Drug addiction stigma in relation to methadone maintenance treatment by different service delivery models in Vietnam

BMC Public Health

Research Article

Huong Thu Thi Phan¹  Carl A. Latkin²  Cuong Tat Nguyen³  Phuong Bich Vu⁴  Bach Xuan Tran⁵  Long Hoang Nguyen⁶  Sophia Knowlton Latkin⁷ 

[1] Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam;Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam;Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, vietnam;Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, vietnam;Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, vietnam;School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam;River Hill, Maryland, USA;

关键词: Stigma;    Drug addiction;    Methadone maintenance treatment;   

DOI  :  10.1186/s12889-016-2897-0

 received in 2015-08-28, accepted in 2016-02-19,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe rapid expansion of methadone maintenance treatment (MMT) services has significantly improved health status and quality of life of patients. However, little is known about its impacts on addiction-related stigma and associated factors.MethodsA cross-sectional survey was conducted in 2013 in Vietnam’s capital, Hanoi, and Nam Dinh province among 1016 methadone maintenance patients; 26.6 % at provincial AIDS centers (PAC) and 73.4 % at district health centers (DHC), respectively. Drug addiction history and related stigma, health status, MMT-related covariates, and sociodemographic characteristics were interviewed.ResultsMore than one-sixth of the sample reported experiencing felt or enacted stigma, including Blame or Judgement (17.2 %), Shame (19.9 %), or Others’ fear of HIV transmission (17.1 %). These proportions were higher in PACs than in DHCs, which are integrated with other HIV or general health care services. Very few patients reported being discriminated at the workplace (2.5 %) or at health care services (1.7 %); however, 15.6 % of patients at PACs and 10.6 % of patients at DHCs reported discrimination in their communities. Drug users taking MMT for longer periods were less likely to report felt stigma. Other factors associated with stigma against MMT patients included the lack of comprehensive services, higher education, presence of pain/discomfort, and anxiety/depression, self-reported HIV positive, and number of previous drug rehabilitation episodes.ConclusionThe study shows a high level of stigma against MMT patients and emphasizes the necessity to integrate MMT with comprehensive health and support services. Mass communication campaigns to reduce stigma against people with drug addiction and HIV/AIDS, as well as vocational trainings and jobs referrals for MMT patients, are needed to maximize the benefits of MMT programs in Vietnam.

【 授权许可】

CC BY   
© Tran et al. 2016