Abstract | SETTING: Thirteen methadone maintenance treatment ( MMT) clinics across Yunnan, the province with the highest human immunodeficiency virus (HIV) burden in China. OBJECTIVES: To determine, among HIV-negative participants on MMT, the proportion lost to follow-up (defined as those who missed the 6-monthly follow-up examination), factors associated with loss to follow-up (LFU), HIV seroconversion rate and factors associated with seroconversion. DESIGN: Prospective cohort study from October 2008 to April 2011. All participants were administered a pre-tested structured questionnaire to capture associated factors and offered HIV testing every 6 months. χ(2) test and log-binomial regression were used for data analysis. RESULTS: Of 1146 participants, 541 (47%) were lost to follow-up in 2.5 years. Factors associated with higher LFU proportion include <6 months of previous MMT, inconvenient location of the MMT clinic and average methadone dose ⩽60 mg/day, with adjusted relative risks (RRs) of respectively 1.4 (95%CI 1.2-1.5), 1.2 (95%CI 1.0-1.4) and 1.1 (95%CI 1.0-1.3). The overall HIV seroconversion rate was 6.6 (95%CI 3.7-11.0) per 1000 person-years. Not living with a partner contributed to higher HIV rates, with an adjusted RR of 3.6 (95%CI 1.0-12.8). CONCLUSION: The retention rate of MMT participants in Yunnan was not satisfactory. Decentralising service delivery in the community and making directly observed treatment more convenient has the potential to improve retention.
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Authors | Y-P Chang, L Duo, A M V Kumar, S Achanta, H-M Xue, S Satyanarayana, R Ananthakrishnan, S Srivastava, W Qi, S-Y Hu |
Journal | Public health action
(Public Health Action)
Vol. 4
Issue 1
Pg. 28-34
(Mar 21 2014)
ISSN: 2220-8372 [Print] France |
PMID | 26423758
(Publication Type: Journal Article)
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