HIV, substance use, and mental health care in prisons.
HIV, substance use, and mental health care in prisons.
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DOI：
10.1016/s2215-0366(22)00243-7
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发表时间：
2022-09
影响因子：
64.3
通讯作者：
Altice, Frederick L.
中科院分区：
文献类型：
--
作者：
Fazel, Seena;Bromberg, Daniel J.;Altice, Frederick L.
监禁、精神病和药物使用障碍以及传染病形成了一种综合流行病。1也就是说，刑事司法系统聚集了已经存在严重健康问题的人，并使其恶化。被监禁者的传染病发病率比普通人群高得多：艾滋病毒感染率高出6倍，丙型肝炎病毒感染率高出8倍，B肝炎病毒感染率高出2倍。[2]在低收入和中等收入国家（LMIC）被监禁的人中，精神障碍的患病率是普通人群的近16倍，重度抑郁症的患病率是普通人群的6倍。3精神障碍和药物使用障碍之间的共病已成为监狱中人面临的一个关键挑战，患有严重精神障碍的人中有一半患有共病的药物使用障碍。4此外，艾滋病毒和精神疾病可能有很高的并发率，特别是在监狱环境中。艾滋病、精神疾病和监狱环境可能相互作用，加剧与健康相关的结果，包括接受和坚持治疗。除美国外，监禁率最高的50个国家是中低收入国家，这些国家的监禁人口占全球的三分之二。低收入和中等收入国家的监狱也有很高的药物使用障碍流行率，3大约一半的被监禁者使用或注射药物，主要是类阿片。
Incarceration, psychiatric and substance-use disorders, and infectious diseases form a syndemic. 1 That is, criminal justice systems gather people with preexisting, serious health problems and exacerbate them. People who are incarcerated have much higher rates of infectious diseases than the general population: six-times higher for HIV, eight-times for hepatitis C virus, and two-times for hepatitis B virus. 2 People who are incarcerated in low-income and middleincome countries (LMICs) have nearly 16-times the prevalence of psychotic disorders, and up to six-times that of major depression, than the general population. 3 Comorbidity between psychiatric and substanceuse disorders has emerged as a key challenge among people in prison, with half of those with severe psychiatric disorders having a co-occurring substanceuse disorder. 4 In addition, HIV and psychiatric disorders can have high rates of co-occurrence, especially in prison settings. HIV, psychiatric disorders, and a prison environment probably interact to exacerbate health-related outcomes, including acceptance of and adherence to treatment.Aside from the USA, the 50 countries with the highest incarceration rates are LMICs, and together have twothirds of the global incarcerated population. Prisons in LMICs also have high prevalence of substanceuse disorders3 and around half of people who are incarcerated use or inject drugs, mostly opioids.