Comparison Of Working Mechanism Between Methadone Maintenance Treatment And Needle And Syringe Exchange In Yunnan Province

BackgroundInjecting drug use has been reported as the main route of HIV transmission in China for many years. The rate of sharing injection equipment amongst the drug users was extremely high. In China, Needle and Syringe Exchange Program (NSP) and Methadone Maintenance Treatment (MMT) was initially developed in 1997 and 2004 respectively. Several studies have also shown that NSP and MMT are extremely effective in preventing HIV transmission in China. However, there has no study on comparing the mechanism of two interventions, NSP and MMT in China up to date. Researching the relationship, benefits and shortcoming between NSP and MMT will provide valuable evidence to prevent and control AIDS in China smoothly.Objective1. To systematic evaluate the status of NSP and MMT mechanism in selected province and institute a comparison in regulation and rules development, implementation, human resource (HR), financial support and partial index status.2. To compare the cost of HR, financial input and output in NSP sites with those cost in MMT clinics.3. To evaluate the advantages, problems, challenges of NSP and MMT, put forward a proposal in combining two interventions.MethodThis survey, which selected Yunnan Province as the research field, was divided into quantitative surveys and qualitative surveys. All NSP sites and MMT clinic in Yunnan Province were investigated with questionnaires. There were 55 MMT clinics and 51 NSP sites responded. Interview in depth was used in qualitative surveys. The 50 interviewees were made up of three groups, the key persons from government, staff in MMT clinics and NSP sites, beneficiaries of NSP and MMT. The qualitative analysis adopted methods of descriptive analysis of induction and classification. Frequency and character analysis, Mann-Whitney test, t test and Chi-square test were used in quantitative surveysConclusion1. From the perspective of mechanism status, the MMT clinics have better operation than NSP sites in regulation and rules development, HR allocation, implementation status of related index.2. Compared the cost of HR and financial output in MMT clinics with those in NSP, the costs of MMT clinics are higher than NSP sites.3. Although the MMT clinics and NSP sites have different target groups, advantages, problems and challenges, the operational effect of MMT clinics were better than NSP sites followed by a comprehensive analysis.