美沙酮维持治疗门诊吸毒人群HCV感染调查分析

目的：调查美沙酮治疗门诊吸毒人群中HCV的感染率并为制定相应的预防措施提供科学依据。方法：兰州市七里河区美沙酮维持治疗门诊569名受治者采静脉血检测抗-HCV抗体,调查在治者的HCV感染率。结果：受治者总抗-HCV阳性率为24.96%,HCV感染率女性高于男性,吸毒人群中HCV感染率高于一般人群。结论：美沙酮维持治疗门诊吸毒人群HCV感染率高,相关危险行为普遍存在,应对吸毒人群加强教育,使其改变吸毒方式或参加美沙酮维持治疗,同时加强对相关人员的防护措施。     

美沙酮维持治疗门诊受治人群HCV感染及影响因素分析

目的：了解西安市美沙酮维持治疗门诊受治人群丙型肝炎病毒（HCV）感染现状及其特点,为制订相应的干预措施提供科学依据。方法：对西安市美沙酮维持治疗门诊（MMT）2007年5月1日至2008年5月31日入组的404名海洛因依赖者进行问卷调查,并采静脉血检测抗-HCV抗体。结果：404名吸毒者中,抗-HCV阳性率为60．6％。静脉注射史中,曾静脉注射吸毒者280人,抗-HCV阳性率为75．4％,高于非静脉吸毒者的27．4％,差异有统计学意义（P〈0．01）。有14人曾共用注射器具,占3．5％（14／404）。共用注射器具的感染率为78．6％。未共用注射器具者的HCV感染率为60．0％。多性伴者HCV感染率明显高于单一性伴或无性伴者．P〈0．01．有统计学意义。结论：西安市海溶因依籁人群HCV感染率高．相关危险行为普谝存在。     

美沙酮门诊吸毒人群HIV、HCV和梅毒感染状况分析

目的 了解在闸弄口街道社区卫生服务中心美沙酮门诊吸毒人群HIV、HCV和梅毒感染状况.方法 采集美沙酮门诊吸毒人员静脉血标本118份,进行HIV、HCV和梅毒血清学检测.结果 118名吸毒人员中,HIV抗体阳性2例(1.69％),HCV抗体阳性44例(37.29％),梅毒抗体阳性5例(4.2 3％);HIV/HCV合并感染2例(1.69％),梅毒/HCV合并感染1例(1.69％).结论 闸弄口街道社区卫生服务中心美沙酮门诊吸毒人群中HIV、HCV、梅毒感染率较高,应积极开展针对性的干预措施.     

美沙酮维持治疗门诊患者HCV感染状况及HCV知识评估

目的:调查参加美沙酮维持治疗患者的HCV感染状况及其对HCV相关知识的了解情况。方法:对114名接受MMT治疗的患者进行HCV感染状况调查,并采用HCV相关知识调查问卷、酒精使用筛查问卷(AUDIT)对该人群的HCV相关知识和酒精使用状况进行评估。结果:MMT门诊患者中HCV感染率为57.0%,HCV知识评估平均得分为11.3±s2.1,酒精使用状况平均得分为3.2±s5.4。68.4%的患者对自身HCV感染状况不了解,其中59.2%患者为HCV阳性,15.3%的HCV阳性患者接受过HCV抗病毒治疗,18.4%的患者曾主动进行HCV相关咨询。结论:美沙酮维持治疗门诊患者HCV感染率高,但HCV相关知识缺乏,对自身感染情况缺乏了解。MMT门诊应将HCV相关知识的普及教育整合到日常工作中,对患者进行HCV相关教育。     

四川省美沙酮维持治疗门诊现状调查

目的:了解四川省美沙酮维持治疗工作现状,分析存在的问题,推动全省美沙酮维持治疗工作的深入开展。方法:通过问卷调查、现场数据核实等形式了解各门诊运行情况。结果:截至2009年3月底,全省共设立38所美沙酮维持治疗门诊,累计入组病人17 161人,门诊所在地估计吸毒人数为46 420人,3月份门诊在治病人为8258例;所有门诊均提供了外展服务,有34所门诊建立了针对病人的激励机制;尿检阳性率为41.16%,脱失率为46.93%。结论:四川省美沙酮维持治疗工作发展迅速、成效显著,但存在治疗工作覆盖率低、病人脱失率高、多部门合作不力和部分门诊工作管理薄弱等问题。     

贵阳市某戒毒所静脉吸毒人群HCV感染现状调查

丙型肝炎(HCV)是一种经血液传播的传染性疾病,吸毒人群尤其是静脉注射吸毒者是HCV感染的高危人群.为了解该人群HCV感染现状,我们对贵阳市某戒毒所该人群进行了 HCV抗体检测,现将结果报告如下.     

