Retention And Its Associated Factors Among HIV-seropositive Drug Users Receiving Methadone Maintenance Treatment

Objective To understand the retention and associated factors among HIV-Seropositivedrug users receiving Methadone Maintenance Treatment(MMT).Methods Using quantitative study and qualitative study. Quantitative study is follow-upstudy, fifty-six MMT clinics(the intervention group and control group have twenty-eightclinics) with no less than ten HIV-Seropositive drug users were selected from Yunnan,Sichuan, Xinjiang, Guangxi, Guizhou. The research subjects were recruited from theclinics for the baseline survey between July2009and January2010. Subjects in controlgroup received routine prevention and control work, persons in intervention groupreceived additional strengthening intervention measures beside that. After the baselinesurvey implemented for six months, Kaplan-Meier and Cox model were used to analyzeretention and associated factors, evaluate the effect of intervention to retention.In-depth interviews were conducted among42subjects and5MMT doctors in4MMT clinics in Yuxi, Gejiu, Wenshan, in order to better understand reasons of retention.The interview records were transcribed and the transcriptions was coded, summarized,and analysed.Results A total of2529subjects were enrolled,648persons were dropped out in6months(the retention was74.4%), with26.4%due to compulsory detoxification,12.0%disease or pregnancy,10.4%death and10.4%active drop out treatment. Cox regression showed area, age over40years, take intervention measures, participate in antiretroviraltherapy, never drop treatment before baseline six months, urine test negative three timesat baseline, high dosage and participate in MMT long time were contribute to itsretention.47subjects were interviewed, including5MMT clinic doctors,32persons whoreceiving MMT and10participants who dropped from MMT. Among42interviewees,27cases were male, and15cases were female,28cases no job,6cases have familymembers receiving MMT. After the treatment, the majority of the participants questionabout the effects of the MMT, the economic conditions improvement family because ofthe improvement of the relationship between family members and the increase of trustfrom family all can provided the opportunity for heroin addicts to use. With the timereceiving the MMT increased, the participants apart from the drug long and get morepsychological treatment and other services, so the participants can be kept for a longtime in the MMT clinic. At the same time the participants who receiving the antiviraltherapy have higher compliance and retention. In addition, the good social support canimprove the retention.Conclusion Special attention should be paid to subjects who participated MMT1-9months; the clinics should actively promote more persons to participate in ART,increasing daily dose of methadone, the intervention to the persons who at the age of40years, participate in MMT short time, ever drop treatment and urine test positive shouldbe strengthened. The intervention can effectively increase the retention, so it should beused for promotion and reference in other MMT clinics.