2004-2021年全国社区美沙酮维持治疗工作进展分析

Progress of community-based methadone maintenance treatment in China from 2004 to 2021

目的 分析全国社区美沙酮维持治疗(MMT)工作进展,为推进MMT工作提供参考。方法 从艾滋病综合防治数据信息系统中下载2004-2021年MMT相关数据,对各项工作指标进行描述性统计分析。结果 2004-2021年,MMT门诊数量持续增长,从8家增加至801家,覆盖省份数从5个增加至30个,在治人数先上升后下降,2012年在治人数到达峰值(20.8万)后呈逐年下降。2015-2021年,在治人员的HIV、HCV、梅毒检测率始终维持在80%~90%,在2020年三项检测率均有下降。2006-2021年,MMT门诊在治人员HIV阳转比例从0.95%下降至0.07%。2008-2014年,MMT门诊在治人员日均服药剂量从52 mg上升至61 mg,此后随之开始下降。2008-2021年,MMT门诊在治人员尿吗啡检测阳性率从27.2%下降至9.6%。结论 社区MMT有效控制了艾滋病在治疗人群中的流行,目前存在在治人数持续下降等诸多问题与挑战,在新形势下应探索创新服务模式,确保全国MMT工作持续有效开展。

Objective To analyze the progress of community-based methadone maintenance treatment in China and to provide a reference for promoting methadone maintenance treatment. Methods The relevant data on drug maintenance treatment for detoxification drugs from 2004-2021 were downloaded from the HIV/AIDS Comprehensive Response Information Management System and descriptive statistical analysis of various work indexes was carried out.Results From 2004 to 2021, the number of methadone clinics increased from 8 to 801. The number of provinces covered increased from 5 to 30. The number of treated patients increased first and then declined, which decreased year by year after reaching the peak(208,000) in 2012. From 2015 to 2021, the detection rates of HIV, HCV, and syphilis remained at 80%-90% and decreased in 2020. From 2006 to 2021, HIV-positive conversion among MMT outpatients decreased from 0.95% to 0.07%. From 2008 to 2014, the average daily dose of methadone outpatients increased from 52 mg to 61 mg and then began to decline. From 2008 to 2021, the positive rate of urinary morphine tests among MMT outpatients decreased from 27.2% to 9.6%. Conclusions Community-based methadone maintenance treatment program has effectively controlled the prevalence of HIV in treated patients. Currently, there are many problems and challenges, such as the continuous decline of the treated population. Under the new situation, innovative service models should be explored to ensure the continuous and effective development of methadone maintenance treatment in the country.