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Thu, Vuong Thi Anh
1
, Nhu, To Nguyen
1
, Thu, Vuong Thi Huong
2
, Giang, Le Minh
3
, Khue, Pham Minh
4
, Thuy, Dinh Thi Thanh
3
, Banys, Peter
1
, West, Gary
1

BACKGROUND METHOD
Vietnam rolled out its national methadone maintenance therapy
(MMT) program for drug users (DUs) in 2008. By 2013, approximately
16,000 DUs have received this treatment nationwide.
Hai Phong has the largest population of injection drug users in
Vietnam. By 2007, registered DUs (mostly heroin users) numbered
approximately 6,000 with an additional 2,000 estimated unreported
users. 65.5% of DUs were HIV-positive (IBBS, 2006). Hai Phong was
one of two cities to pilot the MMT program in Vietnam.
The cohorts were conducted at three MMT clinics: Le Chan, Ngo
Quyen and Thuy Nguyen in Hai Phong. Our aim was to determine
changes in HIV risk behaviors and quality of life at 48 months among
MMT-treated DUs in Vietnam.

A convenience sample of MMT clients was recruited in January 2009
and followed over 24 months. Those who completed the study were
recruited into a second, 12-month prospective cohort study beginning
in January 2013.
Data were collected by face-to-face interviews at baseline, 3, 6, 12,
18, and 24 months in the first two years on MMT and at 4 points
during the second cohort study.
Both cohorts used the same data collection tools, including:
Structured questionnaires on demographics, drug use and criminal
activity;
WHOQOL-BREF and EQ-5D-3L to assess quality of life and health-
related quality of life;
BBV-TRAG-SV to measure drug-related HIV risk behaviors.
McNemars test was used to assess the significance of changes
between baseline and follow-ups
RESULTS
388 out of 467 participants completed the first study, and 318 the
second. Of the 70 who did not complete the second cohort, 4 refused,
5 were transferred, and the remainder were drop-outs.

CONCLUSION
The assessment demonstrates improvements compared to baseline in
health and social aspects among participants receiving MMT. The
positive findings support scaling-up this treatment.
Vocational training and employment services should be linked to MMT
to assist DUs reintegration into society.
Perceived quality of life did not improve there may be a number of
explanations for this, including the inconvenience of daily dosing at the
clinic. This question should be researched further.
A more rigorous evaluation including biological testing to document
reductions in illicit drug use and other outcomes would be helpful.
FIGURE 2. Patients domain-specific quality of life (based on WHOQOL-BREF)
AUTHOR AFFILIATIONS
1
FHI 360 Vietnam
2
The University of New South Wales
3
The Hanoi Medical University
4
The Hai Phong University of Medicine and Pharmacy

ACKNOWLEDGEMENTS
The authors would like to thank all subject participants who shared experience with us. We would also
thank Hai Phong Department of Health, and Le Chan, Ngo Quyen and Thuy Nguyen MMT clinics for
supporting us during the data collection.
The U.S. Presidents Plan for AIDS Relief (PEPFAR) through the United States Agency for International
Development (USAID) provided financial support that made the study Effectiveness Evaluation of the
pilot program for the treatment of opioid dependence by methadone in Hai Phong and Ho Chi Minh
Cities possible.
The Atlantic Philanthropies has provided financial support that makes the study Economic Evaluation
comparing the center-based compulsory rehabilitation and community-based methadone treatment in
Hai Phong City, Vietnam possible.

A patient is taking his daily dose at the clinic before work
Presented at the 2014 International AIDS Conference
RESULTS
Convenience sample with strict selection criteria of the first pilot MMT
program might have caused selection bias.
No comparison groups available.
Findings based upon self-reported data subject to social desirability
bias, especially with regards to sensitive issues such as drug use and
criminal activities.
Insufficient data for drop-out analysis.

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66.4% of patients retained on MMT at 48 months.
The proportion of participants reporting illicit drugs use in the past 3
months was reduced substantially from 100% at enrollment to 8.4%
(CI 95%: 5.8% - 12%, p < 0.05) at 48 months, and from 87.0% to
43.2% (!
2
=134.007, p <0.0001) for reported injecting drug use.
At MMT initiation, 2% shared injection equipment whereas after four
years no participants reported sharing injecting equipment.
Unemployment remained high among participants - 40.8% at starting
MMT and 32.9% (!
2
=10.173, p = 0.0014) at 48 months.
36.0% of participants had engaged in criminal activities in the past
three months at baseline whereas a much lower rate (1.3%, !
2

=105.009, p <0.0001) was documented at 48 months on MMT.
The proportion of participants who perceived their health as good or
very good doubled from 16.0% at baseline to 32.6% (!2 = 35.221, p
<0.0001) at 48 months.
32.8% reported being satisfied or very satisfied with their quality of
life at 24 months, compared to 31.5% at 48 months.
TABLE 1. Socio- demographic characteristic of participants
LIMITATIONS
FIGURE 1. Vietnam and location of Hai Phong City
THPE093
REFERENCES
Ministry of Health (2006). "Results from the HIV/STI Integrated Biological and Behavioral Surveillance
(IBBS) in Vietnam 2005-2006." available at
http://www.unaids.org.vn/sitee/upload/publications/ibbs_en.pdf.
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