[Study on the adherence and related determinants among HIV-positive clients under methadone maintenance treatment in Dali,Yunnan province from 2005 to 2013].
OBJECTIVE
To describe the adherence and related determinants among HIV-positive methadone maintenance treatment(MMT)clients in Dali,Yunnan province from 2005 to 2013.


METHODS
Cases were selected from the "National MMT Information Management System". The main information included demographic, drug abuse behaviors prior to enrollment, MMT treatment and highly active antiretroviral therapy (HAART). Detailed medication records were collected to calculate the adherence to MMT. Multivariate unconditional logistic regression was conducted to analyze the impact factors of adherence.


RESULTS
The MMT adherence rate of 480 subjects is 58.11%. Data from the multivariate unconditional logistic regression indicated that among those HIV-positive MMT clients that on HAART program (OR = 1.52, 95% CI:1.03-2.24), related factors as:having stable job(OR = 1.69, 95% CI:1.11-2.56), having compulsory history prior to enrollment in MMT (OR = 1.78, 95% CI:1.04-3.04) were likely to have higher rate on MMT adherence, whereas clients who showed positive result in the last urine morphine test (OR = 0.38, 95% CI:0.24-0.59) were associated with lower rate on MMT adherence.


CONCLUSIONS
In order to improve the rate of adherence to MMT among those HIV-positive MMT clients, the coverage of HAART needed to be expanded and new approaches in combining MMT and HAART developed. Education and intervention efforts should be focused on clients who currently were jobless, those with last urine morphine testing as positive or had never received compulsory treatment.
School of Public Health, Anhui Medical University, Hefei 230032, China; National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention.
Haibo
H
Jiang
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention.
Xiaobin
X
Cao
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention.
Changhe
C
Wang
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention.
Wei
W
Luo
Yunnan Institute for Drug Abuse.
Jianhua
J
Li
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention.
Keming
K
Rou
Yunnan Institute for Drug Abuse.
Bo
B
Zhang
Dali City Center for Disease Control and Prevention.
Yuehua
Y
Fang
Dali Prefecture No. 2nd People's Hospital.
Cong
C
Li
School of Public Health, Anhui Medical University, Hefei 230032, China; National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention. Email: wuzy@263.net.
Zunyou
Z
Wu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged
D008691:Methadone