Methadone Maintenance Treatment Promotes Referral and Uptake of HIV Testing and Counselling Services amongst Drug Users and Their Partners
April
Methadone Maintenance Treatment Promotes Referral and Uptake of HIV Testing and Counselling Services amongst Drug Users and Their Partners
Bach Xuan Tran 0 1
Long Hoang Nguyen 0 1
Lan Phuong Nguyen 1
Cuong Tat Nguyen 1
Huong Thi Thu Phan 1
Carl A. Latkin 1
0 Institute for Preventive Medicine and Public Health, Hanoi Medical University , Hanoi , Vietnam , 2 Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland, United States of America, 3 School of Medicine and Pharmacy, Vietnam National University , Hanoi , Vietnam , 4 Harvard T.H Chan School of Public Health, Boston, Massachusetts, United States of America, 5 Institute for Global Health Innovations, Duy Tan University , Da Nang , Vietnam , 6 Authority of HIV/AIDS Control, Ministry of Health , Hanoi , Vietnam
1 Editor: Gabriele Fischer, Medical University of Vienna , AUSTRIA
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Data Availability Statement: Data are available from
the Authority of HIV/AIDS Control (VAAC). However,
since the Government of Vietnam issues the Law on
HIV/AIDS, all information of HIV-affected people is
confidential and can not be shared. Requests for data
on this study may be submitted to VAAC and should
go through the review process by the Scientific and
Ethic Research Committee. The contact people for
requesting data use is Dr. Phan Thi Thu Huong, email
, Deputy Director in
Research of the Vietnam Authority of HIV/AIDS
Control, Ministry of Health, Vietnam.
Background
Methadone maintenance treatment (MMT) reduces HIV risk behaviors and improves access to HIV-related services among drug users. In this study, we assessed the uptake and willingness of MMT patients to refer HIV testing and counseling (HTC) service to their sexual partners and relatives.
Methods
Health status, HIV-related risk behaviors, and HTC uptake and referrals of 1,016 MMT patients in Hanoi and Nam Dinh were investigated. Willingness to pay (WTP) for HTC was elicited using a contingent valuation technique. Interval and logistic regression models were employed to determine associated factors.
Results
Most of the patients (94.2%) had received HTC, 6.6 times on average. The proportion of
respondents willing to refer their partners, their relatives and to be voluntary peer educators
was 45.7%, 35.3%, and 33.3%, respectively. Attending MMT integrated with HTC was a
facilitative factor for HTC uptake, greater WTP, and volunteering as peer educators. Older
age, higher education and income, and HIV positive status were positively related to
willingness to refer partners or relatives, while having health problems (mobility, usual care, pain/
discomfort) was associated with lower likelihood of referring others or being a volunteer.
Over 90% patients were willing to pay an average of US $17.9 for HTC service.
Funding: The authors have no support or funding to
report.
Competing Interests: The authors have declared
that no competing interests exist.
Conclusion
The results highlighted the potential role of MMT patients as referrers to HTC and voluntary
peer educators. Integrating HIV testing with MMT services and applying users’ fee are
potential strategies to mobilize resources and encourage HIV testing among MMT patients
and their partners.
Introduction
Expanding HIV testing among most-at-risk populations, including people who inject drug
(PWID), female sex workers (FSW), men who have sex with men (MSM), and their sexual
partners is critical to prevent HIV transmission and promotes early access to HIV-related care
and treatment services in concentrated HIV epidemics [
1
]. However, there is still a high
proportion of people who are at risk of HIV transmission are not aware their HIV status[
2
].
In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS) declared the
9090-90 targets for 2020, with the goal of identifying 90% PLWH living in community [
3
].
Regarding the UNAIDS target, HIV testing and counselling services (HTC) is a crucial
component [
4
]. HTC can provide knowledge of current HIV status for clients, raise awareness of the
importance to change HIV-related risk behaviors, and connecting positive individuals to HIV
medical care if needed [5]. Empirical evidence has shown that HTC can reduce sexual risk
behaviors among HIV positives [
6
] and eventually HIV incidence [
7, 8
]. Therefore, improving
HTC uptake has an indispensable role in improving the efficiency and outcomes of HIV
programs [9].
In Vietnam, scaling-up HTC services has been a priority in the National HIV/AIDS
Strategic Plan [
10, 11
]. To date, there are 1,345 HTC clinics in Vietnam, providing services for
260,000 clients and about 227,000 HIV-positive cases have been reported [12]. However, many
individuals still lack of awareness of their HIV status[
13–15
]. Results of Vietnam 2014 HIV/
STI Sentinel Survey Plus Behavior indicated the low prevalence of HTC uptake in key
populations, such as 38% in FSW and 39.4% in MSM [
15
]. Therefore, widespread introduction of
HTC by divers (...truncated)