Perspectives of clients and providers on factors influencing opioid agonist treatment uptake among HIV-positive people who use drugs in Indonesia, Ukraine, and Vietnam: HPTN 074 study

Harm Reduction Journal

Vivian F. Go¹  Rebecca B. Hershow¹  Carl A. Latkin²  Kathryn E. Lancaster³  William C. Miller³  Irving F. Hoffman⁴  Riza Sarasvita⁵  Erica L. Hamilton⁶  Quynh Bui⁷  Tetiana Kiriazova⁸  Kostyantyn Dumchev⁸ 

[1] Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina At Chapel Hill, 135 Dauer Drive, 27599, Chapel Hill, NC, USA;Department of Health, Behavior, and Society, Johns Hopkins University, 615 N. Wolfe Street, 21205, Baltimore, MD, USA;Division of Epidemiology, College of Public Health, The Ohio State University, 300-D Cunz Hall, 1841 Neil Avenue, 43210, Columbus, OH, USA;Division of Infectious Diseases, School of Medicine, The University of North Carolina At Chapel Hill, 130 Mason Farm Rd, 27599, Chapel Hill, NC, USA;Dr. Cipto Mangunkusumo National Central General Hospital, University of Indonesia, Jalan Pangeran Diponegoro No.71, Salemba, Senen, Jakarta Pusat, Daerah Khusus Ibukota, 10430, Jakarta, Indonesia;Science Facilitation Department, FHI 360, 359 Blackwell Street, Suite 200, 27701, Durham, NC, USA;UNC Project Vietnam, Yen Hoa Health Clinic, Lot E2, Duong Dinh Nghe Street, Cau Giay District, Hanoi, Vietnam;Ukrainian Institute On Public Health Policy, 5 Biloruska Str., Office 20, 27, 04050, Kyiv, Ukraine;

关键词: People who inject drugs;    Barriers to care;    Opioid agonist treatment (OAT);    Drug treatment;    Indonesia;    Ukraine;    Vietnam;    In-depth interviews;   

DOI  :  10.1186/s12954-020-00415-x

来源: Springer

【 摘 要 】

BackgroundOpioid agonist treatment (OAT) is an effective method of addiction treatment and HIV prevention. However, globally, people who inject drugs (PWID) have insufficient OAT uptake. To expand OAT access and uptake, policymakers, program developers and healthcare providers should be aware of barriers to and facilitators of OAT uptake among PWID.MethodsAs a part of the HPTN 074 study, which assessed the feasibility of an intervention to facilitate HIV treatment and OAT in PWID living with HIV in Indonesia, Ukraine, and Vietnam, we conducted in-depth interviews with 37 HIV-positive PWID and 25 healthcare providers to explore barriers to and facilitators of OAT uptake. All interviews were audio-recorded, transcribed, translated into English, and coded in NVivo for analysis. We developed matrices to identify emergent themes and patterns.ResultsDespite some reported country-specific factors, PWID and healthcare providers at all geographic locations reported similar barriers to OAT initiation, such as complicated procedures to initiate OAT, problematic clinic access, lack of information on OAT, misconceptions about methadone, financial burden, and stigma toward PWID. However, while PWID reported fear of drug interaction (OAT and antiretroviral therapy), providers perceived that PWID prioritized drug use over caring for their health and hence were less motivated to take up ART and OAT. Motivation for a life change and social support were reported to be facilitators.ConclusionThese results highlight a need for support for PWID to initiate and retain in drug treatment. To expand OAT in all three countries, it is necessary to facilitate access and ensure low-threshold, financially affordable OAT programs for PWID, accompanied with supporting interventions. PWID attitudes and beliefs about OAT indicate the need for informational campaigns to counter misinformation and stigma associated with addiction and OAT (especially methadone).

【 授权许可】

CC BY