Promoting HIV care continuum outcomes among people who use drugs and alcohol: a systematic review of randomized trials evaluating behavioral HIV care interventions published from 2011 to 2023.
Promoting HIV care continuum outcomes among people who use drugs and alcohol: a systematic review of randomized trials evaluating behavioral HIV care interventions published from 2011 to 2023.
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DOI：
10.1186/s12889-023-17113-5
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发表时间：
2023-11-07
影响因子：
4.5
通讯作者：
Baker DA
中科院分区：
文献类型：
--
作者：
Pitpitan EV;Wiginton JM;Bejarano-Romero R;Baker DA
物质使用仍然是艾滋病毒感染的有力预测因素，并严重阻碍艾滋病毒携带者的艾滋病毒护理持续进展。这项系统性审查的主要研究问题集中在了解行为艾滋病毒护理干预措施在多大程度上有效地帮助了艾滋病毒携带者和使用艾滋病毒护理连续体系中的物质的人。使用PubMed和ProQuest数据库，我们对2011年至2023年8月发表的自治疗即预防时代开始以来在使用药物的人中进行的行为艾滋病毒护理连续干预的随机试验进行了系统回顾。我们确定了11项研究(总参与者：N = 5635)，其中10项故意针对使用药物的人群。四项研究涉及使用 ≥ 1物质(例如酒精、阿片类药物、兴奋剂、大麻)的样本；四项涉及注射吸毒；一项涉及甲基苯丙胺使用；一项涉及酒精使用。一项研究以偶然使用药物的人群为目标(即，大多数参与者报告的酒精、注射药物使用、非注射药物使用)。每项研究定义了一个或多个感兴趣的艾滋病毒护理结果。病毒抑制是9/11研究的目标结果，其次是抗逆转录病毒治疗(ART；7/11)，ART依从性(6/11)，保留在护理中(5/11)，以及与护理的联系(3/11)。虽然大多数(9项)研究发现至少对一种艾滋病毒护理结果有显著影响，但研究结果大多喜忧参半。最低限度地检查了中介效应(2/11)和缓和效应(2/11)。这项系统审查的结果表明，关于以前的艾滋病毒护理干预措施改善使用物质者的艾滋病毒护理连续结果的有效性，结果喜忧参半。然而，研究组成部分的异质性(例如，使用/评估的物质的多样性、自我报告与客观措施、自然减员)阻碍了关于特定物质使用人群对艾滋病毒护理干预的适应性的广泛推断或结论。需要更协调、更全面和更有针对性的努力，以促进和理清干预对药物使用人群中艾滋病毒护理连续结果的影响。
Substance use remains a robust predictor of HIV infection and a serious impediment to HIV care continuum progression for people living with HIV. The primary research question of this systematic review is focused on understanding the extent to which behavioral HIV care interventions have been efficacious in helping people who live with HIV and who use substances along the HIV care continuum. Using PubMed and ProQuest databases, we performed a systematic review of randomized trials of behavioral HIV care continuum interventions among people who use substances published from 2011 to August 2023, since the beginning of the treatment-as-prevention era. We identified 11 studies (total participants: N = 5635), ten intentionally targeting substance-using populations. Four studies involved samples using ≥ 1 substance (e.g., alcohol, opioids, stimulants, marijuana); four involved injection drug use; one involved methamphetamine use; and one involved alcohol use. One study targeted a population with incidental substance use (i.e., alcohol, injection drug use, non-injection drug use reported in most participants). Each study defined one or more HIV care outcomes of interest. Viral suppression was an outcome targeted in 9/11 studies, followed by uptake of antiretroviral therapy (ART; 7/11), ART adherence (6/11), retention in care (5/11), and linkage to care (3/11). While most (nine) of the studies found significant effects on at least one HIV care outcome, findings were mostly mixed. Mediated (2/11) and moderated (2/11) effects were minimally examined. The results from this systematic review demonstrate mixed findings concerning the efficacy of previous HIV care interventions to improve HIV care continuum outcomes among people who use substances. However, heterogeneity of study components (e.g., diversity of substances used/assessed, self-report vs. objective measures, attrition) prevent broad deductions or conclusions about the amenability of specific substance-using populations to HIV care intervention. More coordinated, comprehensive, and targeted efforts are needed to promote and disentangle intervention effects on HIV care continuum outcomes among substance-using populations.
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影响因子：
1.7
作者：
Sullivan PS;Taussig J;Valentine-Graves M;Luisi N;Del Rio C;Guest JL;Jones J;Millett G;Rosenberg ES;Stephenson R;Kelley C
通讯作者：
Kelley C
DOI：
10.1097/qai.0000000000001242
发表时间：
2017-02-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Colasanti J;Stahl N;Farber EW;Del Rio C;Armstrong WS
通讯作者：
Armstrong WS
在过渡，低收入国家注射药物的人中遵守抗逆转录病毒药物：国际系统审查。
影响因子：
4.4
作者：
Feelemyer, Jonathan;Des Jarlais, Don;Arasteh, Kamyar;Uuskula, Anneli
通讯作者：
Uuskula, Anneli
影响因子：
4.2
作者：
Azar, Marwan M.;Springer, Sandra A.;Meyer, Jaimie P.;Altice, Frederick L.
通讯作者：
Altice, Frederick L.
影响因子：
4.1
作者：
El-Bassel N;Shaw SA;Dasgupta A;Strathdee SA
通讯作者：
Strathdee SA