Although opioid agonist therapy (OAT) is associated with positive health outcomes, including improved HIV management, long-term retention in OAT remains low among patients with opioid use disorder (OUD). Using data from the Veterans Aging Cohort Study (VACS), we identify variables independently associated with OAT retention overall and by HIV status. Among 7,334 patients with OUD, 13.7% initiated OAT, and 27.8% were retained 12-months later. Likelihood of initiation and retention did not vary by HIV status. Variables associated with improved likelihood of retention included receiving buprenorphine (relative to methadone), receiving both buprenorphine and methadone at some point over the 12-month period, or diagnosis of HCV. History of homelessness was associated with a lower likelihood of retention. Predictors of retention were largely distinct between patients with HIV and patients without HIV. Findings highlight the need for clinical, systems, and research initiatives to better understand and improve OAT retention.

尽管阿片类激动剂治疗 (OAT) 与积极的健康结果相关，包括改善艾滋病毒管理，但阿片类药物使用障碍 (OUD) 患者的长期保留 OAT 仍然较低。利用退伍军人老龄化队列研究 (VACS) 的数据，我们确定了与总体 OAT 保留率和 HIV 状态独立相关的变量。在 7,334 名 OUD 患者中，13.7% 开始进行 OAT，27.8% 12 个月后保留。开始和保留的可能性并不因艾滋病毒状况而异。与保留可能性改善相关的变量包括接受丁丙诺啡（相对于美沙酮）、在 12 个月期间的某个时间点同时接受丁丙诺啡和美沙酮，或诊断为 HCV。无家可归的历史与保留的可能性较低有关。艾滋病毒感染者和未感染艾滋病毒的患者之间的保留预测因素在很大程度上是不同的。研究结果强调需要临床、系统和研究举措来更好地理解和提高 OAT 保留率。