{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:08:10Z","timestamp":1789844890205,"version":"4.0.1"},"reference-count":59,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,8,9]],"date-time":"2020-08-09T00:00:00Z","timestamp":1596931200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,8,9]],"date-time":"2020-08-09T00:00:00Z","timestamp":1596931200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["D43TW000233"],"award-info":[{"award-number":["D43TW000233"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R25 TW009338"],"award-info":[{"award-number":["R25 TW009338"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Ukraine's HIV epidemic remains concentrated among opioid\u2010dependent people who inject drugs (PWID) where opioid agonist therapies (OAT) like methadone (MMT) and buprenorphine (BMT) maintenance treatments are the most cost\u2010effective HIV prevention strategies, but remain under\u2010scaled. This study aimed to measure the association between dose and type of OAT prescribed and treatment retention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational longitudinal cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants and Setting<\/jats:title>\n                    <jats:p>\n                      Patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a015\u2009290) prescribed OAT throughout Ukraine from 2004 through 2016.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Data were analyzed using time\u2013event strategies to estimate cumulative treatment retention, defined as time to OAT discontinuation. Cumulative retention proportions at 1, 12 and 36\u00a0months were assessed for outcomes. Cox regression with log\u2010rank likelihood assessed independent predictors of treatment discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>The proportion prescribed high (MMT: &gt;\u00a085\u00a0mg; BMT: \u2265\u00a016\u00a0mg), medium (MMT: &gt;\u00a040\u201385\u00a0mg; BMT: &gt;\u00a06\u201315\u00a0mg) and low (MMT: \u2264\u00a040\u00a0mg; BMT: \u2264\u00a06\u00a0mg) dosages was 25, 43 and 32%, respectively. Retention was significantly higher for BMT than MMT both at 12 (89 versus 75%) and 36\u00a0months (80 versus 56%). Although dosing levels for BMT did not influence retention, increasing dosages for MMT were significantly associated with higher retention rates at 1 (90, 96, 99%), 12 (59, 78, 91%) and 36 (34, 59, 79%) months, respectively. Independent predictors associated with 12\u2010month OAT discontinuation were medium [adjusted hazard ratio (aHR)\u00a0=\u00a02.23; 95% confidence limit (CL)\u00a0=\u00a01.95\u20132.54] and low (aHR\u00a0=\u00a04.96; 95% CL\u00a0=\u00a04.37\u20135.63) OAT dosage relative to high dosage, male sex (aHR\u00a0=\u00a01.27; 95% CL\u00a0=\u00a01.14\u20131.41), MMT relative to BMT prescription (aHR\u00a0=\u00a01.57; 95% CL\u00a0=\u00a01.32\u20131.87) and receiving OAT in general (aHR\u00a0=\u00a01.22; 95% CL\u00a0=\u00a01.02\u20131.46) or tuberculosis (aHR\u00a0=\u00a01.43; 95% CL\u00a0=\u00a01.10\u20131.85) hospitals, relative to specialty addiction treatment and AIDS center settings. Lower dosages contributed more to dropout especially at 1\u00a0month (aHR 3.12; 95% CL\u00a0=\u00a02.21\u20134.41 and aHR 7.71; 95% CL\u00a0=\u00a05.51\u201310.79 for medium and low dosages, respectively). Younger age was significantly associated with OAT discontinuation only at 36\u00a0months (aHR\u00a0=\u00a01.08; 95% CI\u00a0=\u00a01.02\u20131.15).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher dosages of opioid agonist therapies, especially for methadone maintenance treatment patients, appear to be associated with higher levels of treatment retention in Ukraine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.15115","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T17:39:17Z","timestamp":1589909957000},"page":"83-93","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["The real\u2010world impact of dosing of methadone and buprenorphine in retention on opioid agonist therapies in Ukraine"],"prefix":"10.1111","volume":"116","author":[{"given":"Scott O.","family":"Farnum","sequence":"first","affiliation":[{"name":"APT Foundation  New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iuliia","family":"Makarenko","sequence":"additional","affiliation":[{"name":"ICF Alliance for Public Health  Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"Madden","sequence":"additional","affiliation":[{"name":"APT Foundation  New Haven CT USA"},{"name":"Department of Psychiatry Yale University School of Medicine  New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyona","family":"Mazhnaya","sequence":"additional","affiliation":[{"name":"ICF Alliance for Public Health  Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9094-0674","authenticated-orcid":false,"given":"Ruthanne","family":"Marcus","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Infectious Diseases Yale University School of Medicine  New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya","family":"Prokhorova","sequence":"additional","affiliation":[{"name":"ICF Alliance for Public Health  Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha J.","family":"Bojko","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Infectious Diseases Yale University School of Medicine  New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Rozanova","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Infectious Diseases Yale University School of Medicine  New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergii","family":"Dvoriak","sequence":"additional","affiliation":[{"name":"Ukrainian Institute on Public Health Policy  Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahedsul","family":"Islam","sequence":"additional","affiliation":[{"name":"ICF Alliance for Public Health  Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7860-693X","authenticated-orcid":false,"given":"Frederick L.","family":"Altice","sequence":"additional","affiliation":[{"name":"APT Foundation  New Haven CT USA"},{"name":"Department of Medicine, Section of Infectious Diseases Yale University School of Medicine  New Haven CT USA"},{"name":"Division of Epidemiology of Microbial Diseases Yale University School of Public Health  New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,9]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS).The Gap Report. Geneva Switzerland: UNAIDS;2014. Available at:http:\/\/www.unaids.org\/en\/media\/unaids\/contentassets\/documents\/unaidspublication\/\/unaids_gap_report_en.pdf(accessed 24 August 2014)."