Methamphetamine use, sexual activity, patient-provider communication, and medication adherence among HIV-infected patients in care, San Francisco 2004-2006
Methamphetamine use, sexual activity, patient-provider communication, and medication adherence among HIV-infected patients in care, San Francisco 2004-2006
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DOI：
10.1080/09540120802385579
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发表时间：
2009-01-01
影响因子：
1.7
通讯作者：
Klausner, Jeffrey D.
中科院分区：
文献类型：
--
作者：
Marquez, Carina;Mitchell, Samuel J.;Klausner, Jeffrey D.
虽然许多研究调查了未感染艾滋病毒的个体使用甲基苯丙胺和相关的危险性行为，但很少有研究调查了卫生保健环境中的艾滋病毒感染者。为了评估甲基苯丙胺的使用频率和趋势，性活动，注射毒品的使用，病人提供者的沟通，以及艾滋病毒感染者在护理中的药物依从性，我们在2004年和2006年进行了一页的匿名调查。这项调查是在加州大学旧金山分校弗朗西斯科的两个艾滋病毒门诊诊所进行的：莫菲特医院（Moffitt），主要为私人保险的患者提供服务，以及旧金山弗朗西斯科综合医院（SFGH），一家县级医院，主要为未投保或公共保险的患者提供服务。2006年，39%的男男性行为者（MSM）、33%的异性恋男性和11%的女性报告在过去12个月内使用过甲基苯丙胺。甲基苯丙胺的使用与男男性行为者和异性恋男性中性伴侣数量的增加以及抗逆转录病毒药物治疗依从性差显著相关。在MSM中，甲基苯丙胺的使用在SFGH诊所更常见。2004年至2006年期间，Moffitt的MSM中报告的过去12个月甲基苯丙胺使用量下降（38%至20%，p 0.01），但SFGH增加（40%至50%，p 0.05）。在甲基苯丙胺使用者中，我们发现注射甲基苯丙胺的频率很高，在SFGH从38%增加到55%，p 0.05。从2004年到2006年，患者与提供者之间关于甲基苯丙胺使用的沟通有所增加，但没有发现提供者询问患者性活动的显著变化。总体而言，我们发现甲基苯丙胺的使用在接受护理的艾滋病毒感染患者中很常见，并且与性伴侣数量增加，注射药物使用频率高以及抗逆转录病毒药物依从性差有关。这些发现支持需要改进筛查和基于临床的干预措施，以减少和治疗甲基苯丙胺滥用和相关的高风险性行为。
While numerous studies examine methamphetamine use and associated risky sexual behaviors in HIV-uninfected individuals, few studies have surveyed HIV-infected individuals in the health care setting. To assess the frequency and trends of methamphetamine use, sexual activity, injection drug use, patient-provider communication, and medication adherence among HIV-infected persons in care, we administered a one-page anonymous survey in 2004 and 2006. The survey was conducted at the two University of California, San Francisco outpatient HIV clinics: at Moffitt Hospital (Moffitt), serving primarily privately insured patients, and at San Francisco General Hospital (SFGH), a county hospital serving primarily patients who are uninsured or publicly insured. In 2006, 39% of men who have sex with men (MSM), 33% of heterosexual men, and 11% of women reported methamphetamine use in the prior 12 months. Methamphetamine use was significantly associated with an increased number of sex partners among MSM and heterosexual men, and poor anti-retroviral medication adherence. Among MSM, methamphetamine use was more common at the SFGH clinic. Between 2004 and 2006, reported methamphetamine use in the last 12 months decreased among MSM at Moffitt (38 to 20%, p0.01), but increased at SFGH (40 to 50%, p0.05). Among methamphetamine users we found a high frequency of injection of methamphetamine, which increased at SFGH from 38 to 55%, p0.05. Patient-provider communication regarding methamphetamine use has increased from 2004 to 2006 but no significant change has been found for providers asking patients about sexual activity. Overall, we found methamphetamine use to be common among HIV-infected patients in care, and associated with an increased number of sex partners, a high frequency of injection drug use, and poor adherence to anti-retroviral medications. These findings support the need for improved screening and clinic-based interventions to reduce and treat methamphetamine abuse and associated high risk sexual behaviors.