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[目的]描述2007～2008年第四轮中国全球基金艾滋病项目(GF4)覆盖的7省美沙酮维持治疗(MMT)工作的季度变化趋势和地区间差异。[方法]对MMT工作报表及相关资料进行质量评价,描述MMT的覆盖、保持情况及门诊HIV感染者/艾滋病人(PLWHA)的纳入、检测和治疗情况,并分析其纵向变化趋势和横向地区差异。[结果]7省单个MMT门诊的在治人数中位数为106人;平均粗保持率为51.0%,该指标呈降低趋势(P﹤0.01),在江西、四川较高,湖南、新疆等较低(P﹤0.05),并与参与项目的机构组织数正相关(P﹤0.01)。各MMT门诊的平均HIV阳性率为17.9%,在贵州、湖南和云南较高,广西、新疆较低(P﹤0.01),与各县接受VCT的吸毒者的HIV阳性率正相关(P﹤0.01);门诊平均抗病毒治疗率为23.8%,在各季度呈增长趋势(P﹤0.01),在广西、湖南和云南较高,四川、新疆较低(P﹤0.05或0.01),并与门诊CD4检测率正相关(P﹤0.01)、与HIV阳性率负相关(P﹤0.01)。[结论]2007年7月～2008年12月7省MMT覆盖人数不断增加,发现和纳入了较多的HIV阳性吸毒者,且各门诊PLWHA的抗病毒治疗率不断提高;但各MMT门诊存在平均治疗人数较少、覆盖率较低、保持率较低、CD4检测率较低及地区工作情况差异显著等问题。
[Objective] To describe the quarterly and inter-regional differences of methadone maintenance treatment (MMT) in seven provinces covered by GF4 in the fourth round from 2007 to 2008 in China. [Methods] The quality evaluation of MMT working reports and related materials was carried out to describe the coverage and maintenance of MMT and the inclusion, detection and treatment of outpatient HIV / AIDS patients (PLWHA), and to analyze the longitudinal changes and horizontal differences . [Results] The median number of patients undergoing treatment in a single MMT clinic in 7 provinces was 106, with an average crude retention rate of 51.0%. This index showed a decreasing trend (P <0.01). In Jiangxi, Sichuan, Hunan and Xinjiang, (P <0.05), and positively related to the number of organizations participating in the project (P <0.01). The average HIV positive rate in each MMT clinic was 17.9%, higher in Guizhou, Hunan and Yunnan, lower in Guangxi and Xinjiang (P <0.01), and positively correlated with the HIV positive rate among VCT drug users in all counties (P <0.01) ). The average outpatient antiviral treatment rate was 23.8%, showing an increasing trend in each quarter (P <0.01), higher in Guangxi, Hunan and Yunnan, lower in Sichuan and Xinjiang (P <0.05 or 0.01) The detection rate was positively correlated (P <0.01), negatively correlated with the HIV positive rate (P <0.01). [Conclusion] The number of MMT coverage in 7 provinces increased from July 2007 to December 2008, more HIV-positive drug users were found and included, and the antiviral treatment rates of PLWHA in various clinics continued to increase. However, there was an average Less treatment, lower coverage, lower retention, lower CD4 detection rates, and significant differences in regional working conditions.