The relationship between reincarceration and treatment of opioid use disorder with extended-release naltrexone among persons with HIV.
The relationship between reincarceration and treatment of opioid use disorder with extended-release naltrexone among persons with HIV.
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HIV 感染者的再监禁与缓释纳曲酮治疗阿片类药物使用障碍之间的关系。
DOI：
10.1016/j.dadr.2023.100159
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发表时间：
2023-06
期刊：
影响因子：
--
通讯作者：
Springer, Sandra A
中科院分区：
文献类型：
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作者：
Parchinski, Kaley;Di Paola, Angela;Wilson, Allison P;Springer, Sandra A
在美国，不成比例的艾滋病毒（PWH）和阿片类药物使用障碍（OUD）患者参与了司法系统。药物治疗OUD（MOUD）可以减少OUD患者的定罪和监禁时间。缓释纳洛酮（XR-NTX）已被证明可以减少阿片类药物的渴望，复发和过量使用，并有助于实现或维持与司法系统有关的OUD的PWH中的HIV病毒抑制。这项回顾性研究旨在描述与再监禁相关的因素，并评估XR-NTX是否与PWH和OUD从监禁中释放到社区的再监禁减少有关。使用广义线性模型分析从一项已完成的随机对照试验中释放到社区的参与者的数据，以估计与再监禁相关的比值比，并使用Kaplan-Meier生存分析确定再监禁和非再监禁个体的时间。在77名参与者中，41名（53.2%）在12个月的研究期间被重新监禁。平均再监禁时间为190天（SD=108.3）。与留在社区的参与者相比，重新监禁的参与者在研究基线时更有可能患有重度抑郁症，阿片类药物渴望增加，平均监禁时间更长，身体生活质量评分更高。在这项分析中，XR-NTX与再监禁在统计学上没有显著相关性。鉴于PWH和OUD在美国司法系统中的比例很高，以及由于重新监禁而返回社区并中断护理的人员比例很高，减少重新监禁是公共卫生的优先事项。这项分析确定，在最近释放的人中识别抑郁症可能会改善艾滋病毒的结果，减少阿片类药物使用的复发，并减少重新监禁。
In the United States, a disproportionate number of persons with HIV (PWH) and opioid use disorder (OUD) are involved in the justice system. Medications for OUD (MOUD) can reduce convictions and incarceration time in persons with OUD. Extended-release naltrexone (XR-NTX) has been shown to reduce craving of opioids, recurrence of use, and overdose and help achieve or maintain HIV viral suppression in PWH with OUD involved with the justice system. This retrospective study aimed to describe factors associated with reincarceration and to evaluate if XR-NTX was associated with reduced reincarceration among PWH and OUD who were released to the community from incarceration. Data from participants released to the community from incarceration from a completed randomized controlled trial was analyzed using a generalized linear model to estimate odds ratios associated with reincarceration and a Kaplan-Meier survival analysis to determine time to reincarceration and non-reincarcerated individuals were compared. Of the 77 participants, 41 (53.2%) were reincarcerated during the 12-month study period. The mean time to reincarceration was 190 days (SD=108.3). Compared with participants who remained in the community, reincarcerated participants were more likely to have major depressive disorder at study baseline, increased opioid cravings, longer mean lifetime incarceration, and a higher physical quality of life score. XR-NTX was not significantly associated statistically with reincarceration in this analysis. Reducing reincarceration is a public health priority, given the high proportion of PWH and OUD in the U.S. justice system as well as high degrees of persons returning to the community and having care interrupted due to reincarceration. This analysis determined that potentially identifying depression in recently released individuals could improve HIV outcomes, decrease recurrence of opioid use, and reduce reincarceration.