2011-2015年我国美沙酮维持治疗人员吸毒过量死亡分析

目的:分析我国参加美沙酮维持治疗吸毒过量死亡人员基本情况和死亡时间分布,为制定降低死亡的措施提供依据。方法:收集2011-2015年全国美沙酮维持治疗门诊报告因吸毒过量死亡的治疗人员基本信息,参加治疗信息,分析死亡人员特点,死亡发生的时间,探讨不同治疗时段死亡的相关因素。结果:2011-2015年间,全国美沙酮维持治疗者累计报告因吸毒过量死亡408例,死亡时平均年龄38.3±7.4岁;第1-4周内死亡人数占总报告死亡人数的28.7%,前8周死亡人数占总报告死亡人数的38.7%;停止服药后4周内死亡人数占总报告死亡人数的54.9%;开始治疗或重新开始治疗4周内死亡人员治疗依从性低于4周以后死亡人员(t=2.63,P=0.009)。结论:参加美沙酮维持治疗人员吸毒过量死亡多发生在治疗(或中断治疗后再次治疗)初始阶段和停止服药后的初期阶段,应针对新参加治疗人员加强干预,对停止治疗人员及时随访,提高治疗依从性。     

重庆市渝北区美沙酮维持治疗门诊患者基线调查

目的:了解美沙酮维持治疗门诊患者的社会人口学特征、行为学特征等基本情况,为进一步采取综合干预措施提供依据.方法:采用<社区药物维持治疗评估基线调查表>对2006年9月-2010年6月重庆市渝北区美沙酮维持治疗门诊收治的吸毒患者进行调查.结果:门诊患者的人口学特征为男性(71.7%)、平均年龄37.3 a±s 7.8 a...     

中国超三十万名吸毒成瘾患获美沙酮维持治疗

截至2011年3月底,中国内地28个省、区、市已开设了708个社区美沙酮维持治疗门诊,累计治疗吸毒成瘾病人306460人。目前正在治疗124862人,门诊平均在治人数176人,年保持率为70．9％。国家卫生部举行的通报会称,为遏制毒品蔓延、控制毒品引发的艾滋病流行,中国自2004年开展针对吸毒人群的社区美沙酮维持治疗工作。     

美沙酮维持治疗及相关问题探讨

当前,发展中国家静脉吸毒的扩散已经与发达国家的静脉吸毒模式相吻合.怎样才能控制住在静脉吸毒人群中艾滋病的流行,部分国家和地区的成功经验表明,美沙酮维持治疗项目能取得较好的减少危害和预防艾滋病传播的效果.     

美沙酮维持治疗中转诊患者服药依从性调查分析

目的：了解美沙酮维持治疗（methadone maintenance treatment,MMI）过程中转诊患者服药依从性情况。方法：收集从其他MMT门诊转入我门诊的160例转诊患者的基本资料,对其能否继续治疗、尿检情况、转入日及转回日至首次服药间隔时间天数等分析。结果：转入后未能继续治疗者33例（20.63％）,其中长转者占4例（2.50％）,临转者占29例（18.13％）;转入后能继续治疗者转入日、转回日至首次服药平均间隔时间分别为3.86±0.53天和3.55±0.41天;转入、转回首次尿检阳性率分别为83.70％和63.50％。结论：MMT中转诊患者服药依从性相对较低,存在转诊后脱失、尿吗啡检测阳性率偏高、转诊后缺服药现象明显等需待完善情况。     

Improving entry to methadone maintenance among out-of-treatment injection drug users

This study of 577 out-of-treatment drug injectors was designed to assess predictors of methadone maintenance treatment entry, including offering free treatment coupons. Using targeted sampling methods, participants were recruited through street outreach; randomly, they were either assigned a coupon for 90 days of free treatment or required to pay for their treatment. Regardless of assignment, all subjects who desired treatment were provided transportation, rapid intake, and a waiver of the treatment entry fee. Overall, 33% entered treatment, including 66% of those who received a free coupon. Other factors associated with treatment entry included desire for treatment, heroin use, prior treatment experience, associating with fewer drug-using friends, and injecting with a previously used unsterile needle/syringe. Injecting cocaine and smoking crack reduced the probability of treatment entry. Findings lend support to street outreach efforts designed to increase rates of treatment entry among chronic out-of-treatment drug injectors. Additional treatment options are required for those abusing cocaine.     

