Simeone Claire A, Seal Stella M, Savage Christine
J Assoc Nurses AIDS Care. 2017 Mar-Apr;28(2):199-215. doi: 10.1016/j.jana.2015.11.006. Epub 2015 Dec 2.
People who use drugs are at increased risk for HIV acquisition, poor engagement in health care, and late screening for HIV with advanced HIV at diagnosis and increased HIV-related morbidity, mortality, and health care costs. This systematic review evaluates current evidence about the effectiveness and feasibility of implementing HIV testing in U.S. substance use treatment programs. The literature search identified 535 articles. Full text review was limited to articles that explicitly addressed strategies to implement HIV testing in substance use programs: 17 met criteria and were included in the review; nine used quantitative, qualitative, or mixed-method designs to describe or quantify HIV testing rates, acceptance by clients and staff, and cost-effectiveness; eight organization surveys described barriers and facilitators to testing implementation. The evidence supported the effectiveness and feasibility of rapid, routine, and streamlined HIV testing in substance use treatment programs. Primary challenges included organizational support and sustainable funding.
吸毒者感染艾滋病毒的风险增加，医疗保健参与度低，艾滋病毒检测延迟，诊断时处于晚期艾滋病毒感染状态，与艾滋病毒相关的发病率、死亡率以及医疗保健成本增加。本系统评价评估了美国物质使用治疗项目中实施艾滋病毒检测的有效性和可行性的现有证据。文献检索共识别出535篇文章。全文审查仅限于明确阐述物质使用项目中实施艾滋病毒检测策略的文章：17篇符合标准并纳入本评价；9篇采用定量、定性或混合方法设计来描述或量化艾滋病毒检测率、客户和工作人员的接受度以及成本效益；8篇机构调查描述了检测实施的障碍和促进因素。证据支持在物质使用治疗项目中进行快速、常规和简化的艾滋病毒检测的有效性和可行性。主要挑战包括机构支持和可持续资金。
