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Updated: Jul 25, 2026

Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays
Published on: September 26, 2011
HIV prevalence and risk behavior among injecting drug users who participate in "low-threshold" methadone programs in
C Hartgers1, A van den Hoek, P Krijnen
1Municipal Health Service, Department of Public Health and Environment, Amsterdam, The Netherlands.
Introduction:
After the onset of the HIV epidemic, the hope arose that the "harm reduction" approach of the Amsterdam "low-threshold" methadone programs would have a function in controlling the spread of HIV among injecting drug users (IDUs).
Methods:
To find evidence for this assumption, 386 IDUs participating in an HIV study between 1985 and 1989 were studied. Long-term regular participants in low-threshold methadone programs were compared with short-term and/or irregular participants.
Results:
Controlling for possible confounders, long-term regular participants had a slightly increased but not statistically significant risk of being HIV infected. With regard to current drug use, they injected daily and shared needles as often as did short-term and/or irregular participants.
Conclusions:
The results suggest that the Amsterdam low-threshold methadone programs fail to diminish HIV risk behavior. If these programs want to have a positive effect on the spread of HIV, expansion of existing HIV prevention efforts, an increase in the daily methadone dose level, and measures to enforce regular attendance may be required.
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