title: Concurrent Heroin Use and Correlates among Methadone Maintenance Treatment Clients: A 12-Month Follow-up Study in Guangdong Province, China.
abstract: OBJECTIVE
  To assess concurrent heroin use and correlates among Methadone Maintenance Treatment (MMT) clients in Guangdong Province, China.
  
  
  METHODS
  Demographic and drug use data were collected with a structured questionnaire, and MMT information was obtained from the MMT clinic registration system in Guangdong. Human immunodeficiency virus (HIV-) and hepatitis C virus (HCV) infected status and urine morphine results were obtained from laboratory tests. Logistic regressions were employed to investigate the factors associated with concurrent heroin use.
  
  
  RESULTS
  Among the 6848 participants, 75% continued using heroin more than once during the first 12 months after treatment initiation. Concurrent heroin use was associated with inharmonious family relationship (OR (odds ratio) = 1.49, 95% CI (confidence intervals): 1.24-1.78), HIV positivity (OR = 1.25, 95% CI: 1.01-1.55), having multiple sex partners (OR = 1.34, 95% CI: 1.07-1.69), having ever taken intravenous drugs (OR = 0.81, 95% CI: 0.69-0.95), higher maintenance dose (OR = 1.13, 95% CI: 1.01-1.28) and poorer MMT attendance (OR < 20% = 1.32, 95% CI: 1.13-1.53; OR 20%- = 1.33, 95% CI: 1.14-1.54; OR 50%- = 1.69, 95% CI: 1.44-2.00). Among those who used heroin concurrently, the same factors, and additionally being older (OR 35- = 1.26, 95% CI: 1.11-1.43; OR ≥ 45 = 1.63, 95% CI: 1.30-2.05) and female (OR = 1.60, 95% CI: 1.28-2.00), contribute to a greater frequency of heroin use.
  
  
  CONCLUSIONS
  Concurrent heroin use was prevalent among MMT participants in Guangdong, underscoring the urgent needs for tailored interventions and health education programs for this population.
authors.affiliation: Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou 510080, China. luoxiaof@lzu.edu.cn.|Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou 510080, China. luoxiaof@lzu.edu.cn.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Luo
authors.affiliation: Guangdong Center for Skin Guangdong Provincial Center for Skin Diseases and STIs Control, No. 2 Lujing Road, Guangzhou 510091, China. 08tjzpz@163.com.
authors.forename: Peizhen
authors.initials: P
authors.lastname: Zhao
authors.affiliation: Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou 510080, China. x.gong@foxmail.com.|Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou 510080, China. x.gong@foxmail.com.
authors.forename: Xiao
authors.initials: X
authors.lastname: Gong
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney NSW 2052, Australia. lei.zhang1@monash.edu.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Guangdong Center for Skin Guangdong Provincial Center for Skin Diseases and STIs Control, No. 2 Lujing Road, Guangzhou 510091, China. weiming_tang@med.unc.edu.
authors.forename: Weiming
authors.initials: W
authors.lastname: Tang
authors.affiliation: Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou 510080, China. zouxia@mail3.sysu.edu.cn.|Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou 510080, China. zouxia@mail3.sysu.edu.cn.
authors.forename: Xia
authors.initials: X
authors.lastname: Zou
authors.affiliation: Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou 510080, China. chenw43@mail.sysu.edu.cn.|Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou 510080, China. chenw43@mail.sysu.edu.cn.
authors.forename: Wen
authors.initials: W
authors.lastname: Chen
authors.affiliation: Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou 510080, China. lingli@mail.sysu.edu.cn.|Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou 510080, China. lingli@mail.sysu.edu.cn.
authors.forename: Li
authors.initials: L
authors.lastname: Ling
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D058850:Opiate Substitution Treatment; D010349:Patient Compliance / Q000706:statistics & numerical data*; D015995:Prevalence; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone
keywords: China; Methadone Maintenance Treatment (MMT); concurrent drug use