Improving treatment adherence in drug abusers who are HIV-positive.
Improving treatment adherence in drug abusers who are HIV-positive.
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DOI：
10.1097/00129234-200011000-00006
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发表时间：
2000-11-01
期刊：
影响因子：
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通讯作者：
Osborne, J J
中科院分区：
文献类型：
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作者：
Malone, S B;Osborne, J J
这篇文章讨论了复杂的双重诊断艾滋病毒/艾滋病（人类免疫缺陷病毒/获得性免疫缺陷综合症）和药物滥用，这影响了越来越多的人在世界范围内。简要审查了艾滋病毒/艾滋病，并说明了艾滋病毒/艾滋病与药物滥用之间的联系。药物滥用使艾滋病毒/艾滋病及其管理复杂化，因为非法药物对各种身体系统产生影响，并且由于使用药物会引起行为紊乱。由于各种原因，该人群对治疗的依从性较差，并概述了对依从性产生负面影响的几个因素。治疗艾滋病毒阳性的药物滥用者比分别治疗药物滥用和艾滋病毒需要更大的灵活性。由于药物治疗方案可能复杂而苛刻，而且不坚持治疗可能导致病毒突变，从而产生耐药菌株，因此必须让患者承诺接受治疗。治疗的目标是戒除非法药物，坚持治疗方案，抑制病毒载量，改善CD4计数，改善生活质量。病例管理人员的作用对于提高治疗依从性至关重要。基本属性包括疾病过程的知识，批判性思维和导航医疗保健系统的能力。改善治疗依从性的病例管理干预措施应针对患者、治疗方案、客户-患者关系和医疗保健系统。由于艾滋病毒/艾滋病现在被列为一种慢性疾病，不再被视为死刑，艾滋病毒阳性的人有希望长寿和治愈。正是这种延长寿命和可能治愈的希望，可以用来激励感染艾滋病毒的药物滥用者改善他们的治疗依从性和生活质量。
This article discusses the complex dual diagnosis of HIV/AIDS (Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome) and substance abuse, which affects a growing number of individuals worldwide. A brief review of HIV/AIDS is provided and the connection between HIV/AIDS and substance abuse is described. Substance abuse complicates both HIV/AIDS and its management because of the effects that illicit drugs have on various body systems and because of the behavioral disturbances that accompany substance use. For a variety of reasons adherence to treatment is poor in this population and several factors that negatively impact adherence are outlined. Treatment of drug abusers who are HIV-positive requires more flexibility than treating drug abuse and HIV separately. Because medication regimens can be complicated and demanding and nonadherence to treatment can cause mutation of the virus resulting in drug-resistant strains, it is essential to get the patient committed to treatment The goals of treatment are abstinence from illicit drugs, adherence to a treatment regimen, suppression of viral load, improved CD4 count, and improved quality of life. The role of the case manager is critical to improving treatment adherence. Essential attributes include knowledge of disease processes, critical thinking, and the ability to navigate the healthcare system. Case management interventions to improve treatment adherence should be directed at the patient, the regimen, the client-patient relationship, and the healthcare system. Because HIV/AIDS is now classified as a chronic disease and is no longer viewed as a death sentence, people who are HIV-positive have hope for longevity and a cure. It is this hope for a longer life and possible cure that can be used to motivate substance abusers who are HIV-infected to improve their treatment adherence and quality of life.