},{"key":"e_1_2_8_3_1","unstructured":"United Nations Office on Drugs and Crime (UNODC).Word Drug Report 2016. Vienna Austria: UNODC;2016. Available at:http:\/\/www.unodc.org\/doc\/wdr\/WORLD_DRUG_REPORT__web.pdf(accessed 27 June 2016)."},{"key":"e_1_2_8_4_1","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS).Global AIDS Update2016. Geneva Switzerland: UNAIDS; 2016. Available at:http:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/global-AIDS-update-_en.pdf(accessed 28\u00a0May 2016)."},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61311-2"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000423"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e5945"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw416"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(19)30373-X"},{"key":"e_1_2_8_10_1","article-title":"Effects of medication\u2010assisted treatment on mortality among opioids users: a systematic review and meta\u2010analysis","author":"Ma J.","year":"2018","journal-title":"Mol Psychiatry"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2006.12.011"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000217586"},{"key":"e_1_2_8_13_1","unstructured":"Verkhovna Rada Ukraine (VRU).National Programme on HIV\/AIDS for 2014\u20132018. Kiev Ukraine: VRU;2014."},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2017.07.025"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2017.05.037"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.06.011"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2016.03.003"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2014.11.005"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2008.02249.x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2017.05.014"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/10550887.2016.1100960"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/00952990802342899"},{"key":"e_1_2_8_23_1","first-page":"347","article-title":"Methadone maintenance treatment (MMT): a review of historical and clinical issues","volume":"67","author":"Joseph H.","year":"2000","journal-title":"Mt Sinai J Med"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(01)00171-5"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7517-8-32"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-016-1375-0"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2014.12.008"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12243"},{"key":"e_1_2_8_29_1","unstructured":"ICF International AIDS Alliance in Ukraine.Automated records management system in harm reduction programs. Kyiv Ukraine: SyrEx2;2015. Available at:http:\/\/www.aidsalliance.org.ua\/cgi-bin\/index.cgi?url=\/en\/library\/syrex\/index.htm(accessed on 16 March 2017)."},{"key":"e_1_2_8_30_1","article-title":"Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence","volume":"2","author":"Mattick R. P.","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1972.tb00899.x"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12303"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30856-X"},{"key":"e_1_2_8_34_1","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS).Prevention Gap Report. Geneva Switzerland: UNAIDS;2016. Available at:http:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/-prevention-gap-report_en.pdf(accessed 14\u00a0July 2016)."},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2352-3018(19)30409-6"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32229-9"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-019-1038-8"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200011023431802"},{"key":"e_1_2_8_39_1","article-title":"Opioid agonist treatment for pharmaceutical opioid dependent people","author":"Nielsen S.","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2019.06.020"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030080"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta11090"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.11.1000"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/1747-597X-9-13"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0b013e3181c8b439"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1255528"},{"key":"e_1_2_8_47_1","first-page":"25","article-title":"Evidence of reliability and validity of the opiate dosage adequacy scale (ODAS) in a sample of methadone maintenance patients","volume":"10","author":"Gonz\u00e1lez\u2010Saiz F.","year":"2008","journal-title":"Heroin Addict Relat Clin Probl"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40360-016-0058-9"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-012-2077-6"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-016-0480-9"},{"key":"e_1_2_8_51_1","unstructured":"United Nations Office on Drugs and Crime (UNODC).World Drug Report 2016. Vienna Austria: UNODC; 2017. Available at:https:\/\/www.unodc.org\/doc\/wdr6\/WORLD_DRUG_REPORT_6_web.pdf(accessed 27\u00a0March 2017)."},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2017.05.014"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.04.037"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2013.02.008"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60829-X"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.12.025"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.14797"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2013.09.020"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001827"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2007.03.001"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fadd.15115","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.15115","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/add.15115","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.15115","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T07:14:30Z","timestamp":1780989270000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.15115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,9]]},"references-count":59,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1111\/add.15115"],"URL":"https:\/\/doi.org\/10.1111\/add.15115","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,9]]},"assertion":[{"value":"2019-08-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}