior 6 months

Serpelloni 1994

Not applicable

Simpson 1995

Prior 30 days

Stark 1996

Prior 6 months

Strang 2000

Prior 30 days

Thiede 2000

1 month prior

Williams 1992

Not applicable

Figures and Tables -
Table 5. Timeframe for assessment
Table 6. Frequency of injecting use at baseline and follow‐up

Study and group

Group size

Measure

Baseline status

Follow‐up status

Significance

Batki 1989

42

Days in past 30

27.5

6.3

significant

Brooner 1998, referred from (1) needle exchange (2) standard sources

(1) 66 (2) 203

Days in prior 30

(1) 24.08 (2) 6.68

(1) 13.70 (2) 3.82

Tukey's HSD (1) 0.01 (2) 0.01

Camacho 1996

326

Frequency in prior 30 days

111 ± 59.5

6 ± 19.3

P < 0.001

Chatham 1999

435

Frequency score for prior 6 months

7.3 ± 1.0

3.6 ± 3.1

P < 0.001

Dolan 2003 (1) methadone maintenance (2) wait‐list control

(1) 129 (2) 124

Times heroin injected in prior month

(1) 9 (2) 15

(1) 1.3 (2) 8.5

P < 0.001

Kwiatkowski 2001, (1) methadone maintenance & risk reduction (2) risk reduction only

(1) 99 (2) 216

Heroin injections in prior month

(1) 77.1 ± 39.9 (2) 60.1 ± 37.4

(1) 22.9 ± 35.9 (2) 36.3 ± 44.5

P < 0.01

Simpson 1995

521

Injections in last 30 days

108 ± 57.6

9.5 ± 47.4

P < 0.001

Strang 2000

15 baseline, 11 follow‐up

Days in past 30

20.1 ± 9.9

11.9 ± 11.7

P < 0.001

Figures and Tables -
Table 6. Frequency of injecting use at baseline and follow‐up
Table 7. Drug risk scores at baseline and follow‐up

Study and group

Group size

Measure

Baseline status

Follow‐up status

Significance

Abbott 1998 (1) methadone‐free at intake (2) transferring from methadone maintenance

(1) 70 (2) 78

Risk Assessment Battery, drug risk score

(1) 9.35 ± 7.49 (2) 4.82 ± 5.14

(1) 2.80 ± 4.21 (2) 2.09 ± 3.90

P < 0.001

Avants 1998

307

Risk Assessment Battery

2.14 ± 3.06

1.25 ± 1.83

P < 0.001

Chatham 1999

435

Risky Needle Exposure Score for prior 6 months

5.3

1.6

P < 0.001

Sees 2000 (1) MMT (2) 180‐day detox

(1) 91 (2) 88

Injection risk score prior 6 months

(1) 6.51 ± 6.69 (2) 6.0 ± 6.44

(1) 3.04 ± 4.35 (2) 4.07 ± 5.79

(1) & (2) not significant

Figures and Tables -
Table 7. Drug risk scores at baseline and follow‐up
Table 8. Frequency of opioid use at baseline and follow‐up

Study and group

Group size

Measure

Baseline status

Follow‐up status

Significance

Batki 1989

42

Mean days in prior 30

27.5

3.8

sig

Brooner 1998, referral from (1) needle exchange (2) standard sources

(1) 66 (2) 203

Days in prior 30

(1) 28.59 (2) 7.06

(1) 16.46 (2) 4.43

Tukey's HSD (1) 0.01 (2) 0.01.

Chatham 1999

435

Frequency score for past 6 months

7.27

3.37

P < 0.001

Gossop 2000, (1) methadone maintenance (2) Methadone reduction

(1) 333 (2) 145

Days use in prior 90

(1) 57.4 ± 36.7 (2) 70.2 ± 31.6

(1) 24.0 ± 30.4 (2) 30.4 ± 33.7

P < 0.0001

Iguchi 1998

51

Use episodes per week

13.8 ± 9.8

2.5 ± 2.8

Not reported

Simpson 1995

521

Frequency score for last 30 days

6.65 ± 2.0

1.03 ± 1.6

P < 0.001

Strang 2000

15 baseline, 10 follow‐up

Days use in past 30

22.4 ± 9.8

8.7 ± 10.8

P < 0.001

Figures and Tables -
Table 8. Frequency of opioid use at baseline and follow‐up
Table 9. Frequency of powder cocaine use at baseline and follow‐up

Study and group

Group size

Measure

Baseline status

Follow‐up status

Significance

Batki 1989

42

Days in past 30

8.1

2.5

sig

Brooner 1998, referral from (1) needle exchange (2) standard sources

(1) 66 (2) 203

Days in prior 30

(1) 15.29 (2) 5.97

(1) 4.84 (2) 3.02

Tukey's HSD (1) 0.01 (2) 0.05

Chatham 1999

435

Frequency score for last 6 months

3.13

2.15

P < 0.001

Gossop 2000, (1) methadone maintenance (2) Methadone reduction

(1) 333 (2) 145

Days use in prior 90

(1) 1.8 ± 9.4 (2) 1.6 ± 4.8

(1) 0.8 ± 6.1 (2) 1.7 ± 10.3

P < 0.001

Simpson 1995

521

Frequency score for last 30 days

1.75 ± 2.4

0.75 ± 1.5

P < 0.001

Figures and Tables -
Table 9. Frequency of powder cocaine use at baseline and follow‐up
Table 10. Frequency of use of opiates and cocaine mixed (speedball), baseline & follow‐up

Study and group

Group size

Measure

Baseline status

Follow‐up status

Significance

Chatham 1999

435

Frequency score in last 6 months

2.47

1.09

P < 0.001

Simpson 1995

521

Frequency score in last 30 days

2.62 ± 3.1

0.58 ± 1.2

P < 0.001

Figures and Tables -
Table 10. Frequency of use of opiates and cocaine mixed (speedball), baseline & follow‐up
Table 11. Sex‐related risk scores, baseline and follow‐up

