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Social and structural barriers for adherence to methadone maintenance treatment among Vietnamese opioid dependence patients

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  • Bach Xuan Tran
  • Long Hoang Nguyen
  • Tung Thanh Tran
  • Carl A Latkin

Abstract

Introduction: Methadone maintenance treatment (MMT) services may reduce the risk of HIV transmission if patients completely adhere to the treatment. Identifying adherence patterns and potential related factors is vital for the sustainability of MMT program in Vietnam. This study examined social and structural factors associated with adherence to MMT among patients in different service delivery models. Materials and methods: A total of 510 patients at three MMT clinics in Hanoi were interviewed. Measures of self-reported adherence included the number of missed doses in the past 7 days and the level of adherence in the past 30 days using a visual analog scale (VAS) scoring from 0 (non-adherence) to 100 (perfect adherence). Multivariate regressions were employed to identify factors associated with non-adherence to MMT. Results: A total of 17.7% of participants reported incomplete MMT adherence in the last 30 days and 8.3% reported missing a dose in the last seven days, respectively. Living with HIV/AIDS, poor self-care and usual activities, and disclosure of health issues to spouses or intimate partners were associated with non-adherence. Those patients with pain or depression were more likely to report better adherence. Disclosing health status to spouse/partner increased the risk of incomplete adherence, while disclosing to friends reduced the number of missed dose in the last seven days. Patients attending clinics with comprehensive services had a lower VAS score of adherence compared to those enrolling in clinics with only MMT and general health care. Conclusions: Sustaining the compliance of patients to MMT is principal in the rapid expansion of this service in Vietnam. It is necessary to address the complexity of health care demands of drug users, their difficulties to be rehabilitated into workforce and society, and the stigmatization to maximize the outcomes of MMT program.

Suggested Citation

  • Bach Xuan Tran & Long Hoang Nguyen & Tung Thanh Tran & Carl A Latkin, 2018. "Social and structural barriers for adherence to methadone maintenance treatment among Vietnamese opioid dependence patients," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-13, January.
    • Handle: RePEc:plo:pone00:0190941
    DOI: 10.1371/journal.pone.0190941
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    References listed on IDEAS

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    1. Chao-Kuang Lin & Chia-Chun Hung & Ching-Yi Peng & En Chao & Tony Szu-Hsien Lee, 2015. "Factors Associated with Methadone Treatment Duration: A Cox Regression Analysis," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-7, April.
    2. Dima, Alexandra L. & Stutterheim, Sarah E. & Lyimo, Ramsey & de Bruin, Marijn, 2014. "Advancing methodology in the study of HIV status disclosure: The importance of considering disclosure target and intent," Social Science & Medicine, Elsevier, vol. 108(C), pages 166-174.
    3. Bach Xuan Tran & Jongnam Hwang & Long Hoang Nguyen & Anh Tuan Nguyen & Noah Reed Knowlton Latkin & Ngoc Kim Tran & Vu Thi Minh Thuc & Huong Lan Thi Nguyen & Huong Thu Thi Phan & Huong Thi Le & Tho Din, 2016. "Impact of Socioeconomic Inequality on Access, Adherence, and Outcomes of Antiretroviral Treatment Services for People Living with HIV/AIDS in Vietnam," PLOS ONE, Public Library of Science, vol. 11(12), pages 1-13, December.
    4. Obermeyer, C.M. & Baijal, P. & Pegurri, E., 2011. "Facilitating HIV disclosure across diverse settings: A review," American Journal of Public Health, American Public Health Association, vol. 101(6), pages 1011-1023.
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    1. Vengketeswara Rao & Nor Asiah Muhamad & Salmah Nordin & Ruziaton Hasim & Siti Nurhani Rafan & Hanisah Shafie & Anizah Muzaid & Vickneswari Ayadurai & Norni Abdullah & Norliza Chemi & Hazlin Mohamed & , 2020. "Describing the Programme on Methadone Maintenance Therapy in Selangor, Malaysia," Global Journal of Health Science, Canadian Center of Science and Education, vol. 12(9), pages 151-151, August.
    2. Tuan Anh Le & Duyen T. T. Pham & Travis T. C. Quek & Giang Thu Vu & Chi Linh Hoang & Tung Thanh Tran & Cuong Tat Nguyen & Ninh Hai Thi Tran & Quan Hoang Vuong & Tung Hoang Tran & Bach Xuan Tran & Carl, 2019. "Polysubstance Use among Patients Enrolling in Methadone Maintenance Treatment Program in a Vietnam Province with Drug-Driven HIV Epidemic," IJERPH, MDPI, vol. 16(18), pages 1-13, September.
    3. Cheng Gong & Xia Zou & Wen Chen & Yin Liu & Qian Lu & Li Ling, 2019. "Factors Associated with Compliance among Methadone Maintenance Treatment Transfers: Evidence from Audit Records at Clinics in Guangdong, China," IJERPH, MDPI, vol. 16(11), pages 1-10, June.

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