An adaptive design to screen, treat, and retain people with opioid use disorders who use methamphetamine in methadone clinics (STAR-OM): study protocol of a clinical trial.

BACKGROUND: Methamphetamine use could jeopardize the current efforts to address opioid use disorder and HIV infection. Evidence-based behavioral interventions (EBI) are effective in reducing methamphetamine use. However, evidence on optimal combinations of EBI is limited. This protocol presents a type-1 effectiveness-implementation hybrid design to evaluate the effectiveness, cost-effectiveness of adaptive methamphetamine use interventions, and their implementation barriers in Vietnam. METHOD: Design: Participants will be first randomized into two frontline interventions for 12 weeks. They will then be placed or randomized to three adaptive strategies for another 12 weeks. An economic evaluation and an ethnographic evaluation will be conducted alongside the interventions. PARTICIPANTS: We will recruit 600 participants in 20 methadone clinics. ELIGIBILITY CRITERIA: (1) age 16+; (2) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) scores ≥ 10 for methamphetamine use or confirmed methamphetamine use with urine drug screening; (3) willing to provide three pieces of contact information; and (4) having a cell phone. OUTCOMES: Outcomes are measured at 13, 26, and 49 weeks and throughout the interventions. Primary outcomes include the (1) increase in HIV viral suppression, (2) reduction in HIV risk behaviors, and (3) reduction in methamphetamine use. COVID-19 response: We developed a response plan for interruptions caused by COVID-19 lockdowns to ensure data quality and intervention fidelity. DISCUSSION: This study will provide important evidence for scale-up of EBIs for methamphetamine use among methadone patients in limited-resource settings. As the EBIs will be delivered by methadone providers, they can be readily implemented if the trial demonstrates effectiveness and cost-effectiveness. TRIAL REGISTRATION: ClinicalTrials.gov NCT04706624. Registered on 13 January 2021. https://clinicaltrials.gov/ct2/show/NCT04706624.

Attitudes and Knowledge of Medical Students in Hanoi regarding Lesbian and Gay People.

The LGBT community faces disproportionate healthcare disparities; poorly trained providers and stigma are likely contributors. Objectives: To evaluate the attitudes, opinions, and knowledge level of medical students regarding LGBT people and to examine which demographic variables are associated with more negative attitudes toward LGBT people. A cross-sectional study surveyed 561 medical students at Hanoi Medical University. Students held positive or very positive attitudes of both lesbians (96.3%) and gay men (88.1%). Students who were younger, female, and those with close relationships to LGBT people tended to have more positive attitudes toward gays and lesbians. The average score for the knowledge scale was 12.5 (total 32 questions) with a standard deviation of 4.7. Knowledge scores and positives attitudes were significantly, directly associated. Most students responded that there should be more LGBT-related content added in the curriculum. More research is needed regarding students in other health professions and at other institutions.

[Depression Among Caregivers of HIV - Positive Injection Drug Users in Hanoi, 2016]. / Tram Cam O Thành Viên Gia Dình Cua Nam Tiêm Chích Ma Túy Nhiem HIV Tai Hà Noi Nam 2016.

Most of people who inject drugs in Vietnam live in their family homes and these living have formed the burden on caring. This study aimed at exploring the characteristic of depression of caregivers of HIV - positive injection drug users and relative factors. Cross - sectional assessment data were gathered from 138 caregivers recruited from Hanoi city. About 20% of the study sample had a depressed condition from mild to extremely severe. Caregiver burden and family function were significantly associated with depression of caregivers. This study addressed the needs of intervention to improve family function and to decrease caregiver burden aimed at raising mental health of caregivers of HIV - positive injection drug users.