戒毒所内吸毒人群美沙酮维持治疗参与意愿调查

Knowledge,attitude and intention toward methadone maintenance treatment among drug users in a drug rehabilitation center

目的了解戒毒所内吸毒人群对美沙酮维持治疗(MMT)的认识及参与意愿。方法对戒毒所内吸毒人群进行问卷调查,收集吸毒人群的人口学特征、行为学特征、艾滋病(AIDS)知识、对MMT的认识及参与意愿等信息,并抽取3-5mL静脉血检测HIV抗体。结果共调查436名戒毒所内吸毒人员,HIV阳性者62人(14.2%);AIDS知识得分(7.47±1.129)分。236名(54.1%)调查对象表示出戒毒所后若复吸,愿意参与MMT。200名不愿意参加MMT的原因主要有:已经戒除毒瘾无需服用美沙酮(33.5%),美沙酮与海洛因一样有毒(17.5%),美沙酮不能替代海洛因无欣快感(8.5%),美沙酮不良反应多(6%)及不了解MMT(7%)等。单因素分析显示,入所前知道所在地MMT服药点、知道针具交换、文化程度、有自愿戒毒史和强制戒毒三次及以上、AIDS知识得分高、HIV感染等因素与MMT参与意愿相关;多因素Logistic回归分析显示,有自愿戒毒史、HIV感染及AIDS知识得分较高,是吸毒人群参与MMT的有利因素。结论被调查的吸毒人员中,愿意参与MMT的占半数以上,不愿意的原因多是对戒毒与MMT的认识不足,建议加大针对此类人群的MMT及AIDS相关知识宣传。

Objective To describe the knowledge, attitude and intention toward MMT among drug users in a drug rehabilitation center. Methods A questionnaire survey was conducted to obtain the information of drug users and their blood specimen were collected for detecting antibodies against HIV. Results A total of 436 drug users were interviewed with questionnaire, and of them 62 were HIV positive （14.2M）. The average score about AIDS knowledge was 7.47 ±1. 129, and 236 （54.1%）drug users expressed their willingness to attend MMT clinic again if they reused drugs afterwards 200 clients expressed their unwillingness to attend MMT clinic for the following reasons： withdrawal from heroin already（33.5%）, methadone is toxic too（17.5%）, methadone cannot replace heroin to cause euphoria （8.5）,methadone is detrimental to health（6%）and no knowledge about MMT（7%）. The Logistic regression model indicated that having experience in voluntary rehabilitation, HIV infection and high score on AIDS knowledge were significantly associated with intention to receive MMT. Conclusions More than half of the drug users are willing to take MMT, and the reasons for not taking MMT are insufficient knowledge about MMT and rehabilitation. More publicity and public education are needed for drug users.