艾滋病毒和注射毒品使用者的风险环境:过去,现在和未来
Steffanie A Strathdee1, Timothy B Hallett, Natalia Bobrova
1University of California, San Diego, Division of Global Public Health, Department of Medicine, CA 92093-0507, USA. sstrathdee@ucsd.edu
Lancet (London, England)
|July 24, 2010
概括
解决注射毒品使用者 (IDU) 预防艾滋病毒的环境因素是关键. 在全球范围内,有针对性的干预措施可以显著降低注射药物使用者中艾滋病毒的流行率.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 社会科学 社会科学 社会科学
背景情况:
- 注射药物使用是全球艾滋病毒流行的主要驱动因素.
- 环境因素对注射毒品使用者 (IDU) 中艾滋病毒传播风险有显著的影响.
- 了解这些风险环境对于有效的艾滋病预防策略至关重要.
研究的目的:
- 系统地审查注射药物使用者感染艾滋病毒的决定因素,重点关注环境影响.
- 为了建模风险环境的变化,并估计潜在的艾滋病毒流行率下降.
- 为艾滋病毒预防和治疗准入提供基于证据,基于权利的干预措施.
主要方法:
- 对94项关于注射药物使用者艾滋病毒决定因素的研究 (2000年至2009年) 的系统审查,根据环境影响进行分类.
- 分析了25项专门研究风险环境的研究.
- 流行病学建模以评估干预措施对高负担地区艾滋病毒流行率的潜在影响.
主要成果:
- 与注射毒品使用相关的艾滋病毒流行病显示出显著的异质性.
- 如果减少60%的未满足的阿片类药物替代,针交换和抗逆转录病毒疗法的需求,可能会使奥德萨,卡拉奇和内罗毕的艾滋病毒患病率降低30-43%.
- 缓解向注射药物使用的过渡和扩大阿片类药物替代方案显示出大幅减少艾滋病毒感染的潜力.
结论:
- 优化干预的有效性和覆盖率对于快速增长的艾滋病毒流行病至关重要.
- 识别环境风险因素为预防艾滋病毒提供了关键的见解.
- 确保药物注射者获得预防和治疗的组合干预措施可以大幅减少艾滋病毒流行病.
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