| [Objective] To document treatment compliance and its determinant among heroin addicts attending the community Methadone Maintenance Treatment (MMT) clinic in Huapu District, Shanghai.[Methods] Epidemiological cohort study was used for this research. Demographic characteristics, history of drug abuse and information for MMT of the heroin addicts who are willing to receive MMT from August 30,2007 to February 28,2009 in the Methadone Maintenance Treatment clinic in Huangpu District were collected, not including the referral cases. There were 223 cases in total. Excel software was used for data input and sorting. SPSS16.0 software was used in descriptive statistics, single-factor and multi-factor analysis.Numeration data was used to chi-square test and measurement data was used to rank sum test.[Results] Among 223 Heroin addicts, the rate of male was 78.5% and female was 21.5%. The mean age of males was 42.29±8.13 years old while the mean age of females was 37.46±6.82 years old.62.8% of them were unmarried and divorced. 57.9% of them had junior middle school or lower education and 93.3% were unemployed. 65.5% of them recognize that the relationship with their family were in general. The average age of male drug users for the first time was 31.14±8.21 years old, while that of female drug users was 27.98±8.36 years old. All of the subjects were heroin users. The mean duration of drug use was 10.30±4.59 years. The average dose of daily drug use was 1.06±0.66g. The majority(73.1%)were injection drug users, of whom, seven(4.3%)reported sharing injection equipments. The seroprevalence of 223 heroin addicts was 77.1% for anti-HCV and that was 84.2% among 183 injection drug users. The risk that they infected hepatitis C was as 6.49 times as those who didn't inject drug users.Injecting drug was one of the main route of Hepatitis C transmission. The first dose of methadone on average was 25.94±7.78mg, that was 32.54±15.78mg in the first day. It needs 6.33±3.92 days on average to find the right dose for every heroin addict. The days of methadone treatment were 304.77±201.28 days on average. The average dose of that was 48.57±21.04mg.67(30.0%) of 223 cases had better compliance.156 (70.0%) were drop out, of which 111(71.2%) were drop out only once and 45(28.8%) were drop out frequently. Heroin addicts were more likely to drop out in the first six months(103,66.0%), especially in the first three months (62,39.7%) when they received methadone maintenance treatment. The phenomenon was obviously in major activities and the end of every year.Univariate logistic regression analysis indicated that the proportion of drop out among those having a good relationship with their family (46.0%) was lower than those who had a general relationship (80.8%).The drop out rate of the first drug use for those aged from 14 to 23(76.4%) was higher than those aged from 34 to 43(58.2%).Nonparametric rank sum test showed that it were significant differences in the first methadone dose,treatment days and methadone used days.Multivariate logistic regression analysis displayed that the proportion of drop out was significantly higher among those aged from 21 to 30, those having a general relationship with their family, and those intaking heroin 1.0 to 2.0g one day before they received methadone maintenance treatment. The longer methadone used days were, the lower the proportion of drop out was, the better the compliance was.[Conclusion] Compliance to methadone maintenance treatment among heroin addicts in Huangpu District was relatively low. More efforts are needed to promote such complicance and to minimize drop out.
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