A Methadone Maintenance Treatment Outcome Study in Three Provinces in China

• MMT retention rate [ Time Frame: 12 months ] [ Designated as safety issue: No ]
• Illicit opioid use rate [ Time Frame: 12 months ] [ Designated as safety issue: No ]
  by urinalysis and self-report

• HIV, HCV, syphilis and HSV-2 infection seroconversion rate [ Time Frame: 12 months ] [ Designated as safety issue: No ]
• High risk needle practice [ Time Frame: 12 months ] [ Designated as safety issue: No ]
• High risk sexual practice [ Time Frame: 12 months ] [ Designated as safety issue: No ]
• Quality of life（WHO Quality of Life -BREF） [ Time Frame: 12 months ] [ Designated as safety issue: No ]
• All-cause mortality [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Methadone treatment has became one of main actions taken in China to control the spread of HIV among drug users. However，the average methadone dose used is relatively low. An intensive methadone maintenance treatment (MMT) provider training on methadone dosage may be effective in increasing the methadone dose levels prescribed to new patients. The study will evaluate the effectiveness of a tailored education program for MMT service providers using subsequent methadone dose prescribed to new patients. The effects of methadone dose, with and without the inclusion of additional psychosocial services, will then be measured through MMT retention and illicit opioid use.

• HIV
• Hepatitis C
• Syphilis
• Herpes Simplex Type II

• Behavioral: MMT provider dosage training
  Training on methadone dosing provided to health care providers working in methadone maintenance clinics
  Other Name: training
• Behavioral: targeted counseling
  targeted counseling provided to methadone maintenance clinic attendees
  Other Name: counseling
• Other: national guidelines
  Provided a hard copy of the existing national guidelines for methadone dosing
  Other Name: dosing guidelines

• Control arm
  Using currently practiced methadone dosage prescription methods
  Intervention: Other: national guidelines
• Experimental: MMT provider dosage training
  Intensive health care provider training on prescribing methadone dosage based on national guidelines
  Interventions:

  • Behavioral: MMT provider dosage training
  • Other: national guidelines
• Experimental: MMT provider dosage training/counseling
  Intensive health care provider training on prescribing methadone dosage, plus providing on-site psychosocial counseling services and peer support to clients .
  Interventions:

  • Behavioral: MMT provider dosage training
  • Behavioral: targeted counseling
  • Other: national guidelines

Inclusion Criteria:

• client participants will include both men and women who are opiate-dependent drug users who started MMT not more than one month prior to enrollment in the study
• 18 years of age or older
• residing in the study areas