Tiip CHi V - pvgc HOC OUAN sy so 6-2014
NGHIEN CU'U MOT SO DAC DIEM C O A BENH NHAN DIEU TR|
THAY THE NGHIEN CHiS;T DANG THUOC PHIEN BANG METHADONE GIAI DOAN T R l / d C DIEU TRj TAI NINH BlNH
NguySn Thi Nuwig'; Bd VSn Dung'; Hoang Huy PhuKmg' TOM T A T
NghiSn c^u md ta cat ngang cd phSn tich kit hpp vdi nghlSn cyu hli cyu trdn 164 bjnh nhan (BN) dilu tri thay the nghidn chat dang thudc phien (CDTP) blng methadone lai Trunj tam Phdng chdng HIV/AIDS linh Ninh Binh, ket qua cho thly dd tuoi su dung ma tiiy cua J6i tupng Ian dlu 14 22,4 ± 8,6; dp ludi Ian dlu Hem chich 24,3 ± 9,2; tdng thdi gian sir dung ma li)y thudng xuydn cOa moi ddi typng khoang 6 nam, ddi tupng su dung ma luy hlu nhu tSt ca cac ngay trong thang; mdi ngay su dung trung binh 2,8 lln. Mdi ngdy doi lupng chl tiSu trung binh 433.000 dong cho ma tuy. 100% doi tupng dS tCrng cai nghlSn, tuy nhidn tat ca dl tai nghien. Banh gia, sang loc trim cam theo thang dilm Kessler; 58,0% nguy co thap/khdng o6 nguy co; 27,4% nguy co trung binh va 14,6% cd nguy co cao. Ty Id nhilm HIV, HBV, HCV Ian lupt la: 13,4%, 13,4% va 53,0%. 82,9% ddi tupng dS lung cd hanh vi pham phap va bi co quan chirc nang xir ly
* n khda: BSnh nhan HIV/AIDS, Chit dpng thudc phian; Dieu In thay the; Methadone.
RESEARCH OF PATIENTS' CHARACTERISTICS OF ADDICTION TREATMENT BY SUBSTUTE METHADONE
IN PRE-TREATMENT IN NINHBINH SUMMARY
A cross-section description study which is analyzed based on the combination between quantitative and qualitative analysis carried out on 164 patients treated with opiate addiction methadone at Center for HIV/AIDS in Ninhbinh province, the group of researchers /denf/f/ed charactehstics of some patients as follows: the age of people who use drug for the first time was 22.4 ± 8.6, the age of people who are at the first injection was 24.3 ± 9.2, the total duration ot regular drug users was about 6 years, they used drug almost every day in the month, the average dally use was 2.8 times. Everyday, they spend 433,000 VN dong for drug. 100% of drug users had addiction, but att of them had relapsed. Assessment, depression screening according to scale Kessler 58.0% at low risl</no risk, 27 4% at medium risk and 14.6% at high risk. Prevalence of i^ty, hepatitis B, hepatitis C, respectively: 13.4%, 13.4%, 53%; 82.9% of people who had been air) wrong doing and they were punished by the law and authorities.
* Key words: HIV/AIDS patients; Drug substance; Alternative treatment; Methadone
' Trung tam Phong chong HIV/AIDS Ninh Binh
Ngwaiphin hoi (Corresponding): BS Van Dung (dungnb62l^gmail.com) Ngiy nh$n bii: 30/03/2014; Ngiy phin bl^n dinh gia bii bio: 13/05/2014
Ngiy bii bio du'p'c ding: 28/07/2014
T9P CHi V - DUpt HOC OUAN SV s6 6-2014 BAT V A N B^
Ca nhilm HIV d l u tidn dypc phat hi$n tai Vipt Nam vao nam 1990 do lay nhilm qua dydng quan hp tinh due, tuy nhien hlnh thai djch tai Vi$t Nam trong han 20 nam qua igi bj tac dpng chu y l u bdi nhdm nghien chich ma tiiy (NCMT), blng chirng la ty le nhilm d nhdm NCMT ehilm
> 50,0% t i n g so ca phat hien mdi tir d l u djch d i n nam 2003 [3, 5]. K i t qua giam sat trpng dilm trdn cae nhdm nguy ca eao ghi nhan ty id nhilm trong nhdm NCMT la eao nhlt tir d l u djch tdi nay, d mO'c > 20,0% tir nam 2000 den 2008 va dat mCre cao nhlt 29,4% vao nam 2001, 2002. Trong khi dd, Oy ban Q u I c gia Phdng, Chdng te nan ma tiiy, mai dam va HIV/AIDS nhan djnh tinh hlnh tpi pham, ngydi sir dyng va ngydi nghien ma tdy v i n gia tang va r l t phu'c tap [1]. D l d l i phd vdi sy gia tang nhanh ciia djch, tir nam 2006, ap dyng bai hpc thyc tiln tCr cae quIc gia khac trong viec triln khai chyang trinh dieu trj nghien cac CDTP bang thude methadone trong dy phdng lay nhilm HIV, Bp Y t l da phli hpp vdi mdt s l to chire xay dyng md hlnh Trien khai thi diem dieu tri nghi$n cac CDTP bing thuoc methadone t$i Thanh pho Hal Phdng va Thanh pho Hd Chi Minh" vi triln khai thi d i l m vSo nam 2008. Vdi nhii'ng k i t qua thanh cdng bydc d l u tir vi$c triln khai thi d i l m t?i 2 dia phyang, Chinh phu da cho phdp nhan ring md hlnh. B i n thang 11 - 2012, ea nydc cd 20
tinh, thanh p h i vdi 12.000 ngydi NCMT dang dypc dilu trj tai 60 ea sd [2].
