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J Subst Abuse Treat. 2018 Mar;86:86-93. doi: 10.1016/j.jsat.2018.01.003. Epub 2018 Jan 5.

A qualitative assessment of attitudes about and preferences for extended-release naltrexone, a new pharmacotherapy to treat opioid use disorders in Ukraine.

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Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA. Electronic address:
Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA.
ICF Alliance for Public Health, Kyiv, Ukraine.
Ukrainian Institute on Public Health Policy, Kyiv, Ukraine.
Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA; Yale School of Public Health, Division of Epidemiology of Microbial Diseases, New Haven, CT, USA; Centre of Excellence on Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia.


Numerous individual barriers, including negative attitudes toward opioid agonist therapies (OAT), have undermined HIV prevention efforts in Ukraine where the epidemic is concentrated in people who inject drugs (PWID). The recent availability of extended-release naltrexone (XR-NTX), an opioid antagonist, provides new opportunities for treatment and prevention, but little is known about patient preferences. We conducted qualitative analysis using focus groups (FG) of PWID recruited based on OAT experience: currently, previously, and never on OAT in five Ukrainian cities. FG included 199 PWID in 25 focus groups. Focus group transcripts were coded and analyzed using a modified grounded theory approach to identify common themes and domains related to attitudes about and preferences for XR-NTX, relative to other treatments. Interest in XR-NTX was supported if supervised opioid withdrawal and psychological support were assured. Other factors supporting XR-NTX included a focus on younger PWID early in their injection career and motivated for recovery. Perceptions of recovery included not receiving psychoactive medications like methadone or buprenorphine. With more information, XR-NTX could be a viable option for PWID in Ukraine, especially if concerns regarding withdrawal and psychological support are adequately addressed.


Addiction; Extended-release naltrexone (VivitrolĀ®); HIV; Implementation science; Medication-assisted treatment; Opioid use disorders; Patient preferences; People who inject drugs; Ukraine

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