Springer Sandra A, Larney Sarah, Alam-Mehrjerdi Zahra, Altice Frederick L, Metzger David, Shoptaw Steven
*Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, CT; †National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia; ‡National Drug and Alcohol Research Centre (NDARC), Faculty of Public Health and Community Medicine, University of New South Wales, Sydney, Australia; §Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; ‖Treatment Research Institute, Philadelphia, PA; and ¶Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.
J Acquir Immune Defic Syndr. 2015 Jun 1;69 Suppl 2(0 1):S155-61. doi: 10.1097/QAI.0000000000000637.
Although there have been significant reductions in the number of new HIV infections globally from 2009 to 2013, incidence remains unacceptably high for persons who use drugs. In many settings, women and girls who inject drugs (WWID) with HIV/AIDS experience poor treatment access, including evidence-based practices like antiretroviral therapy and drug treatment. Medication-assisted therapies (MAT) for substance use disorders are especially inaccessible, which in their absence, increases HIV transmission risk. Irrespective of setting or culture, drug treatment using MAT is not only effective but also cost-effective at reducing opioid use and linked injection and sexual risks. Data presented here for WWID address their access to MAT for opioid addiction and to treatments being developed that address the relationship, family, and vocational needs of this group. The most glaring finding is that globally, WWID frequently are excluded in surveys or studies with an impressive lack of disaggregated data by gender when surveying access to MAT—even in wealthy countries. Despite this, there have been some striking improvements in implementing drug treatment as prevention, notably in Iran and China. Still, real barriers remain for women and girls to accessing drug treatment, other harm reduction services, and antiretroviral therapy. Development and/or implementation of interventions that facilitate women and girls engaging in drug treatment that address their roles within society, work, and family/relationships, and outcome evaluation of these interventions are crucial.
尽管从2009年到2013年全球新增艾滋病毒感染人数大幅减少，但吸毒者的发病率仍然高得令人无法接受。在许多情况下，感染艾滋病毒/艾滋病的注射吸毒妇女和女孩获得治疗的机会很差，包括抗逆转录病毒疗法和药物治疗等循证做法。用于物质使用障碍的药物辅助治疗（MAT）尤其难以获得，而缺少这种治疗会增加艾滋病毒传播风险。无论环境或文化如何，使用MAT进行药物治疗不仅在减少阿片类药物使用以及相关的注射和性传播风险方面有效，而且具有成本效益。此处提供的针对注射吸毒妇女和女孩的数据涉及她们获得针对阿片类药物成瘾的MAT以及针对该群体的关系、家庭和职业需求所开发的治疗方法的情况。最明显的发现是，在全球范围内，注射吸毒妇女和女孩在调查或研究中经常被排除在外，在调查获得MAT的机会时，令人惊讶地缺乏按性别分类的数据——即使在富裕国家也是如此。尽管如此，在将药物治疗作为预防措施实施方面已经取得了一些显著进展，特别是在伊朗和中国。然而，妇女和女孩在获得药物治疗、其他减少伤害服务以及抗逆转录病毒疗法方面仍然存在实际障碍。制定和/或实施有助于妇女和女孩参与药物治疗的干预措施，这些干预措施要考虑到她们在社会、工作以及家庭/关系中的角色，并且对这些干预措施进行结果评估至关重要。
