Post-exposure prophylaxis use and recurrent exposure to HIV among men who have sex with men who use crystal methamphetamine
Post-exposure prophylaxis use and recurrent exposure to HIV among men who have sex with men who use crystal methamphetamine
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DOI：
10.1016/j.drugalcdep.2014.11.010
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发表时间：
2015-01-01
影响因子：
4.2
通讯作者：
Mimiaga, Matthew J.
中科院分区：
文献类型：
--
作者：
Oldenburg, Catherine E.;Jain, Sachin;Mimiaga, Matthew J.
背景：男男性行为者（MSM）谁使用aystal甲基苯丙胺（CM）是在艾滋病毒感染的风险增加。暴露后预防（PEP）是一个有用的艾滋病毒预防策略，如果个人能够识别高风险的暴露，并寻求及时的护理，但迄今为止，有有限的数据使用PEP CM users.Methods：A：回顾性队列研究的所有PEP处方（N = 1130处方788男男性行为者）在芬威社区卫生在波士顿，MA进行。使用多变量模型评估暴露期间使用CM与（7.4%在接触期间使用CM）和长期使用（7.4%的MSM是慢性CM使用者）和至少使用一次PEP的MSM的个人水平和事件水平结果。与那些没有使用CM的人相比，使用CM的MSM PEP用户更频繁地返回重复PEP（aOR 5.13，95% CI 2.82至9.34），并且在随访期间更有可能发生血清转化（aHR 3.61，95% CI 1.51至8.60）。使用CM的男男性行为者增加了无保护的肛交作为暴露源的几率（aOR 2.12，95%CI 1.16 ~ 3.87）和知道其伴侣是HIV感染者（aOR 2.27，95%CI 1.42至3.64）。结论：虽然使用CM的MSM一般在获得ART方面可能存在挑战，这些数据突出表明，那些能够获得PEP的人随后仍然面临艾滋病毒血清转化的风险增加。咨询和/或PEP过程中的物质使用干预应考虑CM使用MSM。(C)2014爱思唯尔爱尔兰有限公司版权所有。
Background: Men who have sex with men (MSM) who use aystal methamphetamine (CM) are at increased risk for HIV infection. Post-exposure prophylaxis (PEP) is a useful HIV prevention strategy if individuals are able to identify high-risk exposures and seek timely care, however to date there has been limited data on the use of PEP by CM users.Methods: A: Retrospective cohort study of all PEP prescriptions (N = 1130 prescriptions among 788 MSM) at Fenway Community Health in Boston, MA was undertaken. Multivariable models were used to assess the association between CM use during exposure (7.4% used CM during exposure) and chronically (7.4% of MSM were chronic CM users) and individual-level and event-level outcomes among MSM who used PEP at least once.Results: Compared to those who had not used CM, MSM PEP users who used CM more frequently returned for repeat PEP (aOR 5.13, 95% CI 2.82 to 9.34) and were significantly more likely to seroconvert over the follow-up period (aHR 3.61, 95% CI 1.51 to 8.60). MSM who used CM had increased odds of unprotected anal intercourse as the source of exposure (aOR 2.12,95% CI 1.16 to 3.87) and knowing that their partner was HIV infected (aOR 2.27,95% CI 1.42 to 3.64).Conclusions: While MSM who use CM may have challenges accessing ART in general, these data highlight the fact that those who were able to access PEP subsequently remained at increased risk of HIV seroconversion. Counseling and/or substance use interventions during the PEP course should be considered for CM-using MSM. (C) 2014 Elsevier Ireland Ltd. All rights reserved.