监狱中处方甲预测了监狱释放后与艾滋病毒护理的联系:一个随机和患者偏好试验
Allison M Mobley1, Martin P Wegman2, Alexander R Bazazi3
1University of Chicago Pritzker School of Medicine, Chicago, IL, USA; Yale School of Public Health, Department of Epidemiology of Microbial Diseases, 60 College Street, New Haven, CT, USA; Faculty of Medicine, Centre of Excellence for Research in AIDS (CERiA) University of Malaya, Level 17, Wisma R&D, Kalan Pantai Baharu, 59990, Kuala Lumpur, Malaysia.
The International journal on drug policy
|February 9, 2025
概括
预释甲显著改善了从监狱过渡的艾滋病毒和阿片类药物使用障碍患者与艾滋病毒护理的联系. 这种干预措施启动了艾滋病毒治疗级联,优化了结果.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 成 药物 药物 药物 药物
背景情况:
- 监狱过渡带来了重大的健康风险,特别是在艾滋病毒和阿片类药物使用障碍 (OUD) 患者中.
- 有效地与释放后的艾滋病毒护理联系对于管理艾滋病毒和预防传播至关重要.
- OUD管理需要持续的治疗,这往往被监禁打乱.
研究的目的:
- 评估释放前甲给药对与艾滋病毒治疗的联系的影响.
- 评估甲作为艾滋病毒治疗作为预防策略的一部分对艾滋病毒和OUD监禁个体的有效性.
主要方法:
- 一个有前景的,开放的试验,涉及310名在马来西亚监狱中的艾滋病毒和OUD感染者.
- 参与者被分配到接受甲预释或不接受甲,随机化和偏好设计.
- 一个反向概率加权的考克斯比例危险模型分析了与艾滋病毒护理的联系,直到发布后的360天.
主要成果:
- 73.6%的参与者在释放之前开始服用美沙.
- 释放前甲在释放后的多个时间点显著预测了与艾滋病毒治疗的联系 (aHR = 1.87).
- 用释放前甲治疗所需的患者数量是30天后14人,360天后5人.
结论:
- 甲应该被纳入艾滋病毒治疗作为预防策略,用于监禁的OUD患者.
- 在释放之前启动美沙可以优化艾滋病毒治疗级联并改善护理联系.
- 确保所有OUD的人都能获得甲,尤其是在监狱过渡期间,这是必不可少的.
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