Tai Ninh Binh, theo bao cao doi typng nhilm HIV la NCMT ehilm khoang 2/3 (62,7%) trong s l eac trydng hap nhilm HIV. Trong khi dd, tinh hlnh te nan ma tuy hien nay v l n dang diln biln phu'c tap.
Toan tinh hien cd 1.780 ngydi NCMT quan ly dype, yde tinh ed khoang 2.500 ngydi tren thye te. Ninh Binh la mdt trong 20 tinh dau tiSn triln khai chyang trinh dilu trj thay t h i nghien CDTP bang methadone, thdi gian triln khai bit d l u tir thang 9 - 2012 [6], Trong giai doan d l u tidn, chyang trinh triln khai tai 1 ca sd dilu tri duy nhlt dat tai Trung tam Phdng, Chdng HiV/AIDS tinh va tilp nhin dilu tri cho BN tai dia ban Thanh p h i Ninh Binh va huyen Hoa Ly. Theo d y kiln, chyang trinh se md rpng xuIng mdt sd dilm ndng v l ma tiiy tren dia ban tinh. Day la mpt chyang trinh mdi, Ian d l u tien trien khai.
De cung cap bang chirng, can eir phyc vu cho vi0e ra quylt djnh va lap k l hogch md rdng chyang trinh, viec nghien ciru danh gia rlt c i n thilt. Vdi ij do trdn, chung tdi tiln hanh nghien eCru nay vdi muc tieu:
- Md ta mot so a0c diem cua nhom BN dieu tri tbay thi nghi$n CDTP bing methadone giai do^n trw&c diSu trj tai Trung tim Phdng, Chdng HiV/AIDS Ninh Binh.
- Xac dinh mpt so yeu to lien quan den tinh trang sr> drjng ma tOy va anh huvng ve si>c khoe, xa hpi ciia vi$c si> dung ma tuy.
79
THP CHi V - DVOC HOC OUSN SySO 6-2014 eOl TU'GNG VA PHU'O'NG PHAP
' NGHIEN CU'U 1. D6i typ'ng nghian cu'u.
Toan bp BN tham gia chyang trinh dilu tri nghi$n CDTP tai Khoa Methadone - Trung tam Phdng, Cheng HlV/AlDS Ninh Binh.
- Hd sa, benh an BN dang dilu trj tai Trung tam.
2. Phyang phap nghien cu'u.
* Thdi gian nghien cufu: tir thang 5 den 12-2013.
* Thiet ke nghien crtu: nghien eiru mi ta eat ngang cd phan tich k i t hpp nghien ciru hdi ciru.
* ca mSu vi chon mBu: toan bd 164 BN dypc tuyln chpn tham gia vao chuong trinh dilu tri thay t h i nghien CDTP bang methadone tai Ninh Binh, tir thang 9 - 2012 d i n 9-2013.
' XCr If s6 li$u:
Philu d i l u tra dypc iam iam sach trydc khi nhap vdo p h i n mIm Epidata 3.1. s l lieu d i l u tra phan tieh trdn phJn m I m SPSS 18.0.
KET QUA NGHIEN CCTU V A B A N LUAN 1. Mot sd dac d i l m cua BN.
