This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The purpose of this study is to clarify the presence or absence of significant drug interactions between opioids used in long term, maintenance treatment of opiate (usually heroin) addiction and frequently prescribed antiretroviral medications. The increasing proportion of AIDS cases in substance abusers and difficulties in providing access and adherence to HIV therapeutics in this population are of great concern from both clinical and public health perspectives. All HIV therapeutics to date have been clinically developed and tested in patients with HIV disease, but without opioid dependence. Given the rapid spread of HIV in opioid dependent patients and the potential for spread of the virus via sexual contact and use of shared needles in injection users, the importance of understanding how best to treat both opioid dependence and HIV disease in this group is underscored. It is especially important to evaluate the effect on the disposition of HIV therapeutics of alternative opiate agonists used for the pharmacotherapy of opiate dependence. Subjects will be recruited from the substance abuse treatment clinic. Subjects will be screened for enrollment and upon enrollment, will be seen both as outpatients and as inpatients for drug administration, assessments, and blood draws.
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