Factors influencing access to methadone maintenance treatment among injecting drug users attending antiretroviral treatment clinics in two counties, Yunnan province

Abstract

To understand the demographic characteristics of HIV infected injecting drug users (IDUs) with access to antiretroviral therapy (ART) and to identify the factors influencing their access to methadone maintenance treatment (MMT). Outpatients infected with HIV through injecting drug use were selected from the ART clinics in 2 counties in Yunnan province. They were divided into 2 groups, MMT group and non MMT group. Descriptive epidemiologic analysis was conducted on their demographic characteristics, disease history and high risk behaviors and logistic regression analysis was done to identify the factors associated with the access to MMT. Among 635 IDUs (536 males, 99 females) surveyed, 247 received MMT (38.9%), 388 received no MMT(61.1%). The median age was 40.33 years and the median diagnosed HIV infection time was 6.08 years. Multivariate logistic regression indicated that being female (OR=2.40, 95%CI:1.00-5.74), educational level of junior high school (OR=3.28, 95%CI:1.75-6.14), educational level of senior high school or above (OR=7.10, 95%CI:1.90-26.62), more than 6 years of diagnosed HIV infection history (OR=3.84, 95% CI:2.11-6.98) and HCV positive (OR=6.21, 95% CI:3.06-12.58) were the positive factors influencing IDUs' access to MMT. However, being married (OR=0.38, 95%CI:0.20-0.72) or being employed (OR=0.01, 95%CI:0.00-0.02) were the negative factors influencing IDUs' access to MMT. The proportion of HIV infected IDUs who received MMT in ART clinics was still very low in the two counties, targeted intervention measures should be taken to increase the MMT coverage, especially among those who are married or employed.