Methadone Treatment Outcomes among Injection Drug Users in South China: the Role of HIV Infection, Gender and Maintenance Dose
- Author(s): Zhao, Lin
- Advisor(s): Holzemer, William
- et al.
Opioid dependence imposes a significant burden of disability and health on individuals, families, communities and societies in China. The objective of this dissertation research is to delineate the profiles of opioid dependents entering one outpatient methadone program in South China based on their retrospective self-report, specifically to examine potential factors that explain HIV infection, maintenance dose and gender with methadone treatment outcomes, and to understand potential inter-relationships among these factors. A convenience sample of 197 adults (71 women, 126 men) currently maintained in the program participated in the study. Their self-reported maintenance dose was 75.57± 37.32 mg/day.
The study starts with a comparison between participants who reported HIV seropositive (N=36) and those who tested HIV negative (N=131). No significant differences were found between the two groups in age, methadone maintenance dose, adherence, sex desire and drug craving level. Participants who were HIV positive reported significantly lower scores on physical health and total health-related qualify of life, and greater engagement in injection related risk behavior before initiating methadone treatment than those who reported being HIV negative. A regression model revealed HIV positive participants had significant higher odds of reporting symptoms related to treatment than HIV negative patients. Participants' current maintenance dose was analyzed. There was a significant difference between genders in current prescribed maintenance dose in the sample, with females more likely to be receiving moderate to high dose. No significant difference was found in adherence, quality of life and prevalence of treatment related symptoms among three dosing groups. Dose was not a significant predictor of outcomes related to HIV risk behavior change or opioid craving. The relationship of gender to HIV risk behavior change and treatment outcomes was explored. Female patients reported better methadone treatment adherence. The number of times in methadone treatment was also gender related.
The findings suggest HIV positive persons in methadone treatment require more focused services to meet their special HIV care and substance treatment needs in China. Strategies need to be employed in future research concerning Chinese opioid dependents to involve the interactive nature of multiple factors related to the treatment and care.