Sang 1: D^c diem nhan khiu hpc cua d l i typng nghien ciru (n = 164).
DACBIIM I SOLUONG Nh6m tuoi (tri nhat 23 tudi, gii nhit 44 tuoi, trung binh 34,6 ±9,6 tuoi)
< 30 tuoi 30 - 40 tuoi
> 40 tuoi Dan t$c
Kinh DSn toe kh^c Trinh do hgc van
MuchCr Tieu hoc Trung hoc ca sa Pho thong trung hoc Trung cip/cao dlng/dai hoc Tinh trgng hon nhan
Chu'a l i p gia dinh Dang s6ng vai va/chong Ly di/ly than
33 93 38
164 0
5 11 38 55 44
55 98 l i
r? L$ (%)
20,1 56,7 23,2
100 0
3,0 6 7 23.2 33,5 26,8
33,5 59,8 6,7
TAP CHi V - DVOC HOC OUfiN SV Sd' 6-2014 Nghe nghiep
Khang c6 vi§c/thlt nghiep Ndng ddn
Cong nhan Laixe
Can bO vien chi^c nha nu'ac/tu' nhan Budn ban/kinh doanh Lao d$ng ty do Thu nhip theo d^u ngu-ai/thang
Ngh6o Kh6ng nghfeo
16 11 11 6 5 109
6
87 77
9,8 6 7 6,7 3,7 3,0 66,5 3,7
53,0 47,0 Dp t u l i trung binh eua d l i typng nghien ciru 34,6 ± 9,6. Da so ddi typng da lap gia dinh va dang s i n g cung vp (59,8%), khoang 1/3 (33,5%) chya lap gia dinh va 6,7% da iy dj/ly than. Nhdm ddi typng cd trinh dp hpc v l n tir trung hpc ca sd trd xuIng ehilm 1/3 (32,9%). Phin idn del typng cd nghl nghiep on djnh, ty ie tyang d l i eao heat ddng trpng ITnh vyc budn ban/kinh deanh (66,5%).
sang 2: Dac d i l m v l su" dung ma tiiy (n = 164).
DAC D I E M Tu6l lln dSu si> dung ma tiiy (tu6i) Tu6i Ian d l u tiSm chich (tu5l)
T6ng thdri gian si> dyng ma tCiy thirdrng xuy§n (thang) S6 ngay sir dyng trong thang (ngay) S6 lln %\ii dyng trong ngay (Ian)
Tong so tiln chi tiSu cho ma tiiy trong ngay (dong)
TRUNG BlNH 22,4 ± 8,6 24,3 ± 9,2 70,4 29.0 2,8 433.292
Tdi THiiU 14 14 12 15 1 200.000
TdlBA 31 37 120 30 6 1.600.000 Ddi typng sir dyng ma tOy l l n d l u d dp t u l i trung binh 22,4 ± 8,6. Tudi l l n d l u TCMT mudn han sp vdi t u l i l l n dau sir dung, trung binh 24,3 ± 9,2 tupi. Ting thdi gian su' dgng ma tiiy thydng xuyen cua doi typng trung binh 70,4 thang (gin 6 nam).
60% ddi typng cd tong thdi gian sir dung thydng xuyen i 5 nam. H l u h i t cdc ngay trong thang d l i typng d l u sir dung ma tiiy (29 ngay). S6 l l n su" dijng trong ngay trung binh 2,8 l l n .
So t i l n chi tieu cho ma tOy/l ngay dao dpng d mire tir 200.000 - 1.600.000 ddng, li/lirc ehi tieu trung binh 1 ngay a l l typng sir dung ma tuy la 433.000 ddng. Nhy vay, binh quan chi tieu trong 1 thang cho ma tiiy It nhlt la 6.495.000 dong va nhilu nhlt la 12.990.000 d i n g cho mdt d l i typng.
81
THP CHi V - DV^C HOC 0UaNSi;S6 6-2014 Ty Id %
X -.""^^
/
iDieu Iri cat can bang thuoc an than kinh
Thuoc y hoc cd truyen Khong dung thuoc Bleu dd 1: Ty la ddi typng da sir dung cae phyang phap h i tra cai nghien.
Cd 3 phyang phap hd try cai nghien ma d l i typng da tirng ap dung; phuang phap khdng sir dung thude kha p h i biln (76,8%), phyang phap d i l u tri cat eon bang thuic, an thin kinh (16,5%) va dilu tri bang thuoc y hpc c l truyin (9,8%).
sang 3: Hanh vl quan he tinh due eua d l i typng.
