title: Changes in drug use are associated with health-related quality of life improvements among methadone maintenance patients with HIV/AIDS.
abstract: OBJECTIVE
  This longitudinal study assessed the changes in drug use patterns and health-related quality of life (HRQL) among HIV-positive drug users in the first methadone maintenance treatment (MMT) cohort in Vietnam.
  
  
  METHODS
  A secondary analysis was conducted on 370 HIV-positive drug users (age: mean ± SD: 29.5 ± 5.9 years; 95.7% men). Modified WHOQOL-BREF, self-report, and opioid confirmatory urine tests were used to assess HRQL and drug use behaviours at baseline, 3, 6, and 9 months. Generalized estimating equations (GEE) models were constructed to adjust for intra-individual correlations.
  
  
  RESULTS
  MMT response rate after 9 months was 89.9%. Rates of positive heroin urine tests rapidly decreased at the first trimester (18.1%) and then stabilized during the next 2 trimesters (11.8 and 14.4%). Among patients with continued drug use, frequency of use decreased from 3.4 to 0.7 time/day. Improvements in HRQL were large over the course of the study and highest in the psychological domain. Adjusting for propensity score in GEE models, ongoing heroin use during MMT resulted in large decrements in all HRQL domains.
  
  
  CONCLUSIONS
  MMT improved the outcomes of treatment for drug users in ways that might facilitate success of antiretroviral therapy. Integrating MMT to HIV care and treatment services could be beneficial in injection-driven HIV epidemics in resource-scare settings.
authors: Department of Public Health Sciences, School of Public Health, University of Alberta, 8303, 112 Street, Edmonton, AB, T6G 2T4, Canada. bach.tran@ualberta.ca
authors: Bach Xuan
authors: BX
authors: Tran
authors: Arto
authors: A
authors: Ohinmaa
authors: Anh Thuy
authors: AT
authors: Duong
authors: Nhan Thi
authors: NT
authors: Do
authors: Long Thanh
authors: LT
authors: Nguyen
authors: Quoc Cuong
authors: QC
authors: Nguyen
authors: Steve
authors: S
authors: Mills
authors: Philip
authors: P
authors: Jacobs
authors: Stan
authors: S
authors: Houston
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections; D006679:HIV Seropositivity; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D011788:Quality of Life / Q000523:psychology*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult
chemical_list: D008691:Methadone