Seal David Wyatt
Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Curr Opin Psychiatry. 2005 Sep;18(5):530-5. doi: 10.1097/01.yco.0000179492.08064.de.
To summarize articles related to HIV/AIDS and correctional populations that were published from January 2004 through March 2005. In all, 43 empirical and seven non-empirical articles are summarized, about two-thirds of which are focused on correctional populations in the USA. The majority of the studies were descriptive; only two articles presented evaluation data for HIV prevention interventions.
Published studies during the review period documented elevated rates of HIV, STIs, and hepatitis among correctional populations--often associated with injection drug use, mental illness, and infectious-disease co-morbidity. These studies highlighted a global public-health need for comprehensive HIV risk-reduction programs that address not only disease prevention but also the factors enabling disease transmission. Research further demonstrated the detrimental effects of release from prison on medication adherence and disease progression among HIV-positive people, underscoring the need for transitional treatment and health-care services.
HIV-related research is urgently needed to document the global scope of HIV disease prevalence and correlates among incarcerated populations, to examine the impact of incarceration and release from prison on HIV risk behavior, to identify optimal treatment programs for HIV-positive individuals, and to rigorously evaluate HIV risk-reduction interventions for incarcerated people--particularly those focused on the period of community re-entry. Finally, research and activism are needed to impact structural factors impeding HIV-prevention efforts with correctional populations.
总结2004年1月至2005年3月发表的与艾滋病毒/艾滋病及惩教人群相关的文章。总共总结了43篇实证文章和7篇非实证文章，其中约三分之二聚焦于美国的惩教人群。大多数研究是描述性的；只有两篇文章提供了艾滋病毒预防干预措施的评估数据。
在综述期间发表的研究记录了惩教人群中艾滋病毒、性传播感染和肝炎的高发病率，这些往往与注射吸毒、精神疾病和传染病合并症有关。这些研究强调了全球公共卫生对全面降低艾滋病毒风险项目的需求，该项目不仅要解决疾病预防问题，还要解决导致疾病传播的因素。研究进一步证明了出狱对艾滋病毒阳性者的药物依从性和疾病进展的不利影响，凸显了过渡治疗和医疗服务的必要性。
迫切需要开展与艾滋病毒相关的研究，以记录艾滋病毒疾病在被监禁人群中的全球流行范围及其相关因素，研究监禁和出狱对艾滋病毒风险行为的影响，确定针对艾滋病毒阳性个体的最佳治疗方案，并严格评估针对被监禁者的艾滋病毒风险降低干预措施，特别是那些侧重于社区重新融入阶段的措施。最后，需要开展研究和行动来影响阻碍针对惩教人群开展艾滋病毒预防工作的结构性因素。
