Methadone Maintenance Treatment-Related Stigma and Adherence Self-Efficacy in Vietnam.

BACKGROUND

Stigma related to methadone maintenance treatment (MMT) remains a substantial barrier to treatment engagement among people who use drugs (PWUD). Understanding how MMT-related stigma influences adherence self-efficacy is critical for supporting treatment engagement and optimizing long-term outcomes.

OBJECTIVES

Our study examined the associations between MMT-related stigma, with a specific focus on anticipated and internalized stigma, and self-efficacy for treatment adherence among PWUD in Vietnam.

METHODS

We used cross-sectional baseline data collected between April and July 2024 from an intervention trial conducted in 3 provinces of Vietnam. Bivariate correlations and hierarchical multiple linear regression models were used to assess the relationships between 2 forms of MMT-related stigma and self-efficacy for treatment adherence, adjusting for relevant sociodemographic and background characteristics.

RESULTS

Among 690 PWUD participants, both anticipated MMT-related stigma (r = -.339, P < .001) and internalized MMT-related stigma (r = -.225, P < .001) were negatively correlated with self-efficacy in treatment adherence. In adjusted regression analyses that included both stigma dimensions and participants' characteristics, only anticipated stigma remained independently associated with lower adherence self-efficacy (B = -0.198, SE = 0.031, β = -.238, P < .001).

CONCLUSIONS

These findings underscore the importance of integrating strategies to address and reduce MMT-related stigma. Interventions that explicitly address anticipated stigma may be critical for strengthening confidence in treatment adherence and supporting sustained outcomes.