项目RETAIN:为使用可卡因的艾滋病毒感染者提供综合护理
Lisa R Metsch1, Daniel J Feaster2, Lauren K Gooden1
1Department of Sociomedical Sciences, Columbia University, New York, New York, USA.
Open forum infectious diseases
|April 25, 2025
概括
综合干预并没有改善使用可卡因的艾滋病毒感染者 (PWH) 的病毒抑制. 虽然干预增加了物质使用治疗参与度和减少了心理痛苦,但病毒抑制率在各组之间仍然相似.
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:
- 使用可卡因的艾滋病毒感染者 (PWH) 通常对艾滋病毒护理的参与度较低,导致病毒抑制率较低.
- 可卡因使用是实现和维持PWH病毒抑制的重要障碍.
- 了解阻碍或促进护理参与的因素对于改善这一群体的健康结果至关重要.
研究的目的:
- 测试综合干预的有效性,结合物质使用治疗和门诊艾滋病毒治疗.
- 为了确定干预措施是否改善了使用可卡因且未被病毒抑制的PWH病毒抑制率.
- 评估干预对物质使用和心理痛苦的影响.
主要方法:
- 在美国两个城市招募了360名可卡因使用的PWH,但没有病毒抑制.
- 随机选择的参与者接受通常治疗 (TAU) 或综合干预组.
- 干预包括患者导航,激励增强疗法和物质使用认知行为疗法. 病毒抑制在6个月和12个月后进行评估.
主要成果:
- 干预 (15.6%) 和TAU (17.1%) 组之间病毒抑制率没有显著差异 (P = .897).
- 与TAU (7.2%) 相比,干预组在物质使用治疗中的参与率 (87.0%) 显著更高 (P < .001).
- 两组都经历了兴奋剂使用的减少;干预组显示氧化使用的减少更大. 在6个月的干预组中,严重的心理痛苦减少了更多 (P = .0492).
结论:
- 综合干预没有改善可卡因使用PWH在12个月的病毒抑制.
- 该干预措施成功地增加了对物质使用治疗的参与度,并减少了心理痛苦.
- 需要进一步的研究来开发能够增强护理和病毒抑制的干预措施,以解决这一群体中复杂的医疗和心理社会需求.
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