Abstract
Methadone Maintenance Treatment (MMT) program has been considered a medium through which human immunodeficiency virus (HIV) risks assessment and prevention on drug use/HIV-infected population can be effectively conducted. Studies concerning the implementation of such idea on patients in remote, under-developed areas, however, have been limited. Having the clinics established in three mountainous provinces of Vietnam, this study aimed to evaluate the changes in knowledge of HIV, perceived risk, and HIV testing uptake of the patients. A longitudinal study was conducted at six MMT clinics in three provinces with a pre- and post-assessments among 300 patients. Outcomes of interest were compared between baseline and after 12 months. The magnitude of changes was extrapolated. The proportion of participants reporting that their HIV knowledge was not good fell by 4.4% (61.3% at the baseline vs. 56.8% at 12 months). The significant improvement seen was in the knowledge that needle sharing was a mode of transmission (82.7% vs. 89.6%). Nevertheless, the majority of participants reportedly considered mosquitoes/insect and eating with the HIV-infected patient were the route of transmission at both time points (84.7% vs. 89.1%, 92.2% vs. 93.3%, respectively). This study found a limited improvement in HIV knowledge and testing uptake among MMT patients following a 12-month period. It also highlighted some shortcomings in the knowledge, attitudes and practices (KAP) of these patients, in particular, incorrect identification of HIV transmission routes, among patients both at program initiation and follow-up. The findings lent support to the argument for enhancing education and counseling efforts at MMT clinics regarding HIV, as well as for improving access to preventive and health care services through the integration of MMT/HIV services.
Highlights
Methadone maintenance treatment (MMT) is seen globally as one of the most effective methods, both in terms of cost and patient outcome, to help people withdraw from using opioid drugs [1,2].Many countries have introduced programs to assist in reducing the number of people using these drugs [3] so as to prevent morbidity and mortality directly in relation to opioid drugs, and due to co-morbidities, such as infection [4,5]
Having the clinics established in three mountainous provinces of Vietnam, this study aimed to evaluate the changes in knowledge of human immunodeficiency virus (HIV), perceived risk, and HIV testing uptake of the patients
This study found a limited improvement in HIV knowledge and testing uptake among MMT patients following a 12-month period
Summary
Methadone maintenance treatment (MMT) is seen globally as one of the most effective methods, both in terms of cost and patient outcome, to help people withdraw from using opioid drugs [1,2].Many countries have introduced programs to assist in reducing the number of people using these drugs [3] so as to prevent morbidity and mortality directly in relation to opioid drugs, and due to co-morbidities, such as infection [4,5]. In the US in 2007, intravenous drug use was estimated to cause an economic burden of $193 billion, mainly due to loss of productivity and absenteeism [10] Reducing this economic burden of drug use through methadone maintenance is seen as highly advantageous, in and can lead to greater numbers of drug users in the workforce and greater productivity [11]. HIV in Vietnam is largely concentrated among the drug using population so targeting of this group through MMT services to reduce HIV is of benefit. Services for both have been rapidly increased in recent years to include 364 HIV outpatient centers [15] and 251 MMT centers [16]
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