Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA.
School of Public Health, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, Lima 15102, Peru.
Int J Environ Res Public Health. 2022 Jun 12;19(12):7198. doi: 10.3390/ijerph19127198.
This scoping review aims to explore the interplay between substance use (SU) and HIV in Latin America (LA). Database searches yielded 3481 references; 196 were included. HIV prevalence among people who used substances (PWUS) ranged from 2.8-15.2%. SU definitions were variable throughout studies, and thus data were not easily comparable. In 2019, only 2% of new HIV infections were attributed to injection drug use (IDU) in LA. Factors associated with HIV among PWUS included being female, IDU and homelessness, and PWUS were likely to engage in risky sexual behaviors, start antiretroviral treatment late, have poor adherence, have treatment failure, be lost to follow-up, have comorbidities, and experience higher mortality rates and lower quality of life, as has been reported in PLWH with SU in other regions. Five intervention studies were identified, and only one was effective at reducing HIV incidence in PWUS. Interventions in other regions have varying success depending on context-specific characteristics, highlighting the need to conduct more research in the LA region. Though progress has been made in establishing SU as a major concern in people living with HIV (PLWH), much more is yet to be done to reduce the burden of HIV and SU in LA.
本范围综述旨在探讨拉丁美洲（LA）物质使用（SU）与 HIV 之间的相互作用。数据库检索产生了 3481 篇参考文献；纳入了 196 篇。使用物质的人群（PWUS）中的 HIV 患病率范围为 2.8-15.2%。研究中 SU 的定义各不相同，因此数据难以比较。2019 年，LA 新感染的 HIV 病例中仅有 2%归因于注射吸毒（IDU）。与 PWUS 中的 HIV 相关的因素包括女性、IDU 和无家可归，PWUS 更有可能从事危险的性行为，延迟开始抗逆转录病毒治疗，治疗依从性差，治疗失败，失访，合并症，以及经历更高的死亡率和更低的生活质量，这在其他地区的有 SU 的 PLWH 中已有报道。确定了五项干预研究，只有一项能够有效降低 PWUS 的 HIV 发病率。其他地区的干预措施根据具体情况的特点取得了不同的成功，这突显了在 LA 地区开展更多研究的必要性。尽管在将 SU 确立为 HIV 感染者（PLWH）的主要关注点方面已经取得了进展，但仍有许多工作要做，以减轻 LA 地区的 HIV 和 SU 负担。
