Sexually Transmitted and Blood-borne Infections Among Patients Presenting to a Low-barrier Substance Use Disorder Medication Clinic.
Sexually Transmitted and Blood-borne Infections Among Patients Presenting to a Low-barrier Substance Use Disorder Medication Clinic.
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DOI：
10.1097/adm.0000000000000801
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发表时间：
2021-11-01
影响因子：
5.5
通讯作者：
Walley AY
中科院分区：
文献类型：
--
作者：
Harvey L;Taylor JL;Assoumou SA;Kehoe J;Schechter-Perkins EM;Bernstein E;Walley AY
通过描述人类免疫缺陷病毒(HIV)、乙型和丙型肝炎病毒(乙肝病毒、丙型肝炎病毒)、梅毒、淋病和衣原体的比例，并确定治疗率和/或与护理的联系，研究在低障碍获取计划(LBAP)启动护理的药物使用障碍患者的感染相关需求。我们回顾了在实施标准化摄取实验室小组(2017年1月1日至2017年9月30日)后的前9个月内，在马萨诸塞州波士顿的LBAP完成入院探视的患者的记录。在开始治疗的393名患者中，84.7%(n=333)完成了至少一次筛查测试。HIV(9/393，2.3%)、现在或过去的丙型肝炎(151/393，38.4%)和慢性乙肝(2/393，0.5%)的基线感染率较高。通过筛查发现了61例新的活动性感染，包括1例HIV，3例梅毒，4例淋病，3例衣原体，1例慢性和1例急性乙肝，以及48例病毒型丙型肝炎。许多患者对乙肝病毒(102/270，37.8%)和甲型肝炎病毒(112/255，43.9%)无免疫反应。在新诊断的病例中，88%的细菌感染得到了治疗，0/1艾滋病毒、2/2乙肝病毒(100.0%)和16/48丙型肝炎病毒(33.3%)病例发生了连锁。在LBAP启动SUD护理的患者有大量的、未得到满足的感染相关需求。结果证明，在LBAP中纳入了全面的感染预防、筛查和联动治疗方案。
To study the infection-related needs of patients with substance use disorders initiating care at a low-barrier-to-access program (LBAP) by describing the proportion with human immunodeficiency virus (HIV), hepatitis B and C virus (HBV, HCV), syphilis, gonorrhea, and chlamydia and determining rates of treatment and/or linkage to care. We reviewed the records of patients who completed an intake visit at an LBAP in Boston, MA during the first 9 months after implementation of a standardized intake laboratory panel (1/1/2017-9/30/2017). Among 393 patients initiating care, 84.7% (n=333) completed at least one screening test. Baseline rates of HIV (9/393, 2.3%), current or past HCV (151/393, 38.4%), and chronic HBV (2/393, 0.5%) were high. Sixty-one new, active infections were identified through screening, including 1 HIV, 3 syphilis, 4 gonorrhea, 3 chlamydia, 1 chronic and 1 acute HBV, and 48 cases of viremic HCV. Many patients were non-immune to HBV (102/270, 37.8%) and HAV (112/255, 43.9%). Among new diagnoses, treatment was documented in 88% of bacterial infections and linkage occurred in 0/1 HIV, 2/2 HBV (100.0%), and 16 /48 HCV (33.3%) cases. Patients initiating SUD care at an LBAP have substantial, unmet infection-related needs. Results justify the inclusion of comprehensive infection prevention, screening, and linkage-to-treatment protocols in LBAPs.