Methadone Maintenance Treatment Reduces the Vulnerability of Drug Users on HIV/AIDS in Vietnamese Remote Settings: Assessing the Changes in HIV Knowledge, Perceived Risk, and Testing Uptake after a 12-Month Follow-Up

Abstract

Methadone Maintenance Treatment (MMT) program has been considered a medium through which human immunodeficiency virus (HIV) risks assessment and prevention on drug use/HIV-infected population can be effectively conducted. Studies concerning the implementation of such idea on patients in remote, under-developed areas, however, have been limited. Having the clinics established in three mountainous provinces of Vietnam, this study aimed to evaluate the changes in knowledge of HIV, perceived risk, and HIV testing uptake of the patients. A longitudinal study was conducted at six MMT clinics in three provinces with a pre- and post-assessments among 300 patients. Outcomes of interest were compared between baseline and after 12 months. The magnitude of changes was extrapolated. The proportion of participants reporting that their HIV knowledge was not good fell by 4.4% (61.3% at the baseline vs. 56.8% at 12 months). The significant improvement seen was in the knowledge that needle sharing was a mode of transmission (82.7% vs. 89.6%). Nevertheless, the majority of participants reportedly considered mosquitoes/insect and eating with the HIV-infected patient were the route of transmission at both time points (84.7% vs. 89.1%, 92.2% vs. 93.3%, respectively). This study found a limited improvement in HIV knowledge and testing uptake among MMT patients following a 12-month period. It also highlighted some shortcomings in the knowledge, attitudes and practices (KAP) of these patients, in particular, incorrect identification of HIV transmission routes, among patients both at program initiation and follow-up. The findings lent support to the argument for enhancing education and counseling efforts at MMT clinics regarding HIV, as well as for improving access to preventive and health care services through the integration of MMT/HIV services.

Changes in Substance Abuse and HIV Risk Behaviors over 12-Month Methadone Maintenance Treatment among Vietnamese Patients in Mountainous Provinces

“…This study utilized simple measures of outcomes in consideration of resource constraints (shortage of staff, limited time and difficulties in recruiting, obtaining data from and monitoring participants (due to geographical barriers, low participant education level, and low participant willingness to respond to complex questions). Nonetheless, the measures used were in line with comparable research conducted on the potential benefits of MMT implementation in Vietnam [28] and on the MMT-enrolled population in Vietnamese mountainous areas [29,30,31].…”

Facing drug addiction: Vietnam’s struggle with opioids

“…Another report reviewed the effect of methadone maintenance treatment on drug users with HIV/AIDS. It highlighted some shortcomings in the knowledge, attitudes, and practices of managing HIV among the patients taking part in the study and has urged for enhanced education and counseling efforts at methadone maintenance treatment clinics regarding HIV, as well as for improving access to preventive and health care services through the integration of methadone maintenance and HIV treatment services (Nguyen et al, 2018(Nguyen et al, , 2019. The misconception and difficulties in persuading and keeping drug users engaged in the program could be the result of a lack of comprehensive knowledge about the treatment program by both health workers and drug users and the long-term perception of opium as a "social vice" in society, leading to deep prejudice and stigma about drug users.…”

Examining common mental health disorders in people living with HIV on methadone maintenance therapy in Hanoi, Vietnam

“…Methadone maintenance therapy (MMT) has been implemented globally as a way to reduce injecting drug use, minimize withdrawal symptoms and treat opiate dependency [ 3 ]. Many countries have implemented MMT programs to reduce work-loss productivity and absenteeism, reduce morbidity and mortality related to substance use and to prevent viral transmission [ 2 ].…”

“…The global prevalence of human immunodeficiency virus (HIV) in people who inject drugs (PWID) is estimated to be between 10.8 and 24.8% with the highest number of PWID present in East and Southeast Asia [1]. In Vietnam it is believed that HIV is primarily transmitted through injecting drug use where an estimated 30% of people living with HIV (PLH) also inject drugs; this has major implications for forward transmission of HIV in Vietnam through unprotected sex, groups injecting, and needle sharing practices [2][3][4][5][6].…”