Why the Treatment of Mental Disorders Is an Important Component of HIV Prevention among People Who Inject Drugs.
Why the Treatment of Mental Disorders Is an Important Component of HIV Prevention among People Who Inject Drugs.
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DOI：
10.1155/2013/690386
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发表时间：
2013
影响因子：
--
通讯作者：
Cournos F
中科院分区：
文献类型：
--
作者：
Buckingham E;Schrage E;Cournos F
注射吸毒者比一般人更有可能是艾滋病毒阳性和精神失常。我们探讨如何检测和治疗注射毒品的人中的精神疾病是至关重要的，在这一人群中的艾滋病毒感染的初级和二级预防。除了阿片类药物成瘾之外，很少有关于精神障碍和注射毒品使用之间联系的研究。然而，独立于注射吸毒文献，越来越多的研究表明，未经治疗的精神疾病，特别是抑郁症和酒精/物质使用障碍，与艾滋病毒相关的风险行为，获得艾滋病毒感染，未能获得艾滋病毒护理和治疗，未能坚持艾滋病毒护理和治疗，以及艾滋病毒相关疾病和合并症的发病率和死亡率增加有关。在我们对已发表的文献和灰色文献的回顾中，我们发现缺乏关于为阿片类药物成瘾和其他精神疾病提供护理的模式的信息，无论艾滋病毒状况如何，特别是在低收入和中等收入国家。因此，我们就如何解决注射毒品的艾滋病毒阳性者的心理健康需求提出建议，其中包括提供阿片类药物替代疗法和综合心理健康，药物滥用和艾滋病毒服务。
People who inject drugs are more likely to be HIV positive and to have a mental disorder than the general population. We explore how the detection and treatment of mental illness among people who are injecting drugs are essential to primary and secondary prevention of HIV infection in this population. Aside from opioid addiction, few studies have been conducted on the links between mental disorders and injection-drug use. However, independent of the injection-drug use literature, a growing number of studies demonstrate that untreated mental illness, especially depression and alcohol/substance use disorders, is associated with HIV-related risk behaviors, acquiring HIV infection, failure to access HIV care and treatment, failure to adhere to HIV care and treatment, and increased morbidity and mortality from HIV-related diseases and comorbidities. In our review of both the published literature and gray literature we found a dearth of information on models for providing care for both opioid addiction and other mental illnesses regardless of HIV status, particularly in low- and middle-income countries. We therefore make recommendations on how to address the mental health needs of HIV-positive people who inject drugs, which include the provision of opioid substitution therapy and integrated mental health, substance abuse, and HIV services.