Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA 90024, USA.
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China.
Int J Drug Policy. 2019 Sep;71:73-77. doi: 10.1016/j.drugpo.2019.06.005. Epub 2019 Jun 21.
Drug use stigma among service providers has been recognized as a barrier to improving the accessibility and outcomes of addiction treatment. This study examined the stigmatizing attitudes towards people who use drugs (PWUD) among service providers in methadone maintenance treatment (MMT) clinics in China and its associated factors.
The cross-sectional study used the baseline data of a randomized intervention trial conducted in China, and the data were collected from January 2012 to August 2013. A total of 418 MMT service providers were included in the study. Stigma towards PWUD was measured via a 10-item scale embedded in two case vignettes (PWUD and non-PWUD). The Wilcoxon signed-rank test was performed to evaluate the vignette difference for each item of the scale. The linear mixed model was used to identify the adjusted association between drug use stigma and other interested variables including demographics, professional background, and MMT knowledge of the service providers.
The Wilcoxon signed-rank tests showed that the participants had a higher level of stigmatizing attitudes towards PWUD than non-PWUD (p-value<0.001 for all items of the stigma scale). The linear mixed model identified that the reception of national MMT training was associated with a lower degree of drug use stigma (estimate=-1.79; 95% CI: -3.13, -0.45; p-value = 0.009).
The findings of the study provide evidence of the existence of drug use stigma among MMT providers in China. The expansion of national-level training and the development of stigma reduction interventions are needed to address this issue.
服务提供者对药物使用者的污名化已被认为是改善成瘾治疗可及性和效果的障碍。本研究调查了中国美沙酮维持治疗（MMT）诊所服务提供者对药物使用者（PWUD）的污名化态度及其相关因素。
这项横断面研究使用了在中国进行的一项随机干预试验的基线数据，数据收集于 2012 年 1 月至 2013 年 8 月。共有 418 名 MMT 服务提供者纳入研究。通过两个案例情景（PWUD 和非 PWUD）中的 10 项量表来衡量对 PWUD 的污名化态度。采用 Wilcoxon 符号秩检验评估量表各项目的情景差异。采用线性混合模型确定药物使用污名与其他感兴趣变量（包括人口统计学、专业背景和服务提供者的 MMT 知识）之间的调整关联。
Wilcoxon 符号秩检验显示，参与者对 PWUD 的污名化态度高于非 PWUD（所有污名量表项目的 p 值均<0.001）。线性混合模型确定，接受国家 MMT 培训与较低程度的药物使用污名化相关（估计值=-1.79；95%CI：-3.13，-0.45；p 值=0.009）。
研究结果提供了中国 MMT 提供者中存在药物使用污名化的证据。需要扩大国家级培训并制定减少污名化干预措施来解决这一问题。
