CAJ | 학술논문

目的分析中国首批8个社区美沙酮维持治疗(MMT)门诊的长期治疗效果.方法在MMT门诊开诊(基线)及运行5年后(5年评估)两个时间点,采用一对一问卷调查的方法,比较分析研究对象的人口学特征、HIV感染危险行为、毒品滥用相关违法犯罪、家庭社会功能恢复等.结果基线与5年评估调查的研究对象分别为252人和195人,其中66人参加了2次调查.基线与5年评估时研究对象在民族、文化程度、职业、婚姻状况居住状况等特征差异无统计学意义(P＞0 05).参加MMT后,研究对象在毒品滥用(100.0％vs.24.1％,P＜0.001)、共用注射器吸毒(19.4％vs.0.0％,P＜0.001)及因毒品而与他人发生性行为(34.5％vs.0.0％,P＜0.001)等HIV感染危险行为方面有显著降低.在安全套使用率(10.6％vs.25.0％,P=0.004)、有工作的比例(27.8％vs.47.7％,P＜0.001)、吸毒相关违法犯罪发生率(15.1％vs.1.5％,P＜0.001)及与吸毒人员交往比例(88.9％vs.31.3％,P＜0.001)均有明显改善.结论 MMT在降低HIV感染危险行为、恢复社会功能、减少违法犯罪等方面具有显著作用.应通过加强培训等措施,提高工作人员能力及服务质量,尽可能减少脱失、延长治疗时间.
목적 분석중국수비8개사구미사동유지치료(MMT)문진적장기치료효과.방법 재MMT문진개진(기선)급운행5년후(5년평고)량개시간점,채용일대일문권조사적방법,비교분석연구대상적인구학특정、HIV감염위험행위、독품람용상관위법범죄、가정사회공능회복등.결과 기선여5년평고조사적연구대상분별위252인화195인,기중66인삼가료2차조사.기선여5년평고시연구대상재민족、문화정도、직업、혼인상황거주상황등특정차이무통계학의의(P＞0 05).삼가MMT후,연구대상재독품람용(100.0％vs.24.1％,P＜0.001)、공용주사기흡독(19.4％vs.0.0％,P＜0.001)급인독품이여타인발생성행위(34.5％vs.0.0％,P＜0.001)등HIV감염위험행위방면유현저강저.재안전투사용솔(10.6％vs.25.0％,P=0.004)、유공작적비례(27.8％vs.47.7％,P＜0.001)、흡독상관위법범죄발생솔(15.1％vs.1.5％,P＜0.001)급여흡독인원교왕비례(88.9％vs.31.3％,P＜0.001)균유명현개선.결론 MMT재강저HIV감염위험행위、회복사회공능、감소위법범죄등방면구유현저작용.응통과가강배훈등조시,제고공작인원능력급복무질량,진가능감소탈실、연장치료시간.
Objective To evaluate the long-term effectiveness of the first set 8 methadone maintenance treatment (MMT) clinics in China. Methods Repeated cross-sectional surveys were conducted on the first month after the enrollment and 5 years later,among drug users who received MMT,using a standard questionnaire.Data on demographic characteristics,HIV-related high-risk bchaviors,criminal records associatcd with drug use and related family/social functions were collected and analyzed.Results There were 252 and 195 participants being interviewed at the baseline and the 5-year surveys,respectively,.Of them,66 participants were involved in both surveys.There was no significant differences on factors as ethnicity,level of education,working status,marital status and living status (P＞0.05) between the baselinc and the 5-year surveys.Compared with data from the baseline survey,participants' behavior on drug abuse (100.0％ vs.24.1％,P＜0.001 ),needle sharing behavior ( 19.4％ vs.0.0％,P ＜ 0.001 ),and exchanging sex for drugs ( 34.5 ％ vs.0.0％,P＜0.001 ) had significant decreases at the 5-year survey.Rates on condom use ( 10.6％ vs.25.0％,P=0.004),and having jobs (27.8％ vs.47.7％,P＜0.001 ) had been improved significantly,while self-reported criminal cases related to drug use (15.1％ vs.1.5％,P＜0.001) and the contacts with drug users (88.9％ vs.31.3％,P＜0.001) had been significantly reduced after joining the MMT program.Conclusion MMT could play an active role in reducing the HIV-related high-risk behaviors,criminal cases associated with drug abuse as well as enhancing the family and social functions of the MMT patients.Providing high quality service to the MMT clinic and trying to keep the drug users stick to the program remain difficult.It was also important to improve the training programs for staff working at the MMT clinics.