title: Self-efficacy and HIV risk behaviors among heroin users in Taiwan.
abstract: OBJECTIVE
  This study examined the predictors of self-efficacy in reducing risky injection behaviors among heroin users receiving methadone maintenance treatment (MMT).
  
  
  METHODS
  The Methadone Maintenance Treatment Outcome Study was an 18-month prospective study from March 2007 to July 2008. Data collection was conducted in the substance use disorders treatment outpatient clinics of three hospitals in southern Taiwan. A total of 368 opioid-dependent heroin users (13.6% women) were interviewed at baseline and at 3-, 6-, 9-, 12-, 15- and 18-month follow-ups. The level of self-efficacy in reducing risky injection behaviors was repeatedly assessed using the Self-Efficacy Scale for HIV Risk Behaviors. Demographic and substance use characteristics, HIV serostatus, family function, depression, and pros and cons of heroin use were collected at baseline, and methadone dosage at each follow-up interview and the duration of retention in the MMT program were also recorded.
  
  
  RESULTS
  The results of the generalized estimating equation indicated that a lower educational level, concurrent methamphetamine use, a younger age at first heroin use, a lower methadone dosage, a higher level of depression, and a shorter duration of retention in the MMT program were predictive of a lower level of self-efficacy in reducing risky injection behaviors.
  
  
  CONCLUSIONS
  This study found that personal and MMT-related factors were predictive of a lower level of self-efficacy among heroin users receiving MMT. Programs implemented to promote a higher level of self-efficacy should be provided to heroin users in the MMT program.
authors.affiliation: Department of Nursing, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan.
authors.forename: Nai-Ying
authors.initials: NY
authors.lastname: Ko
authors.forename: Peng-Wei
authors.initials: PW
authors.lastname: Wang
authors.forename: Hung-Chi
authors.initials: HC
authors.lastname: Wu
authors.forename: Chia-Nan
authors.initials: CN
authors.lastname: Yen
authors.forename: Su-Ting
authors.initials: ST
authors.lastname: Hsu
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Yeh
authors.forename: Kuan-Sheng
authors.initials: KS
authors.lastname: Chung
authors.forename: Cheng-Fang
authors.initials: CF
authors.lastname: Yen
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000635:transmission*; D006556:Heroin Dependence / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage / Q000627:therapeutic use*; D009294:Narcotics / Q000008:administration & dosage / Q000627:therapeutic use; D058850:Opiate Substitution Treatment / Q000379:methods; D011446:Prospective Studies; D012309:Risk-Taking; D020377:Self Efficacy; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000534:rehabilitation; D013624:Taiwan; D013997:Time Factors
chemical_list: D009294:Narcotics; D008691:Methadone