The Impact of Methadone Maintenance Treatment among HIV/AIDS Harm Reduction Program in Taoyuan County

• Main Authors: Tsuei-Mi Huang, 黃翠咪
• Other Authors: Chih-Yin Lew-Ting, Ph.D.
• Format: Others
• Language: zh-TW
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/50329623223311326577

碩士 === 國立臺灣大學 === 公共衛生碩士學位學程 === 100 === Background: Due to an AIDS outbreak among Taiwanese injecting drug users (IDUs) in 2004, a methadone maintenance treatment (MMT) program for AIDS harm reduction was implemented in2006. However, there have been limited studies examining the impact of the MMT program. Aims: (1) To describe the number and rate of drug users participating in the MMT program from 2006 to 2010, (2) To examine the impact of MMT program including the AIDS epidemic and crime rate at the county level, and the employment at the individual level, and (3) To examine the MMT participants’ supportive attitudes towards the program and their self confidence in abstinence from the drugs, and factors associated with these two psychological variables. Methods: Secondary data analysis was conducted by using data from the reporting disease system and MMT program, Centers for Disease Control (CDC), Taiwan. A questionnaire survey was carried out among MMT participants in Taoyuan county. Results: Since 2006 when the AIDS harm reduction program began, the number of MMTparticipants increased sharply, reaching a peak in 2008, and remained stable with only slight fluctuation. After 2008, on average there were 1700 drug users participating in the MMT program daily, corresponding to a 21.6-27.4% of heroin users. The mean attendance rate in the MMT program was 63.9±6.2％. For the AIDS epidemic, the proportion of IDUs among HIV/AIDS cases declined substantially. Among incident cases of HIV/AIDS, there were 214 IDUs (71.6%) in 2006, 89 (53%) in 2007, 28 (21.1%) in 2008, 22 (16.5%) in 2009, and 22 (6.8%) in 2010. There were only 8 (0.2%) MMT participants who became HIV positive from 2006 to 2010. Similarly, a decrease in the crime rate was observed. In 2005, the crime rate in Taoyuan was 2387 per 100,000 people, but it declined to 812 per 100,000 by 2010. The number of arrests involving level I illicit drugs declined as well since 2007. From 2005 to 2010, there were 2519, 2633, 2488, 2411, 2230, and 1868 people, respectively, arrested due to owning, carrying, or using level I drugs. Regarding the questionnaire survey, 1201 questionnaires (98.0%) were completed. The rate of being employed or having a fixed income increased significantly from 2006 to 2009. The mean scores of positive attitudes supporting the MMT program were between 43.4±6.0 and 44.0±6.0. Among the three subscales of positive attitudes supporting the MMT program, advantages to society rated the highest, followed by advantages to IDUs, and doubt/worry rated the lowest. No obvious change in positive attitudes supporting MMT program was observed from 2006 to 2009. Gender and education were two factors that were significantly associated with positive attitudes supporting MMT program. Similarly, there was no obvious change in the mean scores of confidence of abstinence from drugs from2006 and 2009. The mean scores of confidence of abstinence from drugs were between 27.4±4.8and 28.1±4. Gender, education and HIV status were three factors significantly associated with the score of confidence of abstinence from drugs. Conclusions: The MMT program has had a positive impact on reduction of the AIDS epidemic, reduction of the crime rate, and improvement of employment for drug users. However, there was no change in positive attitudes supporting the MMT program and confidence of abstinence from drugs. Gender and education were two factors that were significantly associated with positive attitudes supporting the MMT program. Gender, education and HIV status were three factors that were significantly associated with the score of confidence of abstinence from drugs.