Multilevel predictors of concurrent opioid use during methadone maintenance treatment among drug users with HIV/AIDS.
BACKGROUND: Ongoing drug use during methadone maintenance treatment (MMT) negatively affects outcomes of HIV/AIDS care and treatment for drug users. This study assessed changes in opioid use, and longitudinal predictors of continued opioid use during MMT among HIV-positive drug users in Vietnam, wit...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2012-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3520938?pdf=render |
| _version_ | 1811288687151939584 |
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| author | Bach Xuan Tran Arto Ohinmaa Steve Mills Anh Thuy Duong Long Thanh Nguyen Philip Jacobs Stan Houston |
| author_facet | Bach Xuan Tran Arto Ohinmaa Steve Mills Anh Thuy Duong Long Thanh Nguyen Philip Jacobs Stan Houston |
| author_sort | Bach Xuan Tran |
| collection | DOAJ |
| description | BACKGROUND: Ongoing drug use during methadone maintenance treatment (MMT) negatively affects outcomes of HIV/AIDS care and treatment for drug users. This study assessed changes in opioid use, and longitudinal predictors of continued opioid use during MMT among HIV-positive drug users in Vietnam, with the aim of identifying changes that might enhance program efficacy. METHODS: We analyze data of 370 HIV-positive drug users (mean age 29.5; 95.7% male) taking MMT at multi-sites. Opioid use was assessed at baseline, 3, 6, and 9 months using interviews and heroin confirmatory urine tests. A social ecological model was applied to explore multilevel predictors of continued opioid use, including individual, interpersonal, community and service influences. Generalized estimating equations (GEE) statistical models were constructed to adjust for intra-individual correlations. RESULTS: Over 9 month follow-up, self-reported opioid use and positive heroin urine test substantially decreased to 14.6% and 14.4%. MMT helped improve referrals and access to health care and social services. However, utilization of social integration services was small. GEE models determined that participants who were older (Adjusted Odd Ratio - AOR = 0.97 for 1 year increase), had economic dependents (AOR = 0.33), or were referred to TB treatment (AOR = 0.53) were less likely to continue opioid use. Significant positive predictors of ongoing opioid use included frequency of opioid use prior to MMT, peer pressure, living with sexual partners, taking antiretroviral treatment, other health concerns and TB treatment. CONCLUSION: These findings show that MMT in the Vietnamese context can dramatically reduce opioid use, which is known to be associated with reduced antiretroviral (ART) adherence. Disease stage and drug interactions between antiretrovirals or TB drugs and MMT could explain some of the observed predictors of ongoing drug use; these findings could inform changes in MMT program design and implementation. |
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| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-13T03:41:36Z |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj.art-b283c104e3554182974385a686d05ebf2022-12-22T03:04:09ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-01712e5156910.1371/journal.pone.0051569Multilevel predictors of concurrent opioid use during methadone maintenance treatment among drug users with HIV/AIDS.Bach Xuan TranArto OhinmaaSteve MillsAnh Thuy DuongLong Thanh NguyenPhilip JacobsStan HoustonBACKGROUND: Ongoing drug use during methadone maintenance treatment (MMT) negatively affects outcomes of HIV/AIDS care and treatment for drug users. This study assessed changes in opioid use, and longitudinal predictors of continued opioid use during MMT among HIV-positive drug users in Vietnam, with the aim of identifying changes that might enhance program efficacy. METHODS: We analyze data of 370 HIV-positive drug users (mean age 29.5; 95.7% male) taking MMT at multi-sites. Opioid use was assessed at baseline, 3, 6, and 9 months using interviews and heroin confirmatory urine tests. A social ecological model was applied to explore multilevel predictors of continued opioid use, including individual, interpersonal, community and service influences. Generalized estimating equations (GEE) statistical models were constructed to adjust for intra-individual correlations. RESULTS: Over 9 month follow-up, self-reported opioid use and positive heroin urine test substantially decreased to 14.6% and 14.4%. MMT helped improve referrals and access to health care and social services. However, utilization of social integration services was small. GEE models determined that participants who were older (Adjusted Odd Ratio - AOR = 0.97 for 1 year increase), had economic dependents (AOR = 0.33), or were referred to TB treatment (AOR = 0.53) were less likely to continue opioid use. Significant positive predictors of ongoing opioid use included frequency of opioid use prior to MMT, peer pressure, living with sexual partners, taking antiretroviral treatment, other health concerns and TB treatment. CONCLUSION: These findings show that MMT in the Vietnamese context can dramatically reduce opioid use, which is known to be associated with reduced antiretroviral (ART) adherence. Disease stage and drug interactions between antiretrovirals or TB drugs and MMT could explain some of the observed predictors of ongoing drug use; these findings could inform changes in MMT program design and implementation.http://europepmc.org/articles/PMC3520938?pdf=render |
| spellingShingle | Bach Xuan Tran Arto Ohinmaa Steve Mills Anh Thuy Duong Long Thanh Nguyen Philip Jacobs Stan Houston Multilevel predictors of concurrent opioid use during methadone maintenance treatment among drug users with HIV/AIDS. PLoS ONE |
| title | Multilevel predictors of concurrent opioid use during methadone maintenance treatment among drug users with HIV/AIDS. |
| title_full | Multilevel predictors of concurrent opioid use during methadone maintenance treatment among drug users with HIV/AIDS. |
| title_fullStr | Multilevel predictors of concurrent opioid use during methadone maintenance treatment among drug users with HIV/AIDS. |
| title_full_unstemmed | Multilevel predictors of concurrent opioid use during methadone maintenance treatment among drug users with HIV/AIDS. |
| title_short | Multilevel predictors of concurrent opioid use during methadone maintenance treatment among drug users with HIV/AIDS. |
| title_sort | multilevel predictors of concurrent opioid use during methadone maintenance treatment among drug users with hiv aids |
| url | http://europepmc.org/articles/PMC3520938?pdf=render |
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