Sorensen J L, Copeland A L
Department of Psychiatry, Room 2117, Ward 21, Building 20, UCSF at San Francisco General Hospital, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
Drug Alcohol Depend. 2000 Apr 1;59(1):17-31. doi: 10.1016/s0376-8716(99)00104-0.
We review drug abuse treatment as a means of preventing infection with HIV. Thirty-three studies, with an aggregate of over seventeen thousand subjects, were published in peer-reviewed journals from 1988-1998. Research on the utility of drug abuse treatment as an HIV prevention strategy has focused primarily on methadone maintenance treatment (MMT) rather than other modalities such as residential or outpatient drug-free treatment. Recent research provides clear evidence that MMT reduces HIV risk behaviors, particularly needle-use, and strong evidence that MMT prevents HIV infection. There is less definitive evidence that MMT reduces needle-sharing and unsafe sexual behavior, or that other treatment modalities prevent HIV infection. Future research should take into account patient self-selection processes and investigate other treatment modalities for heroin and stimulant abuse to determine their effects on HIV risk behaviors and HIV infection.
我们将药物滥用治疗作为预防艾滋病毒感染的一种手段进行综述。1988年至1998年间，有33项研究发表在同行评审期刊上，总计涉及超过1.7万名受试者。关于药物滥用治疗作为艾滋病毒预防策略的效用的研究主要集中在美沙酮维持治疗（MMT）上，而非其他治疗方式，如住院或门诊戒毒治疗。近期研究提供了明确证据，表明美沙酮维持治疗可降低艾滋病毒风险行为，尤其是针头使用行为，并有强有力的证据表明美沙酮维持治疗可预防艾滋病毒感染。关于美沙酮维持治疗减少共用针头和不安全性行为，或其他治疗方式预防艾滋病毒感染的证据则不太确凿。未来的研究应考虑患者的自我选择过程，并研究针对海洛因和兴奋剂滥用的其他治疗方式，以确定它们对艾滋病毒风险行为和艾滋病毒感染的影响。
