TY - JOUR
T1 - Stigmatization among methadone maintenance treatment patients in mountainous areas in northern Vietnam
AU - Van Nguyen, Hung
AU - Nguyen, Huong Lan Thi
AU - Mai, Hue Thi
AU - Le, Hai Quan
AU - Tran, Bach Xuan
AU - Hoang, Canh Dinh
AU - Le, Huong Thi
AU - Nguyen, Cuong Tat
AU - Tran, Tho Dinh
AU - Latkin, Carl A.
AU - Vu, Thuc Minh Thi
N1 - Funding Information:
We conducted a cross-sectional study from May to August 2016 in Tuyen Quang Province. Two MMT clinics were involved in the study: one in Tuyen Quang City, a third-grade urban area, and the other in Son Duong District, a rural area. In fact, there are three MMT centers in Tuyen Quang Province; however, we excluded one, Yen Son District, because only nine patients have been treated in this clinic due to its new establishment. Methadone treatment in the two clinics is free of charge and funded by the Australian government and the Royal Dutch government. Apart from daily methadone treatment, patients also receive health counseling from health staffs working at these sites.
Publisher Copyright:
© 2017 The Author(s).
PY - 2017/1/6
Y1 - 2017/1/6
N2 - Background: Stigma and discrimination may adversely affect the benefits of methadone maintenance treatment (MMT) for drug users, especially in disadvantaged settings. This study assessed stigma and discrimination against MMT patients in the mountainous and rural areas in Vietnam and explored their associated factors to inform implementation strategies. Methods: We interviewed 241 MMT patients in two clinics: one in Tuyen Quang Province's inner city and the other in Son Duong District, to assess stigma and discrimination that patients perceived and experienced. Socioeconomic status, health behaviors, health status, and history of drug abuse were examined. Multivariate linear and logistic regression models were used to explore factors associated with stigma and discrimination. Results: The majority of respondents reported experiencing stigma and discrimination including blame/judgment (95.1%), shame (95.1%), disclosure (71.4%), and the fear of human immunodeficiency virus (HIV) transmission by others (74.1%). Unemployed patients were more likely to experience discrimination (Coef = -1.18, 95% CI = -1.87; -0.89). Those who were taking an antiretroviral were more likely to disclose their health status (Coef = 2.27, 95% CI = 0.6; 3.94). In addition, a higher likelihood of being blamed/judged and shamed was associated with those who suffered from anxiety/depression (Coef = 1.59, 95% CI = 0.24; 2.93 and Coef = 1.07, 95% CI = 0.36; 1.79, respectively). Conclusions: MMT patients in these mountainous areas perceived high levels of stigma and discrimination which were associated with mental health disorders, unemployment, and HIV infection. These findings highlighted the importance of reducing drug use and HIV-related stigma against high-risk populations. Besides, psychosocial and familial supports, as well as job referrals, also play crucial roles in terms of promoting quality of life among MMT patients.
AB - Background: Stigma and discrimination may adversely affect the benefits of methadone maintenance treatment (MMT) for drug users, especially in disadvantaged settings. This study assessed stigma and discrimination against MMT patients in the mountainous and rural areas in Vietnam and explored their associated factors to inform implementation strategies. Methods: We interviewed 241 MMT patients in two clinics: one in Tuyen Quang Province's inner city and the other in Son Duong District, to assess stigma and discrimination that patients perceived and experienced. Socioeconomic status, health behaviors, health status, and history of drug abuse were examined. Multivariate linear and logistic regression models were used to explore factors associated with stigma and discrimination. Results: The majority of respondents reported experiencing stigma and discrimination including blame/judgment (95.1%), shame (95.1%), disclosure (71.4%), and the fear of human immunodeficiency virus (HIV) transmission by others (74.1%). Unemployed patients were more likely to experience discrimination (Coef = -1.18, 95% CI = -1.87; -0.89). Those who were taking an antiretroviral were more likely to disclose their health status (Coef = 2.27, 95% CI = 0.6; 3.94). In addition, a higher likelihood of being blamed/judged and shamed was associated with those who suffered from anxiety/depression (Coef = 1.59, 95% CI = 0.24; 2.93 and Coef = 1.07, 95% CI = 0.36; 1.79, respectively). Conclusions: MMT patients in these mountainous areas perceived high levels of stigma and discrimination which were associated with mental health disorders, unemployment, and HIV infection. These findings highlighted the importance of reducing drug use and HIV-related stigma against high-risk populations. Besides, psychosocial and familial supports, as well as job referrals, also play crucial roles in terms of promoting quality of life among MMT patients.
KW - Discrimination
KW - Methadone maintenance treatment
KW - Mountainous area
KW - Stigma
KW - Vietnam
UR - http://www.scopus.com/inward/record.url?scp=85010203648&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85010203648&partnerID=8YFLogxK
U2 - 10.1186/s12954-016-0127-9
DO - 10.1186/s12954-016-0127-9
M3 - Article
C2 - 28056990
AN - SCOPUS:85010203648
SN - 1477-7517
VL - 14
JO - Harm reduction journal
JF - Harm reduction journal
IS - 1
M1 - 1
ER -