Characteristics Of HIV Infection In Some Methadone Clinics In China And The Influencing Factors Of HIV / AIDS Antiviral Therapy

ObjectivesThis research aims to find out the characteristics of HIV infected drug users and current situation of antiretroviral therapy (ART) in methadone maintenance treatment (MMT) clinics. Another purpose is trying to identify major influential factors associated with subjects’ participation in ART. On this basis, coverage of ART in MMT clinics could be expanded.MethodsA mixed method including both qualitative and quantitative methods has been used.6MMT clinics in5cities/counties have been chosen the research field. Eligible subjects were interviewed or surveyed by a questionnaire.Qualitative research:After reviewing the literature and consulting expert of this field, interview outlines were made. HIV infected drug users in MMT clinics, family members of them and related work faculty were3groups of main subjects. The major points of interview included general characteristics and major influential factors associated with subjects’ participation in ART. The interview record or note were translated into word materials, and analyzed with ATLAS. Results of qualitative research provided a basis for the design of questionnaire.Quantitative research:Questionnaire was formulated according to the results of qualitative research. The major points of questionnaire included general characteristics, heroin abuse, HIV infection and acceptance of MMT and ART. Researchers looked up records of MMT and CDCclinics in order to check out the results of questionnaires and make a supplement. Data was entered with Epidata3.0and analyzed with SAS9.1. The main characteristics is described by mean and standard deviation(or median and Inter Quartile Range). Logistic regression was used to identify major influential factors associated with subjects’participation in ART. Results66subjects including26HIV infected drug users,17family members and23work staff were interviewed.293questionnaires were finished among HIV infected drug users, and291of them are eligible.1、 Characteristics of subjects in qualitative research:HIV infected drug users were mainly men aged30-40with lower than high school education. Most of them were married and unemployed. Family members of HIV infected drug users are mainly female and spouse of the HIV infected ones. The work staff are mainly male with2-8years work experience.2、 Characteristic of subjects in quantitative research:General demographic characteristics:Subjects were mainly single men without children and average age of them was (38.4±5.9). Most of them were ethnic Han with lower than high school education, living with family or relatives. Since the unemployed ones took a great proportion, the living expenses mainly come from family members and government minimum subsistence allowances. According to slef-report, most subjects didn’t use alcohol in the recent month.Usage of Heroin and sexual behavior:Most of the subjects have used Heroin for10to19years and changed from oral to injection.35.4%subjects admitted to using Heroin in the recent month.74.2%subjects reported no sex in the last month.Methadone Maintenance Treatment:The duration of MMT was mainly over36months. The most important reason for starting MMT was control of heroin addiction.38.5%subjects had reported exit of MMT.59.1%subjects were palning to take long-term MMT.64.3%family members supported long-term MMT.91.4%subjects reported everyday attendance of MMT and62.5%subjects reported no other activity in MMT clinics during the last month.73.9%were enjoying the awarding measures of MMT clinics.Subjects with everyday dose of less than100mg was61.2%.HIV infection:44.3%subjects had been confirmed for2to5years.Separately27.5%were tested in CDC and compulsory detoxification settings.63.6%subjects had told others about their HIV infection.93.5%were followed by doctors after their confirmation.52.9%subjects had a good feeling about their health status.Antiretroviral therapy:155out of291(53.3%) were taking ART,32.9%were introduced to ART by doctors of MMT clinics.92.3%of them got their ART medicine in city/county hospital.59.4%had to pay for ART.81.9%had no supervision and77.4%reported taking ART medicine on time everyday.98.7%agreed regular ART was very important.136out of291(46.7%) subjects were not taking ART.56.6%of them had talked about ART with MMT doctors during the last6months.77.2%subjects had never thought of accepting ART, and main reasons were good self-perception of health status, disqualification of physical examination and fear of side effects of ART. Except for6subjects who had never took CD4test,46.0%had CD4result less than or equal to350/mm3and58.2%had took ART. Meanwhile,51.9%had CD4result more than350/mm3and51.0%had took ART.3、Major influential factors of ART:According to single factor logistic regression analysis, living alone, self-report drinking in last month, family members’negative attitude towards MMT, poor self-report compliance to MMT in last month, none awarding measures in MMT clinics, unwilling to tell others about their HIV infection, good self-perception of their health status, no discussion of ART related topic with family in last6months, no awareness of family members’attitude towards ART and lack of correct knowledge of ART were main factors influencing subjects’participation in ART. Multivariate logistic regression analysis showed that living alone, unwilling to tell others about their HIV infection, poor self-perception, no discussion of ART related topic with family in last6months and no awareness of family members’attitude towards ART were associated with low participation rate of ART. Conclusions1、6MMT clinics in Yunnan and Guangxi province have HIV infected drug users whose main characteristics are mid-aged male, ethnic Han, low education background, unemployed, long-term Heroin addiction, MMT steadily and years of HIV confirmation.More than half of the subjects are taking ART.2、There are3main aspects of the influential factors. First of all, HIV infected drug users who have good self-perception of their health status or lack the correct knowledge of ART may not accept ART. Secondly, those who lack the support from family such as live alone, family members’lack of MMT and ART knowledge tend not to take ART. Thirdly, factors related to MMT such as poor self-report compliance to MMT in last month and no awarding measures in MMT clinics may also hinder subjects from ART.3、 Comprehensive measures such as health education, promotion of family support and improvement of MMT may be positive to encourage HIV infected drug users to take ART.