Sullivan Lynn E, Bruce Robert D, Haltiwanger David, Lucas Gregory M, Eldred Lois, Finkelstein Ruth, Fiellin David A
Yale University School of Medicine, New Haven, CT 06520-8025, USA.
Clin Infect Dis. 2006 Dec 15;43 Suppl 4:S191-6. doi: 10.1086/508183.
The Centers for Disease Control and Prevention's HIV Prevention Strategic Plan Through 2005 advocated for increasing the proportion of persons with human immunodeficiency virus (HIV) infection and in need of substance abuse treatment who are successfully linked to services for these 2 conditions. There is evidence that integrating care for HIV infection and substance abuse optimizes outcomes for patients with both disorders. Buprenorphine, a recently approved medication for the treatment of opioid dependence in physicians' offices, provides the opportunity to integrate the treatment of HIV infection and substance abuse in one clinical setting, yet little information exists on the models of care that will most successfully facilitate this integration. To promote the uptake of this type of integrated care, the current review provides a description of 4 recently implemented models for combining buprenorphine treatment with HIV primary care: (1) an on-site addiction/HIV specialist treatment model; (2) a HIV primary care physician model; (3) a nonphysician health professional model; and (4) a community outreach model.
美国疾病控制与预防中心的《到2005年的艾滋病预防战略计划》提倡,提高成功获得针对人类免疫缺陷病毒(HIV)感染且需要药物滥用治疗这两种情况的服务的感染者比例。有证据表明,将HIV感染护理与药物滥用护理相结合可优化患有这两种疾病患者的治疗效果。丁丙诺啡是最近批准用于医生办公室治疗阿片类药物依赖的药物,它为在同一临床环境中整合HIV感染治疗与药物滥用治疗提供了机会,但关于最能成功促进这种整合的护理模式的信息却很少。为了推动这种综合护理的采用,本综述描述了4种最近实施的将丁丙诺啡治疗与HIV初级护理相结合的模式:(1)现场成瘾/HIV专科医生治疗模式;(2)HIV初级护理医生模式;(3)非医生健康专业人员模式;(4)社区外展模式。