Intravenous heroin use in Haiphong, Vietnam: Need for comprehensive care including methamphetamine use-related interventions
Laurent Michel, Don C Des Jarlais, Huong Duong Thi, Oanh Khuat Thi Hai, Khuê Pham Minh, Marianne Peries, Roselyne Vallo, Thanh Nham Thi Tuyet, Giang Hoang Thi, Mai Le Sao, Jonathan Feelemyer, Vinh Vu Hai, Jean-Pierre Moles, Didier Laureillard, Nicolas Nagot, DRIVE Study Team, Laurent Michel, Don C Des Jarlais, Huong Duong Thi, Oanh Khuat Thi Hai, Khuê Pham Minh, Marianne Peries, Roselyne Vallo, Thanh Nham Thi Tuyet, Giang Hoang Thi, Mai Le Sao, Jonathan Feelemyer, Vinh Vu Hai, Jean-Pierre Moles, Didier Laureillard, Nicolas Nagot, DRIVE Study Team
Abstract
Background: The aim of this study was to describe patterns among people who inject drugs (PWID), risk-related behaviours and access to methadone treatment, in order to design a large-scale intervention aiming to end the HIV epidemic in Haiphong, Vietnam.
Methods: A respondent-driven sampling (RDS) survey was first conducted to identify profiles of drug use and HIV risk-related behaviour among PWID. A sample of PWID was then included in a one-year cohort study to describe access to methadone treatment and associated factors.
Results: Among the 603 patients enrolled in the RDS survey, 10% were female, all were injecting heroin and 24% were using methamphetamine, including 3 (0.5%) through injection. Different profiles of risk-related behaviours were identified, including one entailing high-risk sexual behaviour (n=37) and another involving drug-related high-risk practices (n=22). High-risk sexual activity was related to binge drinking and methamphetamine use. Among subjects with low sexual risk, sexual intercourse with a main partner with unknown serostatus was often unprotected. Among the 250 PWID included in the cohort, 55.2% initiated methadone treatment during the follow-up (versus 4.4% at RDS); methamphetamine use significantly increased. The factors associated with not being treated with methadone after 52 weeks were fewer injections per month and being a methamphetamine user at RDS.
Conclusion: Heroin is still the main drug injected in Haiphong. Methamphetamine use is increasing markedly and is associated with delay in methadone initiation. Drug-related risks are low but sexual risk behaviours are still present. Comprehensive approaches are needed in the short term.
Keywords: Heroin; Methadone; Methamphetamine; People who inject drugs; Vietnam.
Conflict of interest statement
Conflict of interest
None.
Copyright © 2017 Elsevier B.V. All rights reserved.
Source: PubMed