Stigmatization among methadone maintenance treatment patients in mountainous areas in northern Vietnam

Hung Van Nguyen, Huong Lan Thi Nguyen, Hue Thi Mai, Hai Quan Le, Bach Xuan Tran, Canh Dinh Hoang, Huong Thi Le, Cuong Tat Nguyen, Tho Dinh Tran, Carl A. Latkin, Thuc Minh Thi Vu

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Article number1
JournalHarm reduction journal
Volume14
Issue number1
DOIs
StatePublished - Jan 6 2017

Keywords

  • Discrimination
  • Methadone maintenance treatment
  • Mountainous area
  • Stigma
  • Vietnam

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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