《滥用毒品人群的艾滋病毒感染、病毒性肝炎、性传播疾病和结核病综合预防服务:美国疾病预防控制中心和美国卫生与公众服务部的总结性指导意见》
Integrated prevention services for HIV infection, viral hepatitis, sexually transmitted diseases, and tuberculosis for persons who use drugs illicitly: summary guidance from CDC and the U.S. Department of Health and Human Services.
出版信息
MMWR Recomm Rep. 2012 Nov 9;61(RR-5):1-40.
This report summarizes current (as of 2011) guidelines or recommendations published by multiple agencies of the U.S. Department of Health and Human Services (DHHS) for prevention and control of human immunodeficiency virus (HIV) infection, viral hepatitis, sexually transmitted diseases (STDs), and tuberculosis (TB) for persons who use drugs illicitly. It also summarizes existing evidence of effectiveness for practices to support delivery of integrated prevention services. Implementing integrated services for prevention of HIV infection, viral hepatitis, STDs, and TB is intended to provide persons who use drugs illicitly with increased access to services, to improve timeliness of service delivery, and to increase effectiveness of efforts to prevent infectious diseases that share common risk factors, behaviors, and social determinants. This guidance is intended for use by decision makers (e.g., local and federal agencies and leaders and managers of prevention and treatment services), health-care providers, social service providers, and prevention and treatment support groups. Consolidated guidance can strengthen efforts of health-care providers and public health providers to prevent and treat infectious diseases and substance use and mental disorders, use resources efficiently, and improve health-care services and outcomes in persons who use drugs illicitly. An integrated approach to service delivery for persons who use drugs incorporates recommended science-based public health strategies, including 1) prevention and treatment of substance use and mental disorders; 2) outreach programs; 3) risk assessment for illicit use of drugs; 4) risk assessment for infectious diseases; 5) screening, diagnosis, and counseling for infectious diseases; 6) vaccination; 7) prevention of mother-to-child transmission of infectious diseases; 8) interventions for reduction of risk behaviors; 9) partner services and contact follow-up; 10) referrals and linkage to care; 11) medical treatment for infectious diseases; and 12) delivery of integrated prevention services. These strategies are science-based, public health strategies to prevent and treat infectious diseases, substance use disorders, and mental disorders. Treatment of infectious diseases and treatment of substance use and mental disorders contribute to prevention of transmission of infectious diseases. Integrating prevention services can increase access to and timeliness of prevention and treatment.
本报告总结了美国卫生与公众服务部(DHHS)多个机构截至 2011 年发布的有关预防和控制人类免疫缺陷病毒(HIV)感染、病毒性肝炎、性传播疾病(STD)和结核病(TB)的现行指南或建议,供非法使用毒品的人员使用。它还总结了支持综合预防服务的现有实践效果证据。实施预防 HIV 感染、病毒性肝炎、STD 和 TB 的综合服务旨在增加非法使用毒品者获得服务的机会,提高服务提供的及时性,并提高预防具有共同风险因素、行为和社会决定因素的传染病的效果。本指南供决策者(例如地方和联邦机构以及预防和治疗服务的领导者和管理人员)、医疗保健提供者、社会服务提供者以及预防和治疗支持团体使用。综合指南可以加强医疗保健提供者和公共卫生提供者预防和治疗传染病以及物质使用和精神障碍的努力,提高资源使用效率,并改善非法使用毒品者的医疗保健服务和结果。为非法使用毒品者提供服务的综合方法结合了建议的基于科学的公共卫生策略,包括:1)预防和治疗物质使用和精神障碍;2)外展计划;3)非法使用毒品风险评估;4)传染病风险评估;5)传染病筛查、诊断和咨询;6)疫苗接种;7)预防传染病母婴传播;8)减少风险行为干预;9)伙伴服务和接触后随访;10)转介和链接至护理;11)传染病的医疗治疗;12)综合预防服务的提供。这些策略是预防和治疗传染病、物质使用障碍和精神障碍的基于科学的公共卫生策略。传染病的治疗和物质使用和精神障碍的治疗有助于预防传染病的传播。整合预防服务可以增加预防和治疗的机会和及时性。