美沙酮疗效及副作用对美沙酮维持治疗脱失率的影响分析

目的：探讨美沙酮疗效及其副作用对于美沙酮维持治疗（MMT）脱失率的影响。方法以2006年9月至2007年10月在南昌市东湖区和西湖区两个MMT门诊就诊者705例为研究对象,采用问卷调查方法,用Cox回归模型进行分析。结果单因素Cox分析显示：影响MMT脱失的因素为吃饭比原来好、体重增加和皮疹。多因素Cox回归分析显示：吃饭比原来好时脱失者少,而出现皮疹的美沙酮受治者脱失率明显增高。结论 MMT不仅是一项单纯的给服美沙酮工作,更应多了解就诊者的主观感受和客观身体状况,进行切实有效的咨询和干预,从而减少脱失率。     

Misconceptions toward methadone maintenance treatment (MMT) and associated factors among new MMT users in Guangzhou, China

The methadone maintenance treatment (MMT) program is scaling up in China, but little is known about drug users' cognitions of MMT. To investigate the prevalence and associated factors of MMT-related misconceptions, a totally of 300 newly admitted MMT users were interviewed in three MMT clinics in Guangzhou. Four statements were used to assess MMT-related misconceptions. The results showed that the majority of participants misconceived that MMT is intended primarily for detoxification (92.3%), that one could be completely detoxified and quit using methadone after using it for 2-3months (64.2%), that MMT is not a long-term or even lifetime treatment (77.9%); and that one should attempt to reduce its treatment dosage as methadone is harmful to one's health (84.3%); 48.5% of the respondents possessed all four types of misconceptions. Prior experience of methadone use in voluntary drug detoxification centers (OR=1.82 to 2.55, p<0.05) was associated with some misconception items, whilst being introduced by some peer drug users or community members to use MMT (versus not being introduced by anyone; OR=0.38 to 0.50, p<0.05), having taken up HIV voluntary counseling and testing prior to admission (OR=0.52, p<0.05), and a higher HIV-related knowledge level (OR=0.38, p<0.05) were associated with lower likelihoods for possessing some of the misconceptions. The findings suggested that MMT-related misconceptions were very prevalent among newly recruited MMT users in China. Misconceptions are potential factors causing drop-outs. Interventions targeting such misconceptions are greatly warranted.     

针对美沙酮维持治疗病人开展社会心理支持及治疗研究项目

目的：通过对美沙酮维持治疗病人开展社会心理支持与治疗达到：（1）提高病人的治疗依从性;（2）提高病人治疗保留率;（3）帮助病人适应及回归社会。探索、分析和总结,形成一套符合中国国情的对美沙酮维持治疗病人心理支持与治疗的经验与方法。方法：针对项目试点门诊的美沙酮维持治疗病人开展四个层面的治疗,即（1）针对病人共性特点进行普遍性的心理支持与咨询;（2）针对不同类型病人的特点进行集体心理治疗;（3）针对病人的个性特点进行个别心理治疗;（4）针对病人的家庭问题开展家庭心理治疗。结果：通过对病人进行心理支持与治疗工作后,病人的保留率明显提高,尿吗啡检测阴性率也明显上升。结论：针对美沙酮维持治疗门诊病人的不同特点开展个别心理治疗、集体心理治疗、家庭治疗等后期心理支持与干预,对提高门诊病人的治疗依从性,提高门诊病人的保留率具有明显效果;对帮助病人适应及回归社会奠定了良好的基础。     

深圳市宝安区美沙酮门诊海洛因依赖人群HIV、HCV和梅毒感染状况分析

目的：了解深圳市宝安区美沙酮门诊海洛因依赖人群HIV、HCV和梅毒感染状况,为相应的疾病控制干预提供科学依据。方法：对参加维持治疗的249名海洛因依赖者进行HIV、HCV和梅毒血清学检测。结果：HIV抗体阳性率1．2％（3／249）;HCV抗体阳性率62．2％（155／249）,其中静脉注射吸毒者HCV阳性率72．82％（142／195）明显高于非静脉吸毒者24．07％（13／54）（P〈0．001）;梅毒抗体阳性率2．0％（5／249）;3名HIV及5名梅毒阳性患者均合并感染HCV。结论：深圳市宝安区美沙酮门诊海洛因依赖人群中HCV感染率较高,尤其是静脉注射吸毒者。     

