Who uses methadone services in China? Monitoring the world's largest methadone programme

Abstract

Aims: To describe the data collected by the Chinese methadone maintenance treatment (MMT) system and the characteristics of clients entering the programme.

Design: Descriptive study using routinely collected data from the MMT data management system for the period March 2004 and March 2010.

Setting: All MMT clinics in China.

Participants: Clients who enrolled for services between March 2004 and March 2010.

Measurements: Routinely collected data included: demographic information; drug use, sexual and criminal behaviours; status of infection with human immunodeficiency virus (HIV), hepatitis C virus (HCV) and syphilis; random urine-opiate test results; and the daily methadone dose received. Differences among clients by year were examined.

Findings: During the period examined, there were 251,974 clients attending 684 clinics in 27 provinces. Overall, the mean age was 34.4 years, 83.8% were male, 70.2% were unemployed, 75% had ever injected drugs, 17% had shared needles and 7.4% were HIV-positive. The profile of clients changed over time, with fewer HIV-positive individuals, fewer injecting drug users, fewer needle-sharers, fewer females and fewer unemployed. Half the clients dropped out within 6 months. The average final dose received was 49.4 mg. The estimated probability of interrupting treatment before 6 months was 52.5%.

Conclusions: The profile of clients enrolling in methadone maintenance treatment in China is continually changing and appears to be associated with reduced risk of HIV. High dropout in the programme may limit its effectiveness. The availability of a centralized, real-time data system was extremely useful for monitoring the progress of the Chinese methadone maintenance treatment programme.

Keywords: China; HIV; demographic information; hepatitis C; methadone maintenance treatment; sexual behaviours; syphilis.