UCLA

Background: There were more than 170,000 documented DUs in Vietnam as of June 2012 and it was estimated that 80% of them are heroin injectors. Vietnam started its National MMT Program with a successful pilot project in 2008-2009 in Hai Phong and Ho Chi Minh City. In early 2010, the Vietnam Government approved a scale-up plan with the goal to provide MMT to 80,000 DUs by 2015. Approximately 10,000 DUs were receiving MMT in Vietnam in late 2012.

Objective: (1) To describe perceived facilitators of and barriers to MMT enrollment among opioid IDUs in Hai Phong; (2) To characterize the opioid current IDU population in Hai Phong regarding characteristics and factors that may influence MMT enrollment; (3) To identify factors associated with MMT enrollment among opioid IDUs in Hai Phong.

Methods: Study sites were 2 urban and 2 rural districts in Hai Phong, randomly selected from districts with operating MMT clinics. Qualitative study: In-depth interviews were conducted anonymously with 36 opioid IDUs (from 3 different groups). Cross-sectional survey: 600 current opioid IDUs were recruited via pharmacies and needle-and-syringe programs for anonymous ACASI interviews. Case-control study: Cases were 150 opioid IDUs who had registered for MMT, and controls were 446 current opioid IDUs who had never registered for MMT. For both cases and controls, data were collected anonymously by ACASI interviews.

Results: From qualitative interviews, facilitators and barriers are presented in 3 levels: Structural, family and individual levels. Cross-sectional data on the following areas are presented: demographic and familial characteristics, drug use and cessation history, general health and HIV-related behaviors, MMT-related beliefs, attitude, social pressure and other factors that may influence MMT enrollment. Rural and urban participants were significantly different in many aspects. Based on case-control data, positive predictors and negative predictors of MMT registration are presented.

Conclusion: Facilitators should be enhanced and barriers should be addressed by MMT program managers and policy makers in Vietnam. The cross-sectional data can be used for program planning and outreach purposes. The results on factors associated with MMT enrollment can be used to identify groups of IDUs who may need supports for MMT participation.