Methadone maintenance treatment participant retention and behavioural effectiveness in China: a systematic review and meta-analysis

Methadone maintenance treatment (MMT) has been scaled up by the Chinese government alongside persistent compulsory drug user detention, but the extent to which detention interferes with MMT is unknown. The study systematically reviews Chinese MMT retention rates, reasons for drop out, and behavioura...

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Bibliographic Details
Published in:PloS one 2013-07, Vol.8 (7), p.e68906-e68906
Main Authors: Zhang, Lei, Chow, Eric P F, Zhuang, Xun, Liang, Yanxian, Wang, Yafei, Tang, Caiyun, Ling, Li, Tucker, Joseph D, Wilson, David P
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
AIDS
Behavior
China
Drug abuse
Drug addiction
Drug use
Drugs
HIV
Human immunodeficiency virus
Humans
Maintenance Chemotherapy
Meta-analysis
Methadone
Opiate Substitution Treatment
Patient Dropouts
Patient Participation
Police
Publication Bias
Reforming
Rehabilitation
Retention
Reviews
Sexual Behavior
Studies
Systematic review
Urine
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Summary:Methadone maintenance treatment (MMT) has been scaled up by the Chinese government alongside persistent compulsory drug user detention, but the extent to which detention interferes with MMT is unknown. The study systematically reviews Chinese MMT retention rates, reasons for drop out, and behavioural changes. Chinese and English databases of literature are searched for studies reporting retention rates, drug use and sexual behaviours among MMT participants in China between 2004 and 2013. The estimates are summarized through a systematic review and meta-analysis. A total of 74 studies representing 43,263 individuals are included in this analysis. About a third of MMT participants drop out during the first three months of treatment (retention rate 69.0% (95% CI 57.7-78.4%)). Police arrest and detention in compulsory rehabilitation was the most common cause of drop out, accounting for 22.2% of all those not retained. Among retained participants, changing unsafe drug use behaviours was more effective than changing unsafe sexual behaviours. At 12 months following MMT initiation, 24.6% (15.7-33.5%) of MMT participants had a positive urine test, 9.3% (4.7-17.8%) injected drugs and only 1.1% (0.4-3.0%) sold sex for drugs. These correspond to 0.002 (
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0068906