Barriers to initiation of extended release naltrexone among HIV-infected adults with alcohol use disorders.
Barriers to initiation of extended release naltrexone among HIV-infected adults with alcohol use disorders.
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DOI：
10.1016/j.jsat.2017.05.004
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发表时间：
2018-03
影响因子：
3.9
通讯作者：
Glasner S
中科院分区：
文献类型：
--
作者：
Chokron Garneau H;Venegas A;Rawson R;Ray LA;Glasner S
饮酒是感染艾滋病毒/艾滋病的一个主要危险因素，与艾滋病毒感染者的疾病负担和死亡率增加有关。在酒精使用障碍的现有药物治疗中，纳洛酮被认为是最有效的药物之一，可显著减少酒精渴望和使用。鉴于口服纳洛酮治疗受到依从性问题的限制，这在患有多种慢性并发症的个体中特别普遍，长效制剂可能是艾滋病毒感染物质使用者的一种有前途的方法。然而，很少有人知道的障碍，开始延长释放纳洛酮（XR-NTX）治疗酒精使用者艾滋病毒感染者。在这份报告中，我们提出并讨论了开放式调查问题的内容分析，以及经验教训，关于开始和维持XR-NTX治疗的障碍，作为RCT的一部分，收集评估认知行为短信干预艾滋病毒感染的酒精使用障碍的成年人。在患有酒精使用障碍的HIV+个体中开始和维持XR-NTX药物治疗的障碍似乎属于以下两类之一：[1]可以改变的障碍，包括距离和交通问题，害怕注射，认为酒精使用不需要药物治疗，[2]不适合改变的障碍，例如XR-NTX与另一种药物方案的潜在相互作用。
Alcohol consumption is a major risk factor for the acquisition of HIV/AIDS and is associated with greater disease burden and mortality among those who become HIV-infected. Of the extant pharmacological treatments for alcohol use disorders, naltrexone is recognized as one of the most efficacious, producing robust reductions in alcohol craving and use. Given that treatment with oral naltrexone has been limited by problems with adherence, which are particularly prevalent among individuals with multiple chronic, co-occurring conditions, long-acting formulations may be a promising approach for HIV-infected substance users. However, little is known about the barriers to initiation of extended-release naltrexone (XR-NTX) treatment among alcohol users living with HIV. In this report we present and discuss the content analysis of open-ended survey questions, as well as lessons learned, with regards to barriers to initiation and maintenance of XR-NTX treatment collected as part of an RCT evaluating a cognitive behavioral text messaging intervention for HIV-infected adults with alcohol use disorders. Barriers to initiation and maintenance of XR-NTX pharmacotherapy among HIV+ individuals with alcohol use disorders seem to fall in one of two categories: [1] barriers that are amenable to change, which include distance and transportation issues, fear of injections, belief that alcohol use does not warrant pharmacotherapy, and [2[ barriers that are not amenable to change, such as the potential interaction of XR-NTX with another medication regimen.
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