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Observational Study
. 2015 Oct 16:12:39.
doi: 10.1186/s12954-015-0075-9.

Impact of a methadone maintenance therapy pilot in Vietnam and its role in a scaled-up response

Tran Vu Hoang  1 , Tran Thi Thanh Ha  2 , Tran Minh Hoang  3 , Nguyen To Nhu  4 , Nguyen Cuong Quoc  5 , Nguyen thi Minh Tam  6 , Stephen Mills  7
Affiliations
Observational Study

Impact of a methadone maintenance therapy pilot in Vietnam and its role in a scaled-up response

Tran Vu Hoang et al. Harm Reduct J. .

Abstract

Background: As a dual response to the HIV epidemic and the high level of injecting drug use in Vietnam, the Ministry of Health (MOH) initiated a pilot methadone maintenance therapy (MMT) program in Hai Phong and Ho Chi Minh City (HCMC) in early 2009. The objectives of the pilot were to provide evidence on whether MMT could be successfully implemented in Vietnam and scaled up to other localities.

Methods: A prospective study was conducted among 965 opiate drug users admitted to the pilot. Data on demographic characteristics, sexual behaviors, substance use behaviors (including heroin use), and blood-borne virus infection (HIV, hepatitis B, and hepatitis C) were collected at treatment initiation and then again at 3-, 6-, 9-, 12-, 18-, and 24-month intervals thereafter.

Results: Twenty-four months after treatment initiation, heroin use as measured by urine test or self-report had reduced from 100 % of participants at both sites to 14.6 % in Hai Phong and 22.9 % in HCMC. When adjusted for multiple factors in Generalized Estimating Equations (GEE) logistic regression modeling, independent predictors of continued heroin use after 24 months of MMT in HCMC were the following: poor methadone adherence (adjusted odds ratio (AOR) = 3.7, 95 % confidence interval (CI) 1.8-7.8); currently on antiretroviral treatment (ART) (AOR = 1.8, 95 % CI 1.4-2.4); currently on TB treatment (AOR = 2.2, 95 % CI 1.4-3.4); currently experiencing family conflict (AOR = 1.6, 95 % CI 1.1-2.4); and currently employed (AOR = 0.8, 95 % CI 0.6-1.0). For Hai Phong participants, predictors were the following: currently on ART (AOR = 2.0, 95 % CI = 1.4-3.0); currently experiencing family conflict (AOR = 2.0, 95 % CI = 1.0-3.9); and moderate adherence to methadone (AOR = 2.1, 95 % CI = 1.2-1.9). In Hai Phong, the percentage of participants who were employed had also increased by end of study from 35.0 to 52.8 %, while in HCMC the level remained relatively unchanged, between 52.2 and 55.1 %.

Discussion: Study findings were used in multiple fora to convince policymakers and the public on the significant and vital role MMT can play in reducing heroin use and improving quality of life for individuals and families. Four years after this study was completed, Vietnam had expanded MMT to 162 clinics in 44 provinces serving 32,000 patients.

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Figures

Fig. 1
Fig. 1
Trends in heroin use over time among participants
See this image and copyright information in PMC

References

    1. Mattic RP, Breen C, Kimber J, Davoli M, Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database Syst Rev. 2009;3:CD002209. - PMC - PubMed
    1. Uhlmann S, Milloy M-J, Kerr T, Zhang R, Guillemi S, Marsh, D, et al. Methadone maintenance therapy promotes initiation of antiretroviral therapy among injection drug users. Addiction. 2010;105(5):907–13. - PMC - PubMed
    1. Langendam MW, van Brussel, GHA, Coutinho RA, van Ameijden, EJC, et al. The impact of harm-reduction-based methadone treatment on mortality among heroin users. Am J Public Health. 2001;91(5):774–80. - PMC - PubMed
    1. Gowing L, Farrell M, Bornemann R, Ali R, (2008) Substitution treatment of injecting opioid users for prevention of HIV infection. Cochrane Database of Syst Rev, doi:10.1002/14651858.CD004145.pub3f. - PubMed
    1. Connock M, Juarez-Garcia A, Jowett S, Frew E, Liu Z, Taylor RJ, et al. Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation. Health Technol Assess. 2007;11(9):1–171. - PubMed

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