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; OR20%- = 1.33, 95% CI: 1.14-1.54; OR50%- = 1.69, 95% CI: 1.44-2.00). Among those who used heroin concurrently, the same factors, and additionally being older (OR35- = 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.