Gender differences in patient outcomes following drug abuse treatment in Afghanistan: Results from a new evaluation.

Drug use rates among adults in Afghanistan are over twice as high as the global average which complicates an already challenging situation in the country. Although progress has been made toward improving availability of treatment and the rights and status of women, cultural norms and historical precedents have delayed advances, including in drug treatment. Female Afghan patients access treatment via home-based systems without the option of group in-patient treatment centers available to male patients. Using data from a new evaluation of Afghanistan's drug treatment system we report on updated differences in treatment outcomes for male and female patients in drug treatment centers in Afghanistan. A probability sample was used, selecting 32 centers to evaluate, and including baseline and follow-up data from 865 individuals who were officially admitted to drug treatment. Data collection included: (a) baseline and follow-up interviews; (b) baseline and follow-up urine drug tests; and (c) intake and treatment participation records. Random intercept generalized linear models were used to analyze change by regressing outcomes on a contrast representing time and a correction for selectivity biases. Male and female patients had similar, overall pre-treatment characteristics including low levels of education, though education levels were lower for women. At follow-up, there were significant differences between male and female patients' self-reports of substance use and related consequences, including criminal behavior. These findings represent mixed results; while some progress has been made in offsetting gender disparities in Afghanistan, remaining significant gender differences in posttreatment results suggest more positive outcomes for female than for male patients.