Methadone maintenance treatment and mortality in HIV-positive people who inject opioids in China

Zhao, Yan; Shi, Cynthia X.; McGoogan, Jennifer M.; Rou, Keming; Zhang, Fujie; Wu, Zunyou

doi:10.2471/blt.12.108944

Cited by 29 publications

(24 citation statements)

References 37 publications

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“…While the estimated absolute numbers of HIV-infected PWID has remained constant, the prevalence of HIV among PWID in methadone maintenance treatment has dropped from 1 % in 2006 to 0.2 % in 2012 (Wu Z, conference presentation, 2012). Of note, Chinese PWID engaged in both methadone maintenance treatment and ART experienced lower 6-and 12-month mortality rates of 6.6 and 3.7 per 100 person-years, compared to 16.9 and 7.4 per 100 person-years for PWID engaged only in ART [45]. Hammet TM et al's long-term cross-border study in Vietnam and China found that a package of peer outreach and NSP interventions were correlated with significant declines in HIV prevalence among PWID, HIV incidence among new injectors, and drug-related risk behaviors [32•].…”

Section: Harm Reduction Policy and Implementationmentioning

confidence: 92%

Addressing Injecting Drug Use in Asia and Eastern Europe

Wu¹,

Shi

Detels

2013

Curr HIV/AIDS Rep

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While the global HIV incidence dropped about 20% in the past 10 years, HIV incidences among people who inject drugs (PWID) in Asia and Europe continue to increase and to account for high proportions of new HIV infections among PWID globally. Great changes have been observed in this region, such as progressing from rejection to acceptance of harm reduction strategies in Asian countries, but no such change has occurred in Eastern European countries. China has quickly scaled up harm reduction activities nationwide, resulting in the decline of HIV incidence and HIV prevalence among PWID since 2006. However, insufficient scaling up of harm reduction programs in other countries has failed to slow down their HIV epidemics. In Eastern European countries where the spread of HIV among PWID is the most severe, only about 15% of funding for harm reduction programs are from domestic sources. Strong political and financial commitment from countries in this region is urgently needed to quickly scale up evidence-based harm reduction strategies in order to prevent the HIV epidemic from spreading rapidly from PWID to the heterosexual general population.

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Section: Harm Reduction Policy and Implementationmentioning

confidence: 92%

Addressing Injecting Drug Use in Asia and Eastern Europe

Wu¹,

Shi

Detels

2013

Curr HIV/AIDS Rep

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“…During the past decade, China has established the largest MMT program worldwide (Zhao et al, 2013). By August of 2014, 756 methadone maintenance clinics and more than 300 outreach clinics have been established in 28 provinces, autonomous regions and municipalities, cumulatively treating 410 thousand opiate users (WHO Representative office China, 2014).…”

Section: Introductionmentioning

confidence: 99%

Psychoactive Substance Use Among Methadone Maintenance Therapy Clients in China

Lin

Cao²,

2017

Int J Ment Health Addiction

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A proportion of methadone maintenance therapy (MMT) clients in China shifted their substance use habit from opiate to psychoactive substances. The objective of this study was to examine the pattern and associated factors of psychoactive substance use among MMT clients. The study was conducted among 2,448 clients from 68 MMT clinics of China. The type and frequency of psychoactive substance use were self-reported. About 38.1% (N=933) of the participants reported psychoactive substance use in lifetime, and 6.5% (N=158) in the previous 30 days. The most commonly used psychoactive substances were sedative/hypnotic/antidiarrheal agent and amphetamine. Psychoactive substance use in the past 30 days was correlated with younger age, recent heroin use, having psychoactive substance using friend(s), and depressive symptoms. The finding suggested that urinalysis of psychoactive substances should be routinely administered in the MMT clinics. Young clients, concurrent heroin users, and clients with depressive symptoms deserve more screening and intervention efforts.

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“…7 In addition, psychosocial support is critical to recovery because opioid dependence results in complex cognitive, behavioural and psychological dysfunction, including depression, anxiety and post-traumatic stress disorder. 7 Similarly, since HIV and HCV infections and tuberculosis are common among people who use opioids, a growing body of evidence suggests that integrated care services for disease management will improve outcomes in a variety of settings, 7 including China, as discussed by Zhao et al 6 Thus, the expansion of psychosocial services and infectious disease care services and their co-location and integration with treatment for opioid dependence should be strongly encouraged. The rapidly growing epidemic of dependence on prescription opioids is largely confined to the United States of America but is predicted to spread to other high-income countries and to low-and middle-income countries as well.…”

Section: Expanding Integrated Comprehensive Servicesmentioning

confidence: 99%

“…4 There is good evidence that opioid agonist maintenance treatment can greatly reduce harm by preventing HIV and HCV infection 5 and reducing the risk of death from these infections and drug overdose. 6 Thus, strategies for scaling up opioid agonist maintenance treatment in low-and middle-income countries should be prioritized.…”

mentioning

confidence: 99%