Concurrent Heroin Use and Correlates among Methadone Maintenance Treatment Clients: A 12-Month Follow-up Study in Guangdong Province, China

OBJECTIVE To assess concurrent heroin use and correlates among Methadone Maintenance Treatment (MMT) clients in Guangdong Province, China. METHOD Demographic and drug use data were collected with a structured questionnaire, and MMT information was obtained from the MMT clinic registration system in Guangdong. Human immunodeficiency virus (HIV-) and hepatitis C virus (HCV) infected status and urine morphine results were obtained from laboratory tests. Logistic regressions were employed to investigate the factors associated with concurrent heroin use. RESULTS Among the 6848 participants, 75% continued using heroin more than once during the first 12 months after treatment initiation. Concurrent heroin use was associated with inharmonious family relationship (OR (odds ratio) = 1.49, 95% CI (confidence intervals): 1.24-1.78), HIV positivity (OR = 1.25, 95% CI: 1.01-1.55), having multiple sex partners (OR = 1.34, 95% CI: 1.07-1.69), having ever taken intravenous drugs (OR = 0.81, 95% CI: 0.69-0.95), higher maintenance dose (OR = 1.13, 95% CI: 1.01-1.28) and poorer MMT attendance (OR < 20% = 1.32, 95% CI: 1.13-1.53; OR 20%- = 1.33, 95% CI: 1.14-1.54; OR 50%- = 1.69, 95% CI: 1.44-2.00). Among those who used heroin concurrently, the same factors, and additionally being older (OR 35- = 1.26, 95% CI: 1.11-1.43; OR ≥ 45 = 1.63, 95% CI: 1.30-2.05) and female (OR = 1.60, 95% CI: 1.28-2.00), contribute to a greater frequency of heroin use. CONCLUSIONS Concurrent heroin use was prevalent among MMT participants in Guangdong, underscoring the urgent needs for tailored interventions and health education programs for this population.