Thompson A S, Blankenship K M, Selwyn P A, Khoshnood K, Lopez M, Balacos K, Altice F L
Yale University School of Medicine, New Haven, Connecticut 06510-2483, USA.
J Community Health. 1998 Dec;23(6):419-40. doi: 10.1023/a:1018706107776.
Drug-using women with or at risk for HIV infection have many competing unmet needs, especially for social services, drug treatment, and medical care. High-risk drug-using women were recruited through street outreach, at needle exchange sites, a prison, and local community based organizations in New Haven, Connecticut for a study of the service needs of out-of-treatment drug users and the ability of an interactive case management intervention (ICM) to address those needs. These women were administered baseline and follow-up interviews to identify their health and social service needs and the degree to which these needs were resolved. The women who chose to enroll in the interactive case management intervention (n = 38) did not differ demographically nor in their HIV risk behaviors from those not receiving case management (n = 73). Provision of ICM was most successful in meeting needs for supportive mental health counseling, basic services, and long term housing. The impact of interactive case management was less evident for the acquisition of medical and dental services, which were accessed comparably by women not receiving the intervention. Overall, the women who enrolled in the ICM intervention showed a significant decrease in the number of unmet service needs as compared to those who did not enroll. Multiple contacts were required by the case manager to establish trust and to resolve the unmet service needs of these high-risk women. Women with or at risk for HIV infection can be effectively engaged in an ICM intervention in order to meet their multiple unmet service needs, although such interventions are time-and-labor intensive.
感染艾滋病毒或有感染风险的吸毒女性有许多未得到满足的相互竞争的需求，尤其是在社会服务、戒毒治疗和医疗保健方面。通过街头宣传、针头交换点、一所监狱以及康涅狄格州纽黑文市的当地社区组织招募了高危吸毒女性，以研究戒毒者的服务需求以及交互式个案管理干预措施（ICM）满足这些需求的能力。对这些女性进行了基线和随访访谈，以确定她们的健康和社会服务需求以及这些需求得到解决的程度。选择参加交互式个案管理干预的女性（n = 38）在人口统计学特征和艾滋病毒风险行为方面与未接受个案管理的女性（n = 73）没有差异。提供ICM在满足支持性心理健康咨询、基本服务和长期住房需求方面最为成功。对于获得医疗和牙科服务，交互式个案管理的影响不太明显，未接受干预的女性获得这些服务的情况与之相当。总体而言，与未参加的女性相比，参加ICM干预的女性未得到满足的服务需求数量显著减少。个案经理需要多次接触才能建立信任并解决这些高危女性未得到满足的服务需求。感染艾滋病毒或有感染风险的女性可以有效地参与ICM干预，以满足她们多个未得到满足的服务需求，尽管这种干预需要大量时间和人力。