DAC DI^M Quan h$ tinh dye thuang xuySn (n = 164)
C6 Kh6ng
n
87 77 Tan suit quan he tinh due (trung binh = 4,7 lln/thlng, toi thilu = 2 lln/thang, toi da = Su dyng bao cao su khi quan h# v6i ban tinh (n = 81)
Co Khdng
SO' dung bao cao su khi quan h§ vdi ngu'di ban dam (n = 81) Co
Ktidng
27 54
5 76
T i It (%) 53,0 47,0 0 lln/tliang)
33,3 66,7
6,2 93,8 53,0% dli typng cd quan hd tinh dye thydng xuyen, t i n suit quan h# tinh due trang binh mdi thang 4,7 l l n , it nhlt 2 lan/thang, nhilu nhlt 10 lln/thang. 33,3% sir dyng bao
T9P CHI V - DVOC HOC QUfiN SV SO i-2014 Tyle%
40
n
14,6% ^
/ / /
1
i
Nguy CO cao Nguy co' trung binh Khong co nguy co
J
Bieu dd 2: Danh gia mu-c <30 tram cam tlieo thang diem Kessler.
Tinh trang sCec khoe tSm thiin cua d6i tu'O'ng tn^o-c khi tham gia chu-cng trinh dieu trj du-Q-c danh gia bang thang d^nh gia Kessler - thang do va danh gia mipc do trim cam.
Trong nghien cu-u nay, so di^m trung binh danh gia theo thang Kessler cua doi tu'gng ia 11,5 va dao dpng tu* 0 - 45.
Phlin Ian doi tu-ong khong co nguy cc tram cam theo danh gia n^y (58,0%). Tuy nhien, 14,6% d6i tugng c6 nguy ca cao va 27,4% c6 nguy cc trung binh.
2. Mpt sd y§u td lien quan.
Bang 4: So sanh miPC chi tieu cho ma tuy trong cac nhom tu6i (n = 164).
NHdM TUOI 16-29 30-39 2 40 T6ng
<
n 11 42 32 85
S6TI 300
33,3
%
45,2 84,2
zN CHI TIEU CHO MA TOY HANG NGAY (ngan) 300 - 500
n 17 28 45 90
51,5
%
30,1 27,4
600-1000 n 6 17 22 44
15,2
%
18,3 13,4 18
>1000 n 0 6 12
%
0 6,6 7,3n 33 93 111 164
100
%
100 100 100 X^ = 41,3;p<0,01
Nhom tuoi cang cao, xu hu-ang chi tieu cho ma tCiy cang it han. Sy khac biet ve mu'c chi tieu trong cac nhom co y nghTa thong kd (p < 0,01).
B^ng 5: So sanh mCpc chi tieu cho ma tuy theo thu nhgp (n = 164).
THU NHAP Nghfeo khflng nghio Ting
S6 TISN CHI TISU CHO MA TOY HANG NGAY (ngan)
<300 n 37 48 85
41,6
%
64,0 51,8
300 - 500 n 29 16 45
32.6
%
21,3 27,4
600-1000 n 11 11 22
12,4
%
14,7 13,4
>1000 n 12 0 12
13,6
%
0 7,3
n 69 75 164
100
%
100 100 X^= 16,1: p< 0,001
Nhdm BN ngheo ehi tieu cho ma tuy vdi myc t i l n Idn eao han so vdl nhdm khdng nghdo. S y khac bi$t ed y nghTa thing ke vdi p < 0,001.
TRP CHi V - DVOC HOCOUANSVSd6-2014 Bang 6: So sanh k i t qua xet nghiem
THU NHAP
Ngheo khdng ngh6o Tong
HIV theo myc thu nhap
k^T QuA X^T NGHIEM HIV Dyong tinh
n 22 0 22
%
24,7 0 13,4
Am tinh n 67 75 142
%
75.3 100 86,6 x ' = 21,4; p < 0,001
n = 164).
'ffi
i
CHUNG i
n 89 75 164
TL%
100 100 100
13,4% dli tyyng cd nhilm HiV, thlp han nghien cyu cda Cao Thi Van va CS (50,9%) [3]. Nhdm BN ngheo ed ty le nhilm HIV cao han nhdm khdng ngheo. Sy khac bietco y nghTa thing ke, (p < 0,001).
