Prevention of HIV infection among injection drug users in resource-limited settings.

Prevention of HIV infection among injection drug users in resource-limited settings.
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DOI:
10.1086/651482
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发表时间:
2010-05-15
期刊:
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子:
--
通讯作者:
Strathdee SA
Strathdee SA
中科院分区:
其他
文献类型:
--
作者:
Vlahov D;Robertson AM;Strathdee SA

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通过直接共用针头、注射器和其他注射设备,注射药物的使用导致了与人类免疫缺陷病毒(HIV)感染和艾滋病以及由血源性病原体引起的其他感染相关的相当大的全球发病率和死亡率。在全世界约1600万注射吸毒者中,估计有300万人感染了艾滋病毒。在亚洲和东欧许多国家,注射吸毒者的艾滋病毒感染率很高,可能加剧撒哈拉以南非洲的艾滋病毒流行。这篇综述总结了预防注射吸毒者感染艾滋病毒的综合规划的重要组成部分,包括通过针头交换计划和加强的药学服务,不受限制地合法获得无菌注射器,治疗阿片类药物依赖(即美沙酮和丁丙诺啡治疗),行为干预,以及识别和治疗非注射药物和酒精使用,这是艾滋病毒性传播增加的原因。证据表明,减少危害项目比惩罚性的毒品管制政策更有效。
Injection drug use contributes to considerable global morbidity and mortality associated with human immunodeficiency virus (HIV) infection and AIDS and other infections due to blood-borne pathogens through the direct sharing of needles, syringes, and other injection equipment. Of ~16 million injection drug users (IDUs) worldwide, an estimated 3 million are HIV infected. The prevalence of HIV infection among IDUs is high in many countries in Asia and eastern Europe and could exacerbate the HIV epidemic in sub- Saharan Africa. This review summarizes important components of a comprehensive program for prevention of HIV infection in IDUs, including unrestricted legal access to sterile syringes through needle exchange programs and enhanced pharmacy services, treatment for opioid dependence (i.e., methadone and buprenorphine treatment), behavioral interventions, and identification and treatment of noninjection drug and alcohol use, which accounts for increased sexual transmission of HIV. Evidence supports the effectiveness of harm-reduction programs over punitive drug-control policies.
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