Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan.
Tri-Service General Hospital Songshan Branch, Taipei, Taiwan.
BMC Psychiatry. 2020 Jul 2;20(1):346. doi: 10.1186/s12888-020-02764-0.
The study aims were to investigate adherence to methadone maintenance treatment (MMT) and to identify associated clinical factors in patients who inject drugs diagnosed with human immunodeficiency virus (HIV) infection in Taiwan.
Data were from the National Health Surveillance System on HIV and the National Drug Treatment System on MMT. HIV-positive people who inject drugs (HIVPWID) were defined as the study population. Information obtained included age, sex, education, marital status, employment, methadone dose, and date of diagnosis of HIV infection. Adherence was defined as taking methadone for the past 90, 180 and 365 days, then categorized as high (> 90%), moderate (51 to 90%), or low (<=50%) adherent respectively.
Of 1641 HIVPWID registered in the datasets from 2007 to 2012, 961 (58.56%) had received MMT. For HIVPWID evaluated at 90 days (n = 951), 271 (28.5%), 382 (40.2%), and 298 (31.3%) were classified as high, moderate, and low adherent respectively. For HIVPWID evaluated at 180 days (n = 936), 190 (20.3%), 349 (37.3%), and 397 (42.4%) were classified as high, moderate, and low adherent respectively. For HIVPWID evaluated at 365 days (n = 919), 133 (14.5%), 271 (29.5%), and 515 (56.0%) were classified as high, moderate, and low adherent respectively. After controlling for sociodemographics, results showed that methadone dose, location of MMT clinic, and date of HIV diagnosis were significantly associated with MMT adherence.
Study findings underscore the importance to MMT adherence of methadone dosage, early diagnosis of patient's HIV infection, and area of patient residence.
本研究旨在调查在台湾，接受美沙酮维持治疗（MMT）的注射吸毒人群中，与人类免疫缺陷病毒（HIV）感染相关的药物依从性，并确定相关临床因素。
数据来源于全国 HIV 监测系统和全国 MMT 治疗系统。HIV 阳性的注射吸毒者（HIVPWID）被定义为研究人群。获取的信息包括年龄、性别、教育程度、婚姻状况、就业状况、美沙酮剂量以及 HIV 感染诊断日期。药物依从性定义为在过去 90、180 和 365 天内服用美沙酮，然后分别归类为高（>90%）、中（51-90%）或低（<=50%）依从性。
在 2007 年至 2012 年期间，1641 名 HIVPWID 登记在数据集中，其中 961 名（58.56%）接受了 MMT。在 90 天评估的 HIVPWID（n=951）中，分别有 271 名（28.5%）、382 名（40.2%）和 298 名（31.3%）被归类为高、中、低依从性。在 180 天评估的 HIVPWID（n=936）中，分别有 190 名（20.3%）、349 名（37.3%）和 397 名（42.4%）被归类为高、中、低依从性。在 365 天评估的 HIVPWID（n=919）中，分别有 133 名（14.5%）、271 名（29.5%）和 515 名（56.0%）被归类为高、中、低依从性。在控制了社会人口统计学因素后，结果表明，美沙酮剂量、MMT 诊所的位置以及 HIV 诊断日期与 MMT 依从性显著相关。
研究结果强调了美沙酮剂量、患者 HIV 感染的早期诊断以及患者居住地对 MMT 依从性的重要性。
