N S Aye1, M M Oo2, A D Harries3,4, M M Mon1, S Hone5, H N Oo5, N M A Wan6. 1. Department of Medical Research, Ministry of Health and Sports, Nay Pyi Taw, Myanmar. 2. International Union Against Tuberculosis and Lung Disease (The Union), Mandalay, Myanmar. 3. The Union, Paris, France. 4. London School of Hygiene & Tropical Medicine, London, UK. 5. National AIDS Programme, Ministry of Health and Sports, Nay Pyi Taw, Myanmar. 6. National Drug Abuse Prevention and Control Programme, Ministry of Health and Sports, Nay Pyi Taw, Myanmar.
Abstract
Setting: Two drug treatment centres (DTCs) for people who inject drugs (PWID) and are enrolled in methadone maintenance therapy (MMT), Yangon, Myanmar. Objectives: To determine, in PWID enrolled for MMT from 2015 to 2017, 1) testing uptake and results for human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV); 2) risk factors for infection; and 3) retention in care and risk factors for loss to follow-up (LTFU). Design: Cohort study using secondary data. Results: Of 642 PWID, 578 (90.0%) were tested for HIV, HBV and/or HCV. Overall, 404 (69.9%) were infected: 316 (78.2%) had one infection and the remainder had dual/triple infections. Testing uptake was generally better in 2015 and 2016 than in 2017. Prevalence of HIV infection was 15-17%, for HBV it was 4-7%, and for HCV it was 68-76%. Age >30 years, being single and duration of drug use were independent risk factors for infection. Retention in MMT at 6 months was 76% and declined thereafter. Experimental use of drugs and needle sharing were independent risk factors for LTFU. Conclusion: PWID enrolled in MMT in Yangon had high rates of HIV, HBV and HCV, and retention in care declined with time. Ways to improve individual tracing, programmatic retention and linkage to care are needed.
Setting: Two drug treatment centres (DTCs) for people who inject drugs (PWID) and are enrolled in methadone maintenance therapy (MMT), Yangon, Myanmar. Objectives: To determine, in PWID enrolled for MMT from 2015 to 2017, 1) testing uptake and results for human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV); 2) risk factors for infection; and 3) retention in care and risk factors for loss to follow-up (LTFU). Design: Cohort study using secondary data. Results: Of 642 PWID, 578 (90.0%) were tested for HIV, HBV and/or HCV. Overall, 404 (69.9%) were infected: 316 (78.2%) had one infection and the remainder had dual/triple infections. Testing uptake was generally better in 2015 and 2016 than in 2017. Prevalence of HIV infection was 15-17%, for HBV it was 4-7%, and for HCV it was 68-76%. Age >30 years, being single and duration of drug use were independent risk factors for infection. Retention in MMT at 6 months was 76% and declined thereafter. Experimental use of drugs and needle sharing were independent risk factors for LTFU. Conclusion: PWID enrolled in MMT in Yangon had high rates of HIV, HBV and HCV, and retention in care declined with time. Ways to improve individual tracing, programmatic retention and linkage to care are needed.
Entities:
Keywords:
HIV; hepatitis B; hepatitis C; methadone maintenance therapy; people who inject drugs
Authors: Nick Scott; Thin Mar Win; Tom Tidhar; Hla Htay; Bridget Draper; Phyo Thu Zar Aung; Yinzong Xiao; Anna Bowring; Christian Kuschel; Sonjelle Shilton; Khin Pyone Kyi; Win Naing; Khin Sanda Aung; Margaret Hellard Journal: Lancet Reg Health West Pac Date: 2021-03-23