Drug addiction stigma in relation to methadone maintenance treatment by different service delivery models in Vietnam

• Published in: BMC public health Vol. 16; no. 241; p. 238
• Main Authors: Tran, Bach Xuan, Vu, Phuong Bich, Nguyen, Long Hoang, Latkin, Sophia Knowlton, Nguyen, Cuong Tat, Phan, Huong Thu Thi, Latkin, Carl A
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 08.03.2016; BioMed Central; BMC
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Anxiety; Care and treatment; Cross-Sectional Studies; Discrimination in medical care; Disease transmission; Drug abuse; Drug addiction; Drug use; Drug Users - psychology; Drug Users - statistics & numerical data; Education; Epidemics; Female; Health care; Health care facilities; Health care industry; Health Services Administration; HIV; HIV Infections - psychology; Human immunodeficiency virus; Humans; Maintenance; Male; Methadone; Methadone - therapeutic use; Methadone maintenance treatment; Models, Organizational; Opiate Substitution Treatment; Pain; Patients; Qualitative Research; Quality of life; Rehabilitation; Social Stigma; Stigma; Substance abuse; Substance-Related Disorders - psychology; Substance-Related Disorders - rehabilitation; Support services; Surveys; Vietnam; Vietnam
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-016-2897-0

The rapid expansion of methadone maintenance treatment (MMT) services has significantly improved health status and quality of life of patients. However, little is known about its impacts on addiction-related stigma and associated factors. A cross-sectional survey was conducted in 2013 in Vietnam's capital, Hanoi, and Nam Dinh province among 1016 methadone maintenance patients; 26.6 % at provincial AIDS centers (PAC) and 73.4 % at district health centers (DHC), respectively. Drug addiction history and related stigma, health status, MMT-related covariates, and sociodemographic characteristics were interviewed. More than one-sixth of the sample reported experiencing felt or enacted stigma, including Blame or Judgement (17.2 %), Shame (19.9 %), or Others' fear of HIV transmission (17.1 %). These proportions were higher in PACs than in DHCs, which are integrated with other HIV or general health care services. Very few patients reported being discriminated at the workplace (2.5 %) or at health care services (1.7 %); however, 15.6 % of patients at PACs and 10.6 % of patients at DHCs reported discrimination in their communities. Drug users taking MMT for longer periods were less likely to report felt stigma. Other factors associated with stigma against MMT patients included the lack of comprehensive services, higher education, presence of pain/discomfort, and anxiety/depression, self-reported HIV positive, and number of previous drug rehabilitation episodes. The study shows a high level of stigma against MMT patients and emphasizes the necessity to integrate MMT with comprehensive health and support services. Mass communication campaigns to reduce stigma against people with drug addiction and HIV/AIDS, as well as vocational trainings and jobs referrals for MMT patients, are needed to maximize the benefits of MMT programs in Vietnam.