Abstract
BACKGROUND: The CHOICES study randomized participants with HIV and opioid use disorder (OUD) to HIV clinic-based extended-release naltrexone (XR-NTX), which requires complete cessation of opioid use, versus treatment-as-usual (i.e., buprenorphine, methadone). Study participants randomized to XR-NTX were interviewed to assess their experiences with successful and unsuccessful XR-NTX induction.
METHODS: Semi-structured qualitative interviews were completed with a convenience sample of study participants with HIV and OUD (n = 37) randomized to XR-NTX in five HIV clinics between 2018 and 2019. All participants approached agreed to be interviewed. Interviews were digitally recorded, professionally transcribed, and analyzed using thematic analysis.
RESULTS: Participants included women (43%), African Americans (62%) and Hispanics (16%), between 27 to 69 years of age. Individuals who completed XR-NTX induction (n = 20) reported experiencing (1) readiness for change, (2) a supportive environment during withdrawal including comfort medications, and (3) caring interactions with staff. Four contrasting themes emerged among participants (n = 17) who did not complete induction: (1) concern and anxiety about withdrawal including past negative experiences, (2) ambivalence about or reluctance to stop opioids, (3) concerns about XR-NTX effects, and (4) preferences for other medications.
CONCLUSIONS: The results highlight opportunities to improve initiation of XR-NTX in high-need groups. Addressing expectations regarding induction may enhance XR-NTX initiation rates.
Trial Registration ClinicalTrials.gov: NCT03275350. Registered September 7, 2017. https://clinicaltrials.gov/ct2/show/NCT03275350?term=extended+release+naltrexone&cond=Opioid+Use.
Document Type
Article
Publication Date
11-10-2021
Digital Object Identifier (DOI)
https://doi.org/10.1186/s13722-021-00277-z
Funding Information
An Award from the National Institutes of Health, National Institute on Drug Abuse supported data collection, analysis and preparation of the manuscript (UG1 DA015815, UG1DA013732).
Related Content
CTN quantitative data are released to the public one year after the publication of primary outcome results. See CTN data share site: https://datashare.nida.nih.gov/index.php/data?field_clintri_study_division_target_id=2&field_clintri_keywords_target_id=All. Qualitative data may be obtained by contacting the corresponding author.
Repository Citation
Hoffman, Kim A.; Baker, Robin; Fanucchi, Laura C.; Lum, Paula J.; Kunkel, Lynn E.; Ponce Terashima, Javier; McCarty, Dennis; Jacobs, Petra; and Korthuis, P. Todd, "Perspectives on Extended-Release Naltrexone Induction among Patients Living with HIV and Opioid Use Disorder: A Qualitative Analysis" (2021). Internal Medicine Faculty Publications. 268.
https://uknowledge.uky.edu/internalmedicine_facpub/268
Notes/Citation Information
Published in Addiction Science & Clinical Practice, v. 16, issue 1, article no. 67.
© The Author(s) 2021
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (https://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.