Dickson-Gomez Julia, Bodnar Gloria, Petroll Andy, Johnson Kali, Glasman Laura
Medical College of Wisconsin, Milwaukee, Wisconsin, USA
Fundación Antidrogas de El Salvador, Santa Tecla, El Salvador.
Qual Health Res. 2015 Dec;25(12):1719-32. doi: 10.1177/1049732314568322. Epub 2015 Jan 16.
Since the mid-1990 s, many developing countries have introduced and expanded the availability of combination antiretroviral therapy (cART) to persons living with HIV (PLH). However, AIDS-related mortality continues to be high particularly among drug users. In this article, we present results from in-depth interviews with 13 HIV medical providers and 29 crack cocaine and alcohol using PLH in El Salvador. Providers endorsed negative attitudes toward substance using PLH and warned PLH that combining cART with drugs and alcohol would damage their livers and kidneys resulting in death. Upon diagnosis, PLH received little information about HIV treatment and many suffered depression and escalated their drug use. PLH reported suspending cART when they drank or used drugs because of providers' warnings. Substance using PLH were given few strategies and resources to quit using drugs. Messages from medical providers discourage drug users from initiating or adhering to antiretroviral therapy (ART) and may contribute to treatment abandonment.
自20世纪90年代中期以来，许多发展中国家已向艾滋病毒感染者（PLH）引入并扩大了联合抗逆转录病毒疗法（cART）的可及性。然而，与艾滋病相关的死亡率仍然很高，尤其是在吸毒者中。在本文中，我们展示了对萨尔瓦多13名艾滋病毒医疗服务提供者以及29名同时使用快克可卡因和酒精的艾滋病毒感染者进行深入访谈的结果。医疗服务提供者对吸毒的艾滋病毒感染者持负面态度，并警告他们，将cART与毒品和酒精混合使用会损害肝脏和肾脏，导致死亡。确诊后，艾滋病毒感染者很少获得有关艾滋病毒治疗的信息，许多人患有抑郁症并加剧了吸毒行为。艾滋病毒感染者报告称，由于医疗服务提供者的警告，他们在饮酒或吸毒时会暂停cART。吸毒的艾滋病毒感染者几乎没有得到戒毒的策略和资源。医疗服务提供者传达的信息使吸毒者不愿开始或坚持抗逆转录病毒疗法（ART），并可能导致治疗中断。
