title: Clinical characteristics and risk behavior as a function of HIV status among heroin users enrolled in methadone treatment in northern Taiwan.
abstract: BACKGROUND
  Methadone treatment was introduced in Taiwan in 2006 as a harm-reduction program in response to the human immunodeficiency virus (HIV), which is endemic among Taiwanese heroin users. The present study was aimed at examining the clinical and behavioral characteristics of methadone patients in northern Taiwan according to their HIV status.
  
  
  METHODS
  The study was conducted at four methadone clinics. Participants were patients who had undergone methadone treatment at the clinics and who voluntarily signed a consent form. Between August and November 2008, each participant completed a face-to-face interview that included questions on demographics, risk behavior, quality of life, and psychiatric symptoms. Data on HIV and hepatitis C virus (HCV) infections, methadone dosage, and morphine in the urine were retrieved from patient files on the clinical premises, with permission of the participants.
  
  
  RESULTS
  Of 576 participants, 71 were HIV positive, and 514 had hepatitis C. There were significant differences between the HIV-positive and HIV-negative groups on source of treatment payment, HCV infection, urine test results, methadone dosage, and treatment duration. The results indicate that HIV-negative heroin users were more likely to have sexual intercourse and not use condoms during the 6 months prior to the study. A substantial percent of the sample reported anxiety (21.0%), depression (27.2%), memory loss (32.7%), attempted suicide (32.7%), and administration of psychiatric medications (16.1%). There were no significant differences between the HIV-positive and HIV-negative patients on psychiatric symptoms or quality of life.
  
  
  CONCLUSIONS
  HIV-positive IDUs were comorbid with HCV, indicating the need to refer both HIV- and HCV-infected individuals for treatment in methadone clinics. Currently, there is a gap between psychiatric/psychosocial services and patient symptoms, and more integrated medical services should be provided to heroin-using populations.
authors.affiliation: Department of Health Promotion and Health Education, National Taiwan Normal University, No. 162, He-ping East Road, Section 1, Taipei 10610, Taiwan. tonylee@ntnu.edu.tw
authors.forename: Tony Szu-Hsien
authors.initials: TS
authors.lastname: Lee
authors.forename: Hsi-Che
authors.initials: HC
authors.lastname: Shen
authors.forename: Wei-Hsin
authors.initials: WH
authors.lastname: Wu
authors.forename: Chun-Wei
authors.initials: CW
authors.lastname: Huang
authors.forename: Muh-Yong
authors.initials: MY
authors.lastname: Yen
authors.forename: Bo-En
authors.initials: BE
authors.lastname: Wang
authors.forename: Peing
authors.initials: P
authors.lastname: Chuang
authors.forename: Chien-Yu
authors.initials: CY
authors.lastname: Shih
authors.forename: Ying-Chun
authors.initials: YC
authors.lastname: Chou
authors.forename: Yi-Lien
authors.initials: YL
authors.lastname: Liu
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications*; D006526:Hepatitis C / Q000150:complications; D006556:Heroin Dependence / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000150:complications; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009020:Morphine / Q000652:urine; D058850:Opiate Substitution Treatment / Q000379:methods; D011788:Quality of Life; D012309:Risk-Taking; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D009020:Morphine; D008691:Methadone