阿片类物质使用障碍患者的综合护理模式:我们如何预防 HIV 和 HCV?

Integrated Models of Care for Individuals with Opioid Use Disorder: How Do We Prevent HIV and HCV?

机构信息

Section of Infectious Diseases, AIDS Program, Yale School of Medicine, New Haven, CT, USA.

Frank H. Netter School of Medicine, Quinnipiac University, North Haven, CT, USA.

出版信息

Curr HIV/AIDS Rep. 2018 Jun;15(3):266-275. doi: 10.1007/s11904-018-0396-x.

Abstract

PURPOSE OF REVIEW

To describe models of integrated and co-located care for opioid use disorder (OUD), hepatitis C (HCV), and HIV.

RECENT FINDINGS

The design and scale-up of multidisciplinary care models that engage, retain, and treat individuals with HIV, HCV, and OUD are critical to preventing continued spread of HIV and HCV. We identified 17 models within primary care (N = 3), HIV specialty care (N = 5), opioid treatment programs (N = 6), transitional clinics (N = 2), and community-based harm reduction programs (N = 1), as well as two emerging models. Key components of such models are the provision of (1) medication-assisted treatment for OUD, (2) HIV and HCV treatment, (3) HIV pre-exposure prophylaxis, and (4) behavioral health services. Research is needed to understand differences in effectiveness between co-located and fully integrated care, combat the deleterious racial and ethnic legacies of the "War on Drugs," and inform the delivery of psychiatric care. Increased access to harm reduction services is crucial.

摘要

综述目的:描述阿片类药物使用障碍 (OUD)、丙型肝炎 (HCV) 和 HIV 综合和共置护理的模式。

最新发现:设计和扩大多学科护理模式,以吸引、留住和治疗 HIV、HCV 和 OUD 患者,对于防止 HIV 和 HCV 的持续传播至关重要。我们在初级保健 (N=3)、HIV 专科护理 (N=5)、阿片类药物治疗项目 (N=6)、过渡诊所 (N=2) 和基于社区的减少伤害计划 (N=1) 中确定了 17 种模式,以及两种新兴模式。这些模式的关键组成部分包括:(1) 阿片类药物使用障碍的药物辅助治疗,(2) HIV 和 HCV 治疗,(3) HIV 暴露前预防,和 (4) 行为健康服务。需要研究了解共置和完全综合护理之间的有效性差异,克服“禁毒战争”的有害种族和族裔遗产,并为提供精神保健提供信息。增加获得减少伤害服务的机会至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/332a/6003996/70b372a3fcaa/11904_2018_396_Fig1_HTML.jpg

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