Nguyen Bich Diep, Korthuis P Todd, Nguyen Thu Trang, Van Dinh Hoa, Le Minh Giang
Hanoi Medical University, Hanoi, Vietnam.
Oregon Health and Science University, Portland, OR, USA.
J Subst Abuse Treat. 2016 Oct;69:57-63. doi: 10.1016/j.jsat.2016.07.003. Epub 2016 Jul 19.
Integrated care models for HIV and substance use disorder (SUD) care are proposed as a strategy for closing gaps in the HIV care continuum and decreasing HIV transmission. We examined attitudes regarding integration of HIV and SUD treatment among HIV-infected patients with illicit drug and unhealthy alcohol use.
We conducted a cross-sectional survey of HIV-infected patients receiving care at 5 HIV clinics in Hanoi, Vietnam, regarding substance use and attitudes toward HIV and SUD treatment integration. We used multivariate logistic regression to identify correlates of integrated care preference.
Among 312 participants with current or past illicit drug use or unhealthy alcohol use, 81.4% preferred integrated treatment for HIV and SUD. In multivariate analysis, completing a college education (aOR 0.22, 95% CI 0.08, 0.65), risk of depression (aOR 3.51, 95% CI 1.57, 7.87), ever having received medication-assisted treatment for opioid use disorder (aOR 4.20, 95% CI 1.65, 10.69), being comfortable discussing substance use with counselors/nurses (aOR 3.86, 95% CI 1.38, 10.81) and having discussed alcohol use with their health providers (aOR 2.34, 95% CI 1.09, 4.99) were associated with patients' preference for integrated care, after adjusting for age and gender.
Most, but not all, HIV-infected patients with substance use preferred integrated HIV and SUD treatment. Our findings suggest that policies to expand integration of HIV and SUD treatment will be well received by most patients, and that stand-alone treatment options should be preserved for a significant minority.
提出针对艾滋病毒和物质使用障碍(SUD)护理的综合护理模式,作为弥合艾滋病毒护理连续体差距和减少艾滋病毒传播的一项策略。我们调查了艾滋病毒感染且有非法药物使用和不健康饮酒行为的患者对艾滋病毒与物质使用障碍治疗整合的态度。
我们对在越南河内5家艾滋病毒诊所接受护理的艾滋病毒感染患者进行了一项横断面调查,内容涉及物质使用情况以及对艾滋病毒与物质使用障碍治疗整合的态度。我们使用多变量逻辑回归来确定综合护理偏好的相关因素。
在312名目前或过去有非法药物使用或不健康饮酒行为的参与者中,81.4%的人倾向于对艾滋病毒和物质使用障碍进行综合治疗。在多变量分析中,完成大学教育(调整后的比值比[aOR]为0.22,95%置信区间[CI]为0.08,0.65)、有抑郁风险(aOR为3.51,95%CI为1.57,7.87)、曾接受过阿片类物质使用障碍的药物辅助治疗(aOR为4.20,95%CI为1.65,10.69)、愿意与咨询师/护士讨论物质使用情况(aOR为3.86,95%CI为1.38,10.81)以及曾与医疗服务提供者讨论过饮酒情况(aOR为2.34,95%CI为1.09,4.99)与患者对综合护理的偏好相关,这些分析已对年龄和性别进行了调整。
大多数(但并非全部)有物质使用问题的艾滋病毒感染患者倾向于艾滋病毒与物质使用障碍的综合治疗。我们的研究结果表明,扩大艾滋病毒与物质使用障碍治疗整合的政策将受到大多数患者的欢迎,同时应为相当一部分少数患者保留单独的治疗选择。