Dunn Kelly E, Saulsgiver Kathryn A, Patrick Mollie E, Heil Sarah H, Higgins Stephen T, Sigmon Stacey C
Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States.
Drug Alcohol Depend. 2013 Dec 1;133(2):625-32. doi: 10.1016/j.drugalcdep.2013.08.007. Epub 2013 Aug 30.
The high rates of HIV and Hepatitis C (HCV) infection among opioid abusers is a serious public health problem, and efforts to enhance knowledge regarding risks for HIV/hepatitis infection in this population are important. Abuse of prescription opioids (POs), in particular, has increased substantially in the past decade and is associated with increasing rates of injection drug use and HCV infection.
This study describes the effects of a brief HIV/HCV educational intervention delivered in the context of a larger randomized, double-blind clinical trial evaluating the relative efficacy of 1-, 2-, and 4-week outpatient buprenorphine tapers and subsequent oral naltrexone maintenance for treating PO dependence. HIV- and HCV-related knowledge and risk behaviors were characterized pre- and post-intervention in 54 primary PO abusers.
The educational intervention was associated with significant improvements in HIV (p<.001) and HCV (p<.001) knowledge. Significant improvements (p<.001) were observed on all three domains of the HIV questionnaire (i.e., general knowledge, sexual risk behaviors, drug risk behaviors) and on 21 and 11 individual items on the HIV and HCV questionnaires, respectively. Self-reported likelihood of using a condom also increased significantly (p<.05) from pre- to post-intervention. No additional changes in self-reported risk behaviors were observed.
These results suggest that a brief, easy-to-administer intervention is associated with substantial gains in HIV and HCV knowledge among PO abusers and represents the necessary first step toward the dissemination of a structured prevention HIV and HCV intervention for PO abusers.
阿片类药物滥用者中艾滋病毒（HIV）和丙型肝炎病毒（HCV）的高感染率是一个严重的公共卫生问题，加强该人群对HIV/肝炎感染风险的认识非常重要。特别是，处方阿片类药物（POs）的滥用在过去十年中大幅增加，且与注射吸毒率和HCV感染率上升有关。
本研究描述了在一项更大规模的随机双盲临床试验背景下进行的简短HIV/HCV教育干预的效果，该试验评估了为期1周、2周和4周的门诊丁丙诺啡递减疗法以及随后口服纳曲酮维持疗法治疗PO依赖的相对疗效。对54名原发性PO滥用者在干预前后的HIV和HCV相关知识及风险行为进行了特征描述。
教育干预与HIV（p<.001）和HCV（p<.001）知识的显著改善相关。在HIV问卷的所有三个领域（即一般知识、性风险行为、药物风险行为）以及HIV和HCV问卷上分别有21项和11项个体条目上均观察到显著改善（p<.001）。自我报告的使用避孕套的可能性在干预前后也显著增加（p<.05）。未观察到自我报告的风险行为有其他变化。
这些结果表明，一种简短、易于实施的干预与PO滥用者在HIV和HCV知识方面的显著提高相关，并且是向PO滥用者传播结构化的HIV和HCV预防干预措施的必要第一步。
