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However, to our knowledge, the role of methadone dosing in adherence to antiretroviral therapy (ART) has not yet been investigated. We sought to examine the relationship between methadone dose and ART adherence among a cohort of people who use illicit opioids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Setting<\/jats:title><jats:p>We used data from the AIDS Care Cohort to Evaluate Access to Survival Services (ACCESS) study, an ongoing prospective observational cohort of HIV\u2010positive people who use illicit drugs in Vancouver, Canada, linked confidentially to comprehensive HIV treatment data in a setting of universal no\u2010cost medical care, including medications. We evaluated the longitudinal relationship between methadone dose and the likelihood of \u2265\u200995% adherence to ART among ART\u2010exposed participants during periods of engagement in MMT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Two hundred and ninety\u2010seven ART\u2010exposed individuals on MMT were recruited between December 2005 and May 2013 and followed for a median of 42.1\u2009months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>We measured methadone dose at \u2265\u2009100 versus &lt;\u2009100\u2009mg\/day and the likelihood of \u2265\u200995% adherence to ART.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>In adjusted generalized estimating equation (GEE) analyses, MMT dose \u2265\u2009100\u2009mg\/day was associated independently with optimal adherence to ART [adjusted odds ratio (AOR)\u2009=\u20091.38; 95% confidence interval (CI)\u2009=\u20091.08\u20131.77). In a subanalysis, we observed a dose\u2013response relationship between increasing MMT dose and ART adherence (AOR\u2009=\u20091.06 per 20\u2009mg\/day increase, 95% CI\u2009=\u20091.00\u20131.12).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among HIV\u2010positive individuals in methadone maintenance therapy, those receiving higher doses of methadone (\u2265\u2009100\u2009mg\/day) are more likely to achieve \u2265\u200995% adherence to antiretroviral therapy than those receiving lower doses.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.12970","type":"journal-article","created":{"date-parts":[[2015,5,1]],"date-time":"2015-05-01T18:12:49Z","timestamp":1430503969000},"page":"1330-1339","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Dose\u2013response relationship between methadone dose and adherence to antiretroviral therapy among HIV\u2010positive people who use illicit opioids"],"prefix":"10.1111","volume":"110","author":[{"given":"Leslie","family":"Lappalainen","sequence":"first","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, St Paul's Hospital  Vancouver Canada"},{"name":"Department of Family Medicine University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seonaid","family":"Nolan","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, St Paul's Hospital  Vancouver Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabina","family":"Dobrer","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, St Paul's Hospital  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy","family":"Puscas","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, St Paul's Hospital  Vancouver Canada"},{"name":"Faculty of Health Sciences Simon Fraser University  Burnaby Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio","family":"Montaner","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, St Paul's Hospital  Vancouver Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Ahamad","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, St Paul's Hospital  Vancouver Canada"},{"name":"Department of Family Medicine University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiru","family":"Dong","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, St Paul's Hospital  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Kerr","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, St Paul's Hospital  Vancouver Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Wood","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, St Paul's Hospital  Vancouver Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.\u2010J.","family":"Milloy","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS, St Paul's Hospital  Vancouver Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,7,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000233310.90484.16"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199803263381301"},{"key":"e_1_2_6_4_1","first-page":"659","article-title":"Improved survival among HIV\u2010infected patients after initiation of triple\u2010drug antiretroviral regimens","volume":"160","author":"Hogg R. 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