广东省东莞市社区吸毒人群美沙酮维持治疗认知及行为分析

摘要

Objective To understand the cognition of methadone maintenance treatment (MMT)and to explore the factors associated with the coverage of MMT,among the communitybased drug users in Dongguan,Guangdong province.Mehtods In 2008,respondent-driven sampling was applied to recruit community-based drug users in Dongguan.A structured qucstionnaire was used for a face to face interview.RDSAT was applied to adjust the estimates and the results from bivariate analysis.SPSS was used for multivariate analysis.Results A total of 303 drug users were recruited within a 15-week period.The coverage of MMT program was 8.4%(95%CI:3.4-16.5).62.9% of the drug users had heard of MMT,of which 80.8% had not been enrolled at MMT mainly for the following reasons:fear of being arrested(25%),being not familiar with the application process(18.9%),no certification of domiciliary register and or ever being in detoxification center (18.7%)and thinking poorly of MMT(18.3%).Multiple logistic regression model indicated that those who were local residents(OR=22.5,95%CI:6.6-75.7)and whose effect of MMT being evaluated as positive(OR=24.1,95%CI:6.3-91.6)were more likely to be enrolled at the MMT program.Conclusion Community-based drug users had some irrational cognition on MMT program.Dissemination and sharing of information on MMT should be strengthened through media and existing social network among drug users.More concern should be paid to the people who were on migration when making policy to improve the coverage of MMT.%目的 了解广东省东莞市社区吸毒人群对美沙酮维持治疗(MMT)的认知,并探索MMT项目覆盖率的影响因素.方法 2008年采用同伴推动抽样法(RDS)招募东莞市社区吸毒者进行面对面问卷调查,利用RDSAT分析软件进行权重处理和双变量分析,SPSS对RDSAT导出的权重数据进行多因素分析.结果 经过15周,共招募303名东莞市社区吸毒者,MMT项目覆盖率为8.4%(95%CI:3.4～16.5);62.9%对MMT有一定了解,其中80.8%目前未参加MMT,原因主要包括:担心被抓捕(25.0%)、对办理程序不清楚(18.9%)、不能提供戒毒证明和或户籍证明(18.7%)、认为MMT效果差(18.3%).多因素logistic回归模型显示,本地户籍人口(OR=22.5,95%CI:6.6～75.7)、对MMT效果评价为显著的个体(OR=24.1,95%CI:6.3～91.6)应更大比例地参与到MMT项目.结论 东莞市社区吸毒人群对MMT项目存在认知不足和不合理认知,应利用各种媒体和吸毒人群之间的社会网络加强MMT相关知识宣传.