Methadone maintenance treatment in prisons: The New South Wales Experience

This paper uses the New South Wales experience with methadone maintenance treatment in prison to address the question: should methadone maintenance treatment be provided in Australian prisons for opioid-dependent prisoners? First, it outlines three rationales for providing drug dependence treatment in prisons: as a way of giving prisoners access to community-based forms of drug treatment in the prison setting; as a measure to reduce recidivism in opioid-dependent prisoners; and as a measure to prevent the transmission of HIV and other infectious diseases within prisons, and to the sexual partners of prisoners on their release. Secondly, it reviews the kind of research evidence that supports the effectiveness of community-based methadone maintenance treatment in Australia. Thirdly, the effectiveness of the New South Wales Prison Methadone Programme, one of the few prison-based methadone programmes in the world, is evaluated in the light of the available research evidence.     

Methadone use among HIV-positive injection drug users in a Canadian setting

We examined methadone maintenance therapy (MMT) use among HIV-positive injection drug users (IDU) in Vancouver. Among 353 participants, 199 (56.3%) were on MMT at baseline, and 48 initiated MMT during follow-up. Female gender (adjusted odds ratio [AOR] = 1.73, 95% confidence interval [CI] = 1.14–2.62) and antiretroviral therapy use (AOR = 2.04, 95% CI = 1.46–2.86) were positively associated with MMT use, whereas frequent heroin injection (AOR = 0.34, 95% CI = 0.23–0.50), public injection (AOR = 0.76, 95% CI = 0.59–0.97), syringe borrowing (AOR = 0.54, 95% CI = 0.32–0.90), and nonfatal overdose (AOR = 0.58, 95% CI = 0.36–0.92) were negatively associated with MMT use. The rate of discontinuation of MMT was 12.46 (95% CI = 8.28–18.00) per 100 person years. Frequent heroin use (adjusted hazards ratio = 4.49, 95%CI = 1.81–11.13) was positively associated with subsequent discontinuation of MMT. These findings demonstrate the benefits of MMT among HIV-positive IDU and the need to improve access to and retention in MMT.     

Risk factors associated with HIV/HCV infection among entrants in methadone maintenance treatment clinics in China: A systematic review and meta-analysis

Background: Methadone maintenance treatment (MMT) has rapidly expanded in China, from 8 pilot sites to 696 clinics covering 27 provinces, during 2004–2010. This study evaluates the demographic characteristics and drug use behaviors associated with Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) infections among MMT entrants through a systematic review and meta-analysis of published literature. Methods: Thirty-nine eligible articles (1 in English and 38 in Chinese) were selected for this review. We extracted the relevant indicator information from all eligible studies and performed meta-analyses, by stratifying according to sex of the participants, age groups and drug use behaviors. Five provinces (i.e., Yunnan, Guizhou, Sichuan, Guangxi and Xinjiang) with the population size of HIV-infected drug users greater than 10,000 were defined as high transmission areas (HTAs) for HIV infection; whereas the remaining twenty-six Chinese provinces were considered as low transmission areas (LTAs). Results: The odds of being infected by HIV among male drug users were significantly higher than for females in high transmission areas (OR = 1.49, 95% CI: 1.11–1.99, k = 9), while the opposite results were observed in low transmission areas (OR = 0.46, 0.27–0.79, k = 11). In comparison, no significant differences in risk behaviors were found between sexes in HTAs and LTAs. Younger age was not associated with risk of HIV infection, but was associated with higher risk of HCV infection (<30 years OR = 1.88; 30–40 years OR = 2.21, compared with >40 years, k = 17). Risk of HIV infection was higher among injectors than non-injectors (OR = 4.29, 2.70–6.79, k = 14) and for those who inject, there was greater risk among sharers than non-sharers (OR = 2.47, 1.44–4.23, k = 4). Similar patterns were also observed in HCV infection (injectors: OR = 10.82, 7.60–15.40; sharers: OR = 3.41, 2.56–4.54, k = 7). Conclusions: Characteristics of MMT entrants positive for HIV or HCV in China vary by disease types, geographical region, sex, age, and injecting behavior. These factors need to be considered in targeted interventions for MMT participants, such as age-specific health education and psychological treatment, antiretroviral therapy and needle-syringe exchange programs.