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美沙酮维持治疗降低越南偏远地区吸毒者感染艾滋病毒/艾滋病的脆弱性:评估 12 个月随访后艾滋病毒知识、感知风险和检测率的变化。

Methadone Maintenance Treatment Reduces the Vulnerability of Drug Users on HIV/AIDS in Vietnamese Remote Settings: Assessing the Changes in HIV Knowledge, Perceived Risk, and Testing Uptake after a 12-Month Follow-Up.

机构信息

Vietnam Authority of HIV/AIDS Control, Ministry of Health, Hanoi 100000, Vietnam.

Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.

出版信息

Int J Environ Res Public Health. 2018 Nov 16;15(11):2567. doi: 10.3390/ijerph15112567.

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.

摘要

美沙酮维持治疗(MMT)项目被认为是一种有效评估吸毒人群/HIV 感染者 HIV 风险和进行预防的途径。然而,关于在偏远、欠发达地区的患者中实施这一想法的研究却有限。本研究在越南三个山区省份设立了诊所,旨在评估患者的 HIV 知识、感知风险和 HIV 检测接受率的变化。在三省的六家 MMT 诊所进行了一项纵向研究,对 300 名患者进行了基线和 12 个月后的评估。比较了感兴趣的结果在基线和 12 个月后。变化的幅度被推断出来。报告 HIV 知识不好的参与者比例下降了 4.4%(基线时为 61.3%,12 个月时为 56.8%)。显著改善的是针具共享是一种传播途径的知识(82.7%对 89.6%)。然而,大多数参与者仍报告称,蚊子/昆虫和与 HIV 感染者共餐是传播途径,在两个时间点均为 84.7%对 89.1%,92.2%对 93.3%。本研究发现,在 12 个月后,MMT 患者的 HIV 知识和检测接受率仅略有改善。它还突出了这些患者在知识、态度和实践(KAP)方面的一些不足,特别是在 HIV 传播途径的识别方面,无论是在项目启动时还是随访时,患者都存在不正确的认识。这些发现支持了在 MMT 诊所加强 HIV 教育和咨询工作的论点,以及通过整合 MMT/HIV 服务来改善预防和保健服务的可及性。

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