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The prevalence from sensitivity analyses including studies with all patients undergoing ART, and only studies with low risk of bias were close to crude prevalence (Additional file 1: Tables S6)

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The key limitations of aversion therapy include the temporary nature of its effects, the potential for relapse, the ethical concerns around administering aversive stimuli, the difficulty in generalizing the conditioned response to real-world situations, and the lack of evidence for its long-term efficacy compared to other addiction treatment approaches

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