Bang 7: So sanh k i t qua xet nghipm viem gan B theo thu nhdp va quan he tinh dye (n = 164).
cAc Y^U T 6 LIEN QUAN
Thu nhap Nghio Khflng ngh6o Ting
Quan hd tinh dye thudng xuyen
Cd Khdng Tong
KiT QUA xeT NGHIEM VlgM GAN B Dydng tinh
n
15 5 20
%
16,9 6,7 12,2
Am tinh n
74 70 144
%
83,1 93,3 87,8
CHUNG n
89 75 164
%
100 100 100 OR = 2,8:x^=3,9;p<0,05
15 5 20
17,0 6,6 12,2
73 71 144
83,0 93,4 87,8 OR = 2,9;x' = 4,2;p<0,05
88 78 164.
100 100 100
12,2% d l i typng bi viem gan B, t h l p ban nghien cyu khac (16,7%) [3]. T9 1$ nhiilii BN nghep cap g i p 2,8 i l n nhdm khdng ngheo, p < 0,05. Ty i# nhdm d l i tyang cd quan he tinh dye thydng xuyen nhilm viem gan B eao g I p 2,9 l l n nhdm khdng thydnc
TeP CHf V - DVOC HOC OUAN SV SO 6-2014 Bang 8: M i l lien quan
CAC Y^U TO L|£N QUAN
Thu nhgp Ngheo Khdng ngheo Ting
joi viem gan C (n = 1 34).
k^T QUA X^T NGHIEM VI§M GAN 0 Duang tinh
n
39 48 87
%
43,8 64,0 53,0
Am tinh n
50 27 77
%
56,2 36,0 47,0
CHUNG n
89 75 164
%
100 100 100 OR = 2 , 3 ; x ' = 6 , 7 ; p < 0 , 0 5
Nhdm tuoi 16-29 30-39
£40 Ting
22 38 27 87
66,7 40,9 71,1 53,0
11 55 11 77
33,3 59,1 28,9 47,0
33 93 38 164
100 100 100 100 X^= 12,9, p < 0,05
Tidm chich Chung bam kim tidm Cd
Khdng Tong
12 75 87
100 49,3 53,0
0 77 77
0 50,7 47,0
12 152 164
100 100 100 p < 0,001
53,0% d l i typng nhilm viem gan 0, cao han nghien cyu khac (42,5%) [3]. Nhdm BN khdng ngheo cd ty ip nhilm viem gan C cap gIp 2,3 ian sp vdi nhdm nghdp, p < 0,05.
Nhdm t u l i > 40 cd ty ip nhilm vidm gan C eao han cac nhdm khao (p < 0,05). Nhdm BN cd hanh vi diing chung bam kim tiem cd ty ie nhilm viem gan C cao han nhdm khdng dung chung bam kim tiSm, vdi p < 0,001.
Bang 9; Y l u t l lien quan d i n hanh vi ciJa ddi typng (n = 164).
CAC Y^U T 6 LlgN QUAN
Thu nhlp Ngheo khdng ngheo Ting
HANH VI VI PHAM PHAP LUAT Cd
n
83 53 136
%
93,3 70,7 82,9
Khdng n
6 22 28
%
6,7 29,3 17,1
CHUNG n
89 75 164
%
100 100 100 OR = 5,7; x^= 14,7; p < 0,001
TAP CHi V - DVOC HOC 0 U 8 N SV s6 6-2014 Trinh do hpc v l n
~~
TCr cip 3 trd xuong Tir trung cap trd Idn Tdng
Nhom tuoi 16-29 30-39 a 40 Tdng
97 39 136
89,8 69,6 82,9
11 17 28 OR = 3,8; x ' = 10,6; p < 0,001
33 71 32 136
)
100 76,3 84,2
0 22 6 28
^= 9,7; p < 0,05
10,2 30,4 17,1
0 23,7 15,8
108 56 164
33 93 38 164
100 100 100
100 100 100 100
82,9% doi tyang vi pham phap luat. Nhdm ddi typng ngheo cd ty Ip vi ph?m phip luat eao ban 5,7 l l n so vdi nhdm khdng ngheo (p < 0,001). Nhdm trinh dp hpc vln thap c6 ty ie vi pham phap luat eao ban 3,8 Ian so vdi nhdm cd trinh dp hpc v l n eao (p < 0,001), Nhdm d l i typng tre tuli cd ty ie vi pham phdp luat cao han cac nhdm tudi khdc, p < 0,06.
