Department of Emergency Medicine, Alameda Health System, Highland Hospital, Oakland, CA, United States of America.
PLoS One. 2020 Jun 4;15(6):e0233927. doi: 10.1371/journal.pone.0233927. eCollection 2020.
The opioid epidemic has led to an increase in the number of persons who inject drugs, and this population accounts for 12% of new human immunodeficiency virus (HIV) and 60% of new hepatitis C virus (HCV) infections in the United States annually. While persons who inject drugs disproportionately utilize the emergency department (ED), accurate data is lacking on the prevalence and patterns of injection drug use, and prevalence of co-occurring HIV and HCV infections among ED patients.
The primary outcome was to assess the prevalence of injection drug use and co-occurring HIV and HCV infection among patients presenting to an urban ED.
This was a cross sectional study conducted at an urban ED, with an annual census of 65,000 visits. A closed-response questionnaire was developed based on publicly available validated surveys to assess patterns of injection drug use and HIV and HCV infection status, and administered by trained research assistants to all registered adult patients during 4-hour blocks of time.
Of the 2,319 eligible patients, 2,200 (94.9%) consented and completed the survey. 241 (11.0%) had ever used injection drugs, 103 (4.7%) currently used injection drugs, and 138 (6.3%) formerly used injection drugs. White patients age 25 to 34 years and white patients age 55 to 64 years had the highest prevalence of current (25.6%) and former (27.1%) injection drug use, respectively. Persons who use injection drugs had a higher prevalence of HCV infection (52.7% vs. 3.4%) and HIV infection (6.2% vs. 1.8%) than the rest of the population.
A high prevalence of ED patients report injection drug use, and this population self-reports a high prevalence of HIV and HCV infection. Emergency departments are in a unique position to engage with this population with regards to substance use treatment and linkage to care for HIV and HCV infection.
阿片类药物泛滥导致美国注射毒品者人数增加，这一人群占每年新感染人类免疫缺陷病毒（HIV）人数的 12%，占新感染丙型肝炎病毒（HCV）人数的 60%。尽管注射毒品者大量使用急诊部（ED），但 ED 患者中注射毒品使用的流行程度和模式以及 HIV 和 HCV 合并感染的流行率缺乏准确数据。
主要结果是评估城市 ED 就诊患者中注射毒品使用和合并 HIV 和 HCV 感染的流行率。
这是一项在城市 ED 进行的横断面研究，每年有 65000 次就诊。根据公开的经过验证的调查，开发了一个封闭式问卷来评估注射毒品使用模式和 HIV 和 HCV 感染状况，并由经过培训的研究助理在 4 小时的时间段内向所有登记的成年患者进行管理。
在 2319 名符合条件的患者中，有 2200 名（94.9%）同意并完成了调查。241 名（11.0%）曾使用过注射毒品，103 名（4.7%）目前正在使用注射毒品，138 名（6.3%）曾使用过注射毒品。年龄在 25 至 34 岁的白人患者和年龄在 55 至 64 岁的白人患者分别是目前（25.6%）和以前（27.1%）注射毒品使用的最高患病率。使用注射毒品的人 HCV 感染（52.7%比 3.4%）和 HIV 感染（6.2%比 1.8%）的患病率均高于其他人群。
大量 ED 患者报告使用注射毒品，且该人群报告 HIV 和 HCV 感染的患病率较高。急诊部在针对该人群开展物质使用治疗以及 HIV 和 HCV 感染的治疗和管理方面具有独特的地位。