Study and group

Group size

Measure

Baseline mean

Follow‐up mean

Signficance

Abbott 1998 (1) methadone‐free at intake (2) transferring from methadone maintenance

(1) 70 (2) 78

RAB, sexual risk

(1) 4.38 ± 2.73 (2) 3.85 ± 2.69

(1) 3.25 ± 2.33 (2) 3.32±2.62

P = 0.002

Avants 1998

307

RAB

3.23 ± 3.82

2.59 ± 2.68

P < 0.001

Sees 2000 (1) methadone maintenance (2) 180 day detox

(1) 91 (2) 88

Sexual risk score

(1) 5.0 ± 3.67 (2) 4.26 ± 2.87

(1) 4.31 ± 3.32 (2) 3.69±3.07

(1) & (2) not significant

Figures and Tables -
Table 11. Sex‐related risk scores, baseline and follow‐up
Table 12. Overall HIV risk scores, baseline and follow‐up

Study and group

Group size

Measure

Baseline

Follow‐up

Significance

Abbott 1988 (1) Methadone‐free at intake (2) Transfer from MMT

(1) 70 (2) 78

Risk Assessment Battery Score

(1) 0.22 ± 0.13 (2) 0.13 ± 0.09

(1) 0.09 ± 0.08 (2) 0.08 ± 0.08

For both groups over time, p<0.001

Avants 1998

307

Risk Assessment Battery

5.37 ± 5.56

3.84 ± 3.83

P < 0.001

Finch 1995

22

HIV Risk Behaviour Scale Score

13.32

7.27

P < 0.001

Margolin 2003, methadone maintenance + (1) harm reduction (2) standard treatment

(1) 45 (2) 45

Risk Assessment Battery score

(1) 4.09 ± 3.1 (2) 5.4 ± 3.93

(1) 1.57 ± 1.98 (2) 1.89 ± 1.63

For both groups over time, P < 0.01

Figures and Tables -
Table 12. Overall HIV risk scores, baseline and follow‐up
Comparison 1. Drug use and risk outcomes (follow‐up studies)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Proportion reporting injecting use Show forest plot

6

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 Controlled studies

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 Cohort studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Descriptive studies

5

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Proportion sharing injecting equipment Show forest plot

7

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 Controlled studies

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Cohort studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Descriptive studies

6

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Opioid use (proportion reporting use or with positive urine samples) Show forest plot

7

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

3.1 Controlled studies

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 Cohort studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 Descriptive studies

6

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4 Cocaine use (proportion using or with positive urine screens) Show forest plot

4

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4.1 Controlled studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 Cohort studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Descriptive studies

4

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 1. Drug use and risk outcomes (follow‐up studies)
Comparison 2. Sex‐related risk outcomes (follow‐up studies)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Proportion reporting multiple sex partners Show forest plot

4

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 Controlled studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 Cohort studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Descriptive studies

4

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Proportion reporting unprotected sex (or use of condoms in half or less of occasions) Show forest plot

6

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

2.1 Controlled studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Cohort studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Descriptive studies

6

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3 Proportion reporting exchanges of sex for drugs or money Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

3.1 Controlled studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 Cohort studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 Descriptive studies

2

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 2. Sex‐related risk outcomes (follow‐up studies)
Comparison 3. Overall risk assessments (follow‐up studies)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Proportion at risk Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 Controlled studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 Cohort studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Descriptive studies

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 3. Overall risk assessments (follow‐up studies)
Comparison 4. Drug use and risk outcomes ‐ substitution treatment versus no substitution treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Proportion reporting injecting use Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

1.1 Controlled studies

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 Cohort studies

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Descriptive studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

2 Frequency of injecting use Show forest plot

3

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

2.1 Controlled studies

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Cohort studies

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Descriptive studies

2

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3 Proportion sharing injecting equipment Show forest plot

4

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

3.1 Controlled studies

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 Cohort studies

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 Descriptive studies

2

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4 Frequency of opioid use Show forest plot

2

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

4.1 Controlled studies

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 Cohort studies

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Descriptive studies

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Frequency of cocaine use Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

5.1 Controlled studies

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5.2 Cohort studies

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5.3 Descriptive studies

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

6 Drug risk scores Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

6.1 Controlled studies

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

6.2 Cohort studies

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

6.3 Descriptive studies

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 4. Drug use and risk outcomes ‐ substitution treatment versus no substitution treatment
Comparison 5. Sex‐related risk outcomes ‐ substitution treatment versus no substitution treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Sex‐related risk score Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

1.1 Controlled studies

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.2 Cohort studies

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

1.3 Descriptive studies

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2 Number of sex partners Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

2.1 Controlled studies

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.2 Cohort studies

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

2.3 Descriptive studies

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

3 Proportion reporting unprotected sex (or use of condoms in half or less of occasions) Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

3.1 Controlled studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3.2 Cohort studies

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

3.3 Descriptive studies

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4 Frequency of condom use Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

4.1 Controlled studies

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.2 Cohort studies

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

4.3 Descriptive studies

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

5 Proportion reporting exchanges of sex for drugs or money Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

5.1 Controlled studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5.2 Cohort studies

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

5.3 Descriptive studies

0

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

6 Frequency of exchanges of sex for drugs or money Show forest plot

1

Std. Mean Difference (IV, Random, 95% CI)

Totals not selected

6.1 Controlled studies

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

6.2 Cohort studies

0

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

6.3 Descriptive studies

1

Std. Mean Difference (IV, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 5. Sex‐related risk outcomes ‐ substitution treatment versus no substitution treatment