KfiT LUAN
1. IMpt s6 dac d i l m cua ddi t y a n g nghien ciru.
- Bd tudi sir dyng ma tuy lln d l u 22,4 ± 8,6, dp tuli lln d l u tiem chich 24,3 ± 9,2.
he 4,7 l l n , 33,3% SLP dung bae cao su ktii quan hp vdi ban tinh va chl 6,2% sir dung bao eao su khi quan hp vdi ngydi ban dam,
- Ty ip nhilm HIV, viem gan B, viem gan C l l n iypt la 13,4%, 13,4%, 53,0%.
Danh gia, sang ipc trim cam thep thang TAnn th™ r,i=.„ ,,-. .J, „ „ . • , ! , . - f a n n gia, sang ipc tram cam thep thang xuven khpano 6 n ^ J ? , " ' ' ' " I ' ™ ^ «^"^ ^^^=1-^: 58,0% nguy ca thlp/khonl xuyen khoang 6 nam, 1/2 so d l i typng ^6 nguy ca, 27,4% nguy ca trunq binh trong nghien ciru sir duno > 5 nam .. J, . ^ ' ' " " 3 " ' " "
trong nghien ciru sCr dung > 5 nam - cac ddi typng sir dung ma tiiy h l u nhu t i t ca eac ngay trong thang (29 ngay), mdi ngay sir dung trung binh 2,8 lln.
- Mdi ngay, mdt ddi typng chi tidy tmng binh 433.000 ddng cho ma tuy. Nhy vay, trung binh mdi thang, del typng chi cho matuyia 12.557.000 dong.
- 100% ddi typng da tirng eai nghien.
Chu y l u bang phyang phap khdng diing thuoc (76,8%) va d l u that bai.
- 53,0% d l i typng cd quan h# tinh diie thydng xuyen, trung binh mdi thang quan
14,6% cd nguy ea eao.
- Hdnh vi vi pham phap luat: 82,9% d4i typng da tirng cd hanh vi pham phap vi b! ea quan ehu'c nang xy ly. Trong do, 2 hanh vi pham nhilu nhat: 83.9% do sJ dung, tang try matuy;16,1% do trdm cap.
2. M6t sd y l u td lien quan d i n tinh tr?ng su" dyng ma tuy va anh hydng cua viec sip dung ma tiiy.
- Nhdm tuli cang cao, xu hydng chl tl6u cho ma tuy cang it han.
- Nhdm BN ngheo chl tieu cho ma tuy vS
TIIP CHI V - DVOC HOC QUAN SV SO 6-2014 ngheo. Ty le vidm gan B va C cao nhdm
khdng ngheo (2,8 va 2,3 iln); hanh vi vi pham phap luat eao ban nhdm khdng ngheo 5,7 l l n .
- Nhdm d l i typng cd quan h | tinh dye thydng xuyen nhilm viem gan B cao g I p 2,9 l l n nhdm khdng thydng xuyen.
- Nhdm tuoi > 40 cd ty ie nhilm viem gan C cao han ede nhdm khac. Nhdm BN ed hanh vl diing chung bam kim tiem cd ty le nhilm vidm gan 0 eao han nhdm khdng diing chung bam kim tiem.
- Nhdm ddi typng cd trinh dp hpc v l n thlp, ty le vi pham phap luat cap g I p 3,8 ian SP vdi nhdm ed trinh dd hpe van cao.
Nhdm ddi typng tre tudi ed ty le vi pham phap luat cao han cac nhdm tuli eao ban.
TAI LIEU THAM K H A O 1. Cue Phdng, Chdng HIV/AIDS. TSi liSu tham khao dilu tr| nghien CDTP bang thudc methadone. Ha Ndi 2012.
2. Oy ban QuSc gia Phong, Chdng AIDS vi Phdng chdng ma toy, mai dim, 2012. sao do tiln do phdng, chong AIDS Viat Nam nam 2012 thyc hlin tuySn bo chinh tri nam 2011 vlHlV/AIDS. HaNol. 2012.
3. Cao Kim Vin, Kiem Sr!)C Huang vi CS.
Kit qua dieu tri thay the ng'iiSn CDTP bSng methadone tai phdng kham ngoai trii quan 4, TP Hd Chi Minh. Tap chl Y hoc thyc hanh.
2012, s6 742+743, tr-243-244
4. Hoang Huy Phuang va CS. Ty id nhilm HIV va nhan thu'c, thai dp, hanh vi v l HIV/AIDS cua nhdm nghldn chich ma tuy tinh Ninh Binh nam 2009. Tap chi Y hoc thyc hdnh. 2009, sd 742+743, tr125-126
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