1. THE 6 TH NATIONAL SCIENTIFIC CONFERENCE ON HIV/AIDS Dropout and return rate in methadone maintenance treatment program in Thai Nguyen from 30/9/2011 to 31/8/2015 Researchers: An Thi Minh Dao. Huong Thi Thu Nguyen. Trang Thi Huyen Nguyen. Giang Thi Huong Nguyen. Anh Ai Kim Le. Thang Van Nguyen. Long Hoang Nguyen.

2. The 6 th National Scientific Conference on HIV/AIDS Outline 1.Background 2.Objectives 3.Methods 4.Results & Discussions 5.Conclusions 6.Recommendations

3. The 6 th National Scientific Conference on HIV/AIDS INTRODUCTION Thai Nguyen is one of the provinces started early Methadone Maintenance Treatment (MMT) in 2011 August 31, 2015: 6 MMT facilities in 5 districts/city Total 2.638 cumulative patients.

4. The 6 th National Scientific Conference on HIV/AIDS Dropout According to Circular No. 03/2015/TT-BYT (March 16,2015): Did not receive Methadone continuously from 30 days and over without reasons

5. The 6 th National Scientific Conference on HIV/AIDS According to Circular No. 03/2015/TT-BYT (March 16,2015): Voluntarily stop treatment with request Be able to quit heroin with MMT reduction schedule Death Contraindicated with MMT Move to other MMT facilities Arrested Left for 06 center Movement to other place Was tested with 2 times of Heroin positive urine test (be forced out of the program- Clause 2, Article 21 of Decree 96) Exited from the MMT program

6. The 6 th National Scientific Conference on HIV/AIDS Return to MMT program According to Decision No. 3140 / QD – BYT (30/8/2010): Skip doses < 5 days : Receiving treatment and maintain old medical records Days 5<Skip doses<30 days : Receiving treatment, maintain old medical records, again the first dose Quit treating >= 30 consecutive days : Receive and restart with a new medical record and start from the beginning MMT therapy

7. The 6 th National Scientific Conference on HIV/AIDS INTRODUCTION (cont) MMT is long term process treatment, the maintenance in program is very important No studies in Thai Nguyen about dropout and return return to treatment

8. The 6 th National Scientific Conference on HIV/AIDS OBJECTIVE To identify proportions of dropout with or without reasons. To identify reasons of dropping out from the MMT program To define proportions of return to MMT program

9. The 6 th National Scientific Conference on HIV/AIDS METHOD

10. The 6 th National Scientific Conference on HIV/AIDS 1. Study Design Cross sectional study 2. Time: 31/08/2015 – 10/9/2015 3. Place: 6 MMT facilities in Thai Nguyen 4. Subject: Patients have registered for MMT from September 30, 2011-August 31, 2015, eligible for MMT, were prescribed MMT. 5. Sampling and sample size: Convenient of 2,638 eligible patients

11. The 6 th National Scientific Conference on HIV/AIDS Retrospective extracting data of dropout/return events and reasons from treatment managing book Cleaning and analysis Data by Stata 12 Analysis frequency, percent and chi-square (X 2 ). 6. Collection and Analysis Data

12. The 6 th National Scientific Conference on HIV/AIDS The Science and Ethics Committee of the Vietnam Administration of HIV/AIDS Control reviewed and approved the protocol Confidentiality of individual characteristics was ensured Personal data were analyzed as aggregated data. 7. Ethical considerations

13. The 6 th National Scientific Conference on HIV/AIDS RESULTS

14. The 6 th National Scientific Conference on HIV/AIDS

16. Figure 1: Reasons of dropping out from MMT program of patients in 6 MMT facilities in Thai Nguyen (30/09/2011-31/08/2015)

17. The 6 th National Scientific Conference on HIV/AIDS

18. CONCLUSION Proportion of no longer retaining after 4 years of MMT was 30.3%(18.2% without reason and 12.1% with reason Dropout rate is the highest among age group  29 (22.1% and 13.3%). Statistical difference of dropout rate MMT facilities,

19. The 6 th National Scientific Conference on HIV/AIDS CONCLUSION (cont) Main reasons of dropout are: Being arrested, Death and Move to other MMT facilities with (44.0%; 16.4% and 11.0%), respectively. Proportion of return to MMT program is 8.9% in general. Returning to MMT among group of “feel be able to quit heroin with dose reduction athgorim is 12.5%

20. The 6 th National Scientific Conference on HIV/AIDS RECOMMENDATION Training for health workers at MMT facilities on updating and recording reasons of dropping out MMT. Patients dropping out MMT with “dose reduction althgorim” should before receive intensive supports from family to prevent them form relapse More qualitative studies needed to have further understand on reasons of cases who dropped out without reasons and who returning to the MMT after a period of dropping out the program.

21. The 6 th National Scientific Conference on HIV/AIDS Source: from Dai Tu MMT facilities, Thai Nguyen Thank you for your listening!