Implementing methadone maintenance treatment in prisons in Malaysia
Jeffrey A Wickersham, Ruthanne Marcus, Adeeba Kamarulzaman, Muhammad Muhsin Zahari & Frederick L Altice
Volume 91, Number 2, February 2013, 124-129
Table 1. Characteristics of HIV-infected participants in methadone maintenance treatment (MMT) programmes and outcomes observed before and after their release from prison, Kajang and Pengkalan Chepa prisons (Selangor and Kelantan states, respectively), Malaysia, 2008–2009
| Characteristic | No. (%) of participants |
|
|---|---|---|
| Pengkalan Chepa prison (n = 42) | Kajang prison (n = 30) | |
| Year MMT programme initiateda | 2008 | 2009 |
| Sex | ||
| Male | 42 (100) | 30 (100) |
| Ethnicity | ||
| Malay | 40 (95.2) | 22 (73.3) |
| Indian | 2 (4.8) | 6 (20.0) |
| Chinese | 0 (0) | 2 (6.7) |
| Religion | ||
| Muslim | 40 (95.2) | 22 (73.3) |
| Hindu | 2 (4.8) | 4 (13.3) |
| Christian | 0 (0) | 3 (10.0) |
| Buddhist | 0 (0) | 1 (3.3) |
| Employed full time before incarceration | ||
| Yes | 24 (57.1) | 16 (53.3) |
| No | 38 (36.9) | 13 (43.3) |
| Highest level of education | ||
| Elementary | 11 (26.2) | 5 (16.3) |
| Some secondary | 19 (45.2) | 16 (53.3) |
| Completed secondary or higher | 12 (28.6) | 9 (30.0) |
| Age in years, mean (SD) | 33.7 (6.7) | 37.1 (7.0) |
| Have injected illicit drugs | ||
| Yes | 42 (100) | 29 (96.7) |
| No | 0 (0) | 1 (3.3) |
| Years of incarceration, mean (SD) | 1.2 (0.6) | 1.0 (0.5) |
| Years of incarceration over lifetime, mean (SD) | 5.6 (3.9) | 6.6 (4.2) |
| Years since diagnosis of HIV infection, mean (SD) | 6.1 (5.7) | 8.3 (6.5) |
| Met criteria for moderate to severe major depressive disorderb |
18 (42.9) |
12 (40.0) |
| Outcome | ||
| Before release | (n = 42) | (n = 30) |
| Discontinued methadone, because: | 12 (28.6) | 3 (10.0) |
| side-effects (nausea, vomiting) | 4 (10.0) | 0 (0) |
| death (from HIV-related causes) | 3 (7.1) | 3 (10.0) |
| transfer to community-based MMT | 2 (4.8) | 0 (0) |
| breach of contract (discord with staff) | 2 (4.8) | 0 (0) |
| no longer interested in treatment | 1 (2.4) | 0 (0) |
| After release | (n = 30) | (n = 27) |
| Had difficulty accessing MMT, because: | 10 (23.9) | 8 (26.7) |
| forced to relocate (corrective police orders) | 3 (10.0) | 2 (7.4) |
| harassed by police at MMT sites (with or without re-arrest) | 7 (23.3) | 6 (22.2) |
| Still on MMT at 12 months | 18 (60.0) | 10 (37.0) |
| Released on ≤ 80 mg daily | 7/17 (41.2) | 2/14 (14.2) |
| Released on > 80 mg daily | 11/13 (84.6) | 8/13 (61.5) |
HIV, human immunodeficiency virus; SD, standard deviation.
a All values in the table are absolute numbers followed by percentages in parentheses except in this row where they indicate the year.
b Depression scored using the Clinical Epidemiological Scale for Depression (CES-D).