通过远程医疗为阿片类药物使用障碍提供药物,并通过远程医疗为注射器服务计划提供艾滋病毒暴露前预防:试点研究
Mehri S McKellar1, Andrea C Des Marais2, Hillary Chen2
1Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, P.O. Box 102359, Durham, NC, 27710, USA. mehri.mckellar@duke.edu.
Harm reduction journal
|March 27, 2024
概括
远程医疗有效地为注射毒品的人 (PWID) 提供了治疗阿片类药物使用障碍 (MOUD) 和暴露前预防 (PrEP) 的药物. 虽然MOUD的坚持率很高,但PrEP的坚持率下降,参与者认为艾滋病毒风险低.
科学领域:
- 公共卫生 公共卫生
- 远程医疗远程医疗
- 预防传染病 预防传染病
背景情况:
- 注射吸毒者 (PWID) 面临阿片类药物过量服用和艾滋病毒等传染病的风险增加.
- 注射器服务计划 (SSP) 是减少伤害服务的关键接入点.
- 远程医疗为将医疗保健服务扩展到服务不足的人群提供了一个潜在的解决方案.
研究的目的:
- 试点一个基于远程医疗的计划 (PARTNER UP),用于为阿片类药物使用障碍 (MOUD) 提供药物,并对PWID进行暴露前预防 (PrEP).
- 评估参与者对MOUD和PrEP的保留和药物坚持.
- 评估将这些服务整合到SSP中的可行性.
主要方法:
- 在SSP进行首次面对面访问后,随后进行了远程医疗咨询.
- 参与者接受了布普伦诺芬/纳洛 (bup/nx) 治疗MOUD,并接受了 PrEP 治疗的特诺福维尔二氧化 fumarate/emtricitabine.
- 收集的数据包括人口统计,病史,物质使用,性行为,以及在基线和3个月和6个月的随访期间自我报告的药物坚持.
主要成果:
- 71%的参与者在6个月后仍在研究中,其中67%的人报告遵守MOUD和PrEP.
- 在参与者中,阿片类药物的使用和艾滋病毒风险行为下降.
- 据报道,MOUD的每日坚持率很高,但PrEP的坚持率下降,通常是由于人们认为艾滋病毒感染风险低.
结论:
- 远程医疗是通过SSP管理MOUD和PrEP的可行方法.
- 由于缺乏艾滋病毒风险的感知,PrEP的坚持可能较低,可能受到MOUD使用的影响.
- 需要进一步的研究来确定PWID的最高风险,并优化PrEP的交付策略.
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