Bulletin of the World Health Organization

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).