艾滋病毒感染者囚犯获得充分过渡性护理的公共卫生影响:五个基本要素。

Public health implications for adequate transitional care for HIV-infected prisoners: five essential components.

机构信息

AIDS Program, Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut 06511, USA.

出版信息

Clin Infect Dis. 2011 Sep;53(5):469-79. doi: 10.1093/cid/cir446.

Abstract

In the United States, 10 million inmates are released every year, and human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) prevalence is several-fold greater in criminal justice populations than in the community. Few effective linkage-to-the-community programs are currently available for prisoners infected with HIV. As a result, combination antiretroviral therapy (cART) is seldom continued after release, and virological and immunological outcomes worsen. Poor HIV treatment outcomes result from a myriad of obstacles that released prisoners face upon reentering the community, including homelessness, lack of medical insurance, relapse to drug and alcohol use, and mental illness. This article will focus on 5 distinct factors that contribute significantly to treatment outcomes for released prisoners infected with HIV and have profound individual and public health implications: (1) adaptation of case management services to facilitate linkage to care; (2) continuity of cART; (3) treatment of substance use disorders; (4) continuity of mental illness treatment; and (5) reducing HIV-associated risk-taking behaviors as part of secondary prevention.

摘要

在美国,每年有 1000 万囚犯获释,而刑事司法人群中的人类免疫缺陷病毒 (HIV) 感染和获得性免疫缺陷综合征 (AIDS) 流行率比社区高几倍。目前,针对感染 HIV 的囚犯,几乎没有有效的社区联系项目。因此,联合抗逆转录病毒疗法 (cART) 在释放后很少继续使用,病毒学和免疫学结果恶化。不良的 HIV 治疗结果源于囚犯在重新进入社区后面临的无数障碍,包括无家可归、缺乏医疗保险、药物和酒精使用的复发以及精神疾病。本文将重点介绍 5 个对感染 HIV 的释放囚犯的治疗结果有重大影响的因素,并对个人和公共健康产生深远影响:(1)调整病例管理服务以促进与护理的联系;(2)cART 的连续性;(3)物质使用障碍的治疗;(4)精神疾病治疗的连续性;以及(5)减少作为二级预防的一部分与 HIV 相关的冒险行为。

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