Pang Lin, Hao Yang, Mi Guodong, Wang Changhe, Luo Wei, Rou Keming, Li Jianhua, Wu Zunyou
National Centre for AIDS/STD Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China.
AIDS. 2007 Dec;21 Suppl 8:S103-7. doi: 10.1097/01.aids.0000304704.71917.64.
To evaluate the effectiveness of the first phase of eight methadone maintenance treatment (MMT) clinics in China.
Repeated cross-sectional surveys.
Three surveys of clients attending the first phase of eight MMT clinics were carried out at entry, and 6 and 12 months after enrolment. Drug using behaviours, drug-related criminal activity, and relationships with families were compared for the three periods. Blood specimen were collected and tested for HIV for each client at entry, and HIV-negative clients were re-tested after 12 months.
A total of 585, 609 and 468 clients participated in the first, second and third surveys, respectively. The proportion of clients who injected drugs reduced from 69.1 to 8.9 and 8.8%, and the frequency of injection in the past month had reduced from 90 times per month to twice per month, employment increased from 22.9 to 43.2 and 40.6%, and self-reported criminal behaviours reduced from 20.7 to 3.6 and 3.8% in the three surveys. By the third survey, 65.8% of clients reported a harmonious relationship with families, an increase from 46.8% at entry, and 95.9% of clients were satisfied with MMT services. Eight HIV seroconversions were found among 1153 clients during 12 months.
The study demonstrated that the first phase MMT contributed to a reduction in drug use, drug injecting behaviours, drug-related criminal behaviours, HIV infections, and improved relationships within families among heroin users who participated in the MMT programme. MMT needs to be scaled up nationwide rapidly with improved services.
评估中国8家美沙酮维持治疗(MMT)门诊第一阶段的治疗效果。
重复横断面调查。
对8家MMT门诊第一阶段的服务对象进行3次调查,分别在入组时、入组后6个月和12个月进行。比较这三个时期的吸毒行为、与毒品相关的犯罪活动以及家庭关系。在入组时为每位服务对象采集血样检测HIV,HIV阴性的服务对象在12个月后再次检测。
分别有585、609和468名服务对象参与了第一次、第二次和第三次调查。在这三次调查中,注射吸毒的服务对象比例从69.1%降至8.9%和8.8%,过去一个月的注射频率从每月90次降至每月两次,就业率从22.9%升至43.2%和40.6%,自我报告的犯罪行为从20.7%降至3.6%和3.8%。到第三次调查时,65.8%的服务对象报告与家人关系融洽,较入组时的46.8%有所增加,95.9%的服务对象对MMT服务满意。在1153名服务对象的12个月随访期内发现8例HIV血清阳转。
该研究表明,第一阶段的MMT有助于减少参与MMT项目的海洛因使用者的吸毒、注射行为、与毒品相关的犯罪行为、HIV感染,并改善家庭关系。MMT需要迅速在全国范围内扩大规模并改善服务。