米国におけるオピオイド危機とHIV: 致命的な相乗効果

Sally L Hodder¹, Judith Feinberg¹, Steffanie A Strathdee²

¹West Virginia Clinical and Translational Science Institute, University Health Sciences Center, West Virginia University, Morgantown, WV, USA.

Lancet (London, England)

|February 22, 2021

まとめ

米国におけるオピオイドの流行と薬物注射者におけるHIV診断は関連していますオピオイド使用障害の効果的な治療とHIV予防には,汚名や政策上の障壁に対処することが不可欠です.

科学分野:

公衆衛生
流行病学
依存症医学

背景:

米国は深刻なオピオイドの流行に直面しており,フェンタニルによる過剰摂取による死亡は2013年から2017年の間に倍増しています.
麻薬を注射する人の間で新たに診断されるHIV患者の人口統計の変化は,白人,若年層 (13-34歳),大都市圏外の人の増加を含んでいます.
シリンジ共有の傾向は人種的格差を示し,黒人とヒスパニック人の割合は減少したが,白人の割合は2005年から15年の間に変化しなかった.

研究の目的:

米国におけるオピオイドの流行とHIV感染の交差点を調べる
HIV診断と注射器の共有行動における人口の変化を強調するためです
オピオイド使用障害の効果的な治療とHIV予防への障壁を特定する.

主な方法:

オピオイド過剰摂取による死亡とHIV診断に関する国内データ分析
薬物注射者における人口動態と行動データ (注射器の共有) の調査
オピオイド使用障害とHIV予防のための既存の証拠に基づいた介入のレビュー

主要な成果:

特にフェンタニルの増加に伴い,オピオイド過剰摂取による死亡が著しく増加しています.
HIVの新規診断は,都市部以外の地域や特定の人口集団で増加しています.
汚名や政策の制約などの障壁は,注射薬物使用者のための基本的医療や予防サービスへのアクセスを妨げています.

結論:

オピオイド使用障害の効果的な治療とHIV感染の予防は,証拠に基づいた介入で達成可能である.
汚名をなくし,差別的な政策を改革し,アクセス可能な総合的な医療を提供することは,注射薬物使用者のHIV予防に不可欠です.
絶望感を含むオピオイドの流行の根本的な原因に対処することは公衆衛生にとって不可欠です

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