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The authors followed a cohort of 610 opioid users for 1 year after admission to methadone maintenance. At the end of the year, 52% were on methadone and 48% were off methadone. Among subjects on methadone, days of intravenous drug use, crime, and needle-sharing decreased markedly from the month preceding admission to the month preceding the first anniversary of admission. Among subjects off methadone, days of these activities also decreased, but the decreases appeared in large part to be an effect of increased days of incarceration. Among those on methadone, days of productive activity increased markedly. Subjects with more years of intravenous drug use were more likely to be on methadone at the end of the year, and subjects under compulsory supervision were less likely to be on methadone. The findings confirm previous reports of decreased illicit opioid use, decreased crime, and decreased needle risk for infection with the human immunodeficiency virus among opioid users who remain on methadone.

Several reports have suggested that required treatment fees impair retention on methadone maintenance. In a controlled study, 152 illicit opioid users admitted to methadone maintenance were randomly assigned to fee or nofee status. The fee subjects were required to pay a fee of $2.50per day and the no-fee subjects were required to pay nothing. Elimination of fees significantly increased retention. Only 34% of the fee subjects but 54% of the no-fee subjects were retained for one year. Of those retained for one year, the fee subjects and the no-fee subjects showed only small and nonsignificant differences on urine test results and measures of social performance. Interviews per month with caseworker were inversely related to retention. Increased interviews and decreased retention may both have reflected treatment problems of subjects.

Few HIV/AIDS educational programs have been tailored specifically for women, and most have promoted methods requiring the full participation and cooperation of male partners. This study introduced drug-involved women to the female condom—a female-controlled method of protection from HIV and other sexually transmitted diseases. The primary aim was to assess the acceptability of this new device among high-risk women in St. Louis, San Antonio, and Rio de Janeiro. All respondents participated in a female condom education program, were asked to try the condom, and to report their experiences at two points of contact. Outcome data indicated that a sizable proportion of the women followed up used the female condom during vaginal sex on one or more occasions. In addition, many women also preferred the female condom to the male condom in terms of overall satisfaction, suggesting that there is a viable role for this device in the HIV prevention field.