AIDS and intravenous drug use in San Francisco.
AIDS and intravenous drug use in San Francisco.
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旧金山的艾滋病和静脉注射毒品。
DOI：
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发表时间：
1988
期刊：
影响因子：
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通讯作者：
Chaisson Re
中科院分区：
文献类型：
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作者：
Mossadeq Ar;Chaisson Re
1985年，旧金山弗朗西斯科总医院的获得性免疫缺陷综合症（艾滋病）流行病学小组发起了一项检测和转移方案，旨在阻止人体免疫缺陷病毒（艾滋病毒）在静脉注射吸毒者中的传播。据估计，旧金山静脉吸毒者的艾滋病毒血清阳性率为13%，30多岁的黑人男性风险最高。根据在同性恋群体中观察到的威慑作用，即通知危险群体成员其血清反应呈阳性，决定也将艾滋病毒抗体检测作为吸毒者的公共卫生工具。治疗旧金山大多数吸毒者的美沙酮和戒毒方案得到了合作，并在每个方案和街道上进行了定期现场检查。通过这一程序查明的血清阳性者被转入特别治疗方案，包括安全性行为和药物设备、教育、通知性伴侣以及转介社会服务和治疗资源。在该方案实施3年后，75%的吸毒者向医院报告了抗体检测结果，80%的血清阳性者同意参加临床跟踪方案。尽管近年来在药物治疗项目中发现血清阳性的总体比率有所减缓，但在旧金山弗朗西斯科黑人中，这一比率实际上有所上升，从1985年的15%上升到1987年的35%。总的来说，这个加州筛查项目的经验提出了几个指导原则：1）筛查应该是匿名和保密的; 2）受试者应该面对面地得到他们的抗体测试结果; 3）结果应该从治疗项目中公布，没有通知的威胁; 4）成瘾治疗和临床随访的转介应该对所有血清阳性者有效;（5）应提供小额费用或至少报销费用。
The Acquired Immunodeficiency Syndrome (AIDS) Epidemiology Group at San Francisco General hospital launched a testing and diversion program in 1985 aimed at halting the spread of human immunodeficiency virus (HIV) among intravenous drug abusers. The HIV seropositivity rate among San Franciscos intravenous drug users is estimated at 13% with the highest risk among Black men in their 30s. Based on the deterrent effect observed in the gay community of notifying risk group members of their seropositive status it was decided to use the HIV antibody test as a public health tool among drug users as well. The cooperation of the methadone and detoxification programs that treat the majority of San Franciscos drug addicts was gained and periodic screenings were held on site in each program and on the streets. Seropositives who are identified through this process are diverted into special treatment programs encompassing safe sex and drug equipment education notification of sexual partners and referrals to social services and treatment resources. 75% of the drug addicts tested in the programs 3 years of operation have reported to the hospital to receive the results of their antibody test and 80% of the seropositives identified have agreed to enter a clinical follow-up program. Although there as been some slowing of the overall rate at which seropositives have been detected in drug treatment programs in recent years this rate actually increased among San Francisco blacks--from 15% in 1985 to 35% in 1987. Overall the experience of this California screening program suggests several guidelines: 1) screening should be anonymous and confidential; 2) subjects should be given their antibody test results face to face; 3) results should be given away from the treatment program with no threat of notification; 4) referral for addiction treatment and clinical follow-up should be available to all seropositives; and 5) a small fee or at least expense reimbursement should be provided for visits.