Lesko Catherine R, Tong Weiqun, Moore Richard D, Lau Bryan
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD, 21205, USA.
School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
AIDS Behav. 2017 Apr;21(4):1016-1024. doi: 10.1007/s10461-016-1585-5.
Compared to HIV-infected persons who do not inject drugs (non-IDU), persons who inject drugs (PWID) experience disparities in linking to medical care, initiating antiretroviral therapy (ART) and achieving viral suppression. There has been little attention to changes in these disparities over time. We estimated the proportion of PWID and non-IDU retained in care, on ART, and virally suppressed each year from 2001-2012 in the Johns Hopkins HIV Clinical Cohort (JHHCC). We defined active clinic patients as those who had ≥1 clinical visit, CD4 cell count, or viral load between July 1 of the prior year, and June 30 of the analysis year. Within a calendar year, retention was defined as ≥2 clinical visits or HIV-related laboratory measurements >90 days; ART use was defined as ≥1 ART prescription active ≥30 days; and viral suppression was defined as ≥1 HIV viral load <400 copies/mL. While PWID were less likely to be retained in earlier years, the gaps in retention closed around 2010. After 2003-2004, PWID and non-IDU retained in care had similar probability of receiving a prescription for ART and PWID and non-IDU on ART had similar probability of viral suppression.
与不注射毒品的艾滋病毒感染者（非注射吸毒者）相比，注射毒品者（PWID）在获得医疗护理、开始抗逆转录病毒治疗（ART）以及实现病毒抑制方面存在差异。随着时间的推移，这些差异的变化很少受到关注。我们估计了2001年至2012年约翰霍普金斯艾滋病毒临床队列（JHHCC）中每年接受护理、接受ART治疗以及病毒得到抑制的PWID和非注射吸毒者的比例。我们将活跃的门诊患者定义为在前一年7月1日至分析年度6月30日期间有≥1次临床就诊、CD4细胞计数或病毒载量的患者。在一个日历年内，留存率定义为≥2次临床就诊或艾滋病毒相关实验室检测间隔>90天；ART使用定义为≥1次ART处方且有效期≥30天；病毒抑制定义为≥1次艾滋病毒病毒载量<400拷贝/毫升。虽然PWID在早期不太可能被留存，但留存率的差距在2010年左右缩小。2003 - 2004年之后，接受护理的PWID和非注射吸毒者接受ART处方的概率相似，接受ART治疗的PWID和非注射吸毒者病毒抑制的概率也相似。
