Substance Abuse Treatment in Persons withHIV/AIDS: Challenges in Managing Triple Diagnosis
Substance Abuse Treatment in Persons withHIV/AIDS: Challenges in Managing Triple Diagnosis
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DOI：
10.1080/08964289.2013.866540
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发表时间：
2014-04-03
影响因子：
2.3
通讯作者：
Miller, Theodore R.
中科院分区：
文献类型：
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作者：
Durvasula, Ramani;Miller, Theodore R.
HIV 的临床管理必须考虑到 HIV 的“三重诊断”、精神诊断和物质使用障碍，并且需要综合治疗服务，其重点不仅仅是缓解物质使用以及精神和医学症状，还应解决其他健康行为。由于随着 20 世纪 90 年代中期高效抗逆转录病毒疗法 (HAART) 的出现，艾滋病毒/艾滋病的临床管理发生了显着变化，因此我们利用广泛的文献检索数据库对 2000 年以来发表的文献进行了文献综述，并使用相关关键词进行了文献综述。本文献综述得到了研究的补充，以扩展具体的治疗方式（目前缺乏针对艾滋病毒感染人群的文献），并就药物滥用治疗作为艾滋病毒预防工具的问题进行讨论。现有的药物滥用治疗模式，包括认知行为疗法和动机访谈，已被证明有助于提高门诊患者的依从性和减少药物使用，而美沙酮维持治疗和直接观察治疗对于特定的使用者亚组是有用的。服务的情境化提高了成功结果和预防复发的可能性。
Clinical management of HIV must account for the "triple diagnosis" of HIV, psychiatric diagnosis, and substance use disorders and requires integrated treatment services that focus beyond just mitigation of substance use and psychiatric and medical symptoms but also address other health behaviors. Because clinical management of HIV/AIDS has shifted significantly with the advent of highly active antiretroviral therapies (HAART) in the mid 1990s, a literature review focusing on literature published since 2000, and using relevant key words was conducted using a wide range of literature search databases. This literature review was complemented by studies to expand on specific treatment modalities for which there was a dearth of literature addressing HIV infected cohorts and to provide discussion of issues around substance abuse treatment as an HIV prevention tool. Existing models of substance abuse treatment including cognitive behavioral therapy and motivational interviewing have proven to be useful for enhancing adherence and reducing substance use in outpatient populations, while methadone maintenance and directly observed treatment have been useful with specific subgroups of users. Contextualization of services heightens the likelihood of successful outcomes and relapse prevention.