Yale School of Medicine, Section of Infectious Disease, AIDS Program, 135 College Street, Suite 323, New Haven, CT 06510, United States; University of Connecticut, Storrs, CT, United States.
Yale School of Medicine, Section of Infectious Disease, AIDS Program, 135 College Street, Suite 323, New Haven, CT 06510, United States.
Int J Drug Policy. 2021 Oct;96:103283. doi: 10.1016/j.drugpo.2021.103283. Epub 2021 May 18.
Improving HIV and Hepatitis C Virus (HCV) management among people involved in the criminal justice (CJ) system who use drugs, in particular those with opioid use disorder (OUD), requires effective approaches to screening, linkage, and adherence to integrated prevention and treatment services across correctional and community agencies and providers. This manuscript reviews the literature to explore gaps in HIV, Hepatitis C, and OUD prevention, treatment, and delivery cascades of care for persons involved in the CJ system. Specifically, we compare two models of linkage to prevention and treatment services: Peer/Patient Navigation (PN) wherein the PN links CJ-involved individuals to community-based infectious disease (ID) and substance use prevention and treatment services, and Mobile Health Units (MHU) wherein individuals are linked to a MHU within their community that provides integrated ID and substance use prevention and treatment services. The most notable finding is a gap in the literature, with few to no comparisons of models linking individuals recently released from the CJ system to integrated HIV, Hepatitis C, and OUD prevention and treatment and other harm reduction services. Further, few published studies address the geographical distinctions that affect service implementation and their effects on these substance use, ID and harm reduction care cascades. This manuscript makes specific recommendations to fill this gap through a detailed evaluation of PN and MHU linkage models to co-located and integrated HIV, Hepatitis C, and OUD prevention and treatment services across different communities within the U.S.
提高参与刑事司法（CJ）系统且有药物使用问题的人群（尤其是阿片类物质使用障碍者）的艾滋病毒和丙型肝炎病毒（HCV）管理水平，需要在矫正和社区机构及提供者中采用有效的方法来对综合预防和治疗服务进行筛选、对接和坚持。本文对文献进行综述，以探讨在 CJ 系统人群中艾滋病毒、丙型肝炎和阿片类物质使用障碍预防、治疗和护理连续服务方面的差距。具体而言，我们比较了两种预防和治疗服务的对接模式：同伴/患者导航（PN），其中 PN 将 CJ 相关个人与社区为基础的传染病（ID）和物质使用预防和治疗服务联系起来；移动健康单位（MHU），其中个人与社区内提供综合 ID 和物质使用预防和治疗服务的 MHU 联系起来。最显著的发现是文献中的一个空白，几乎没有比较将最近从 CJ 系统释放的个人与综合艾滋病毒、丙型肝炎和阿片类物质使用障碍预防和治疗以及其他减少伤害服务联系起来的模型。此外，很少有已发表的研究解决影响服务实施及其对这些物质使用、传染病和减少伤害护理连续服务的地理差异。本文通过详细评估 PN 和 MHU 与位于不同社区的综合 HIV、丙型肝炎和阿片类物质使用障碍预防和治疗服务的对接模型，提出了具体的建议来填补这一空白。
