Department of Health Promotion and Health Education, National Taiwan Normal University, No. 162, He-ping East Road, Section 1, Taipei 10610, Taiwan.
Subst Abuse Treat Prev Policy. 2011 Apr 8;6:6. doi: 10.1186/1747-597X-6-6.
Methadone treatment was introduced in Taiwan in 2006 as a harm-reduction program in response to the human immunodeficiency virus (HIV), which is endemic among Taiwanese heroin users. The present study was aimed at examining the clinical and behavioral characteristics of methadone patients in northern Taiwan according to their HIV status.
The study was conducted at four methadone clinics. Participants were patients who had undergone methadone treatment at the clinics and who voluntarily signed a consent form. Between August and November 2008, each participant completed a face-to-face interview that included questions on demographics, risk behavior, quality of life, and psychiatric symptoms. Data on HIV and hepatitis C virus (HCV) infections, methadone dosage, and morphine in the urine were retrieved from patient files on the clinical premises, with permission of the participants.
Of 576 participants, 71 were HIV positive, and 514 had hepatitis C. There were significant differences between the HIV-positive and HIV-negative groups on source of treatment payment, HCV infection, urine test results, methadone dosage, and treatment duration. The results indicate that HIV-negative heroin users were more likely to have sexual intercourse and not use condoms during the 6 months prior to the study. A substantial percent of the sample reported anxiety (21.0%), depression (27.2%), memory loss (32.7%), attempted suicide (32.7%), and administration of psychiatric medications (16.1%). There were no significant differences between the HIV-positive and HIV-negative patients on psychiatric symptoms or quality of life.
HIV-positive IDUs were comorbid with HCV, indicating the need to refer both HIV- and HCV-infected individuals for treatment in methadone clinics. Currently, there is a gap between psychiatric/psychosocial services and patient symptoms, and more integrated medical services should be provided to heroin-using populations.
2006 年，台湾引入美沙酮治疗作为艾滋病毒（HIV）减害方案，因为台湾的海洛因使用者中 HIV 呈地方性流行。本研究旨在根据 HIV 状况检查台湾北部美沙酮患者的临床和行为特征。
研究在四家美沙酮诊所进行。参与者为在诊所接受美沙酮治疗并自愿签署同意书的患者。2008 年 8 月至 11 月期间，每位参与者完成了一次面对面访谈，内容包括人口统计学、风险行为、生活质量和精神症状。在参与者同意的情况下，从临床档案中检索有关 HIV 和丙型肝炎病毒（HCV）感染、美沙酮剂量和尿液中吗啡的数据。
在 576 名参与者中，有 71 人 HIV 阳性，514 人 HCV 阳性。在治疗费用来源、HCV 感染、尿液检测结果、美沙酮剂量和治疗持续时间方面，HIV 阳性组与 HIV 阴性组存在显著差异。结果表明，在研究前 6 个月，HIV 阴性的海洛因使用者更有可能发生性行为且不使用安全套。很大一部分样本报告了焦虑（21.0%）、抑郁（27.2%）、记忆力减退（32.7%）、自杀企图（32.7%）和精神科药物治疗（16.1%）。在精神症状或生活质量方面，HIV 阳性患者与 HIV 阴性患者无显著差异。
HIV 阳性 IDU 合并 HCV，这表明需要在美沙酮诊所将 HIV 和 HCV 感染者都转介进行治疗。目前，精神科/心理社会服务与患者症状之间存在差距，应该为海洛因使用者提供更多综合医疗服务。
