Integrating hepatitis C services into existing HIV services: the experiences of a sample of U.S. drug treatment units.
Integrating hepatitis C services into existing HIV services: the experiences of a sample of U.S. drug treatment units.
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将丙型肝炎服务纳入现有的艾滋病毒服务：美国戒毒治疗单位样本的经验。
DOI：
10.1089/apc.2005.19.78
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Hagan,Holly
中科院分区：
文献类型：
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作者：
Strauss,ShielaM;Astone,JanettaM;DesJarlais,DonC;Hagan,Holly
丙型肝炎病毒（HCV）是美国最普遍的血源性传染病，特别是在吸毒者中，与HIV合并感染是常见的。由于吸毒者往往得不到医疗服务，药物治疗单位是为这些传染病提供服务的重要场所。鉴于艾滋病毒和丙型肝炎病毒传播途径的共性，以及许多药物治疗单位已经建立了提供艾滋病毒服务的基础设施，一些人建议将丙型肝炎病毒服务纳入已经建立的艾滋病毒服务。本文利用对美国89个药物治疗单位的电话调查收集的数据，考察了药物治疗单位将艾滋病毒服务扩大到包括丙型肝炎病毒服务的程度，以及艾滋病毒服务的到位促进了这种扩大的程度。总体而言，美沙酮维持比无药物治疗单位提供艾滋病毒和丙型肝炎病毒服务的比例更高。在提供艾滋病毒和丙型肝炎相关服务的两种模式中，大多数单位扩大了艾滋病毒服务范围，包括类似的丙型肝炎服务，三分之一的单位扩大了所有艾滋病毒服务。然而，许多这些单位表示，拥有艾滋病毒服务基础设施并不能促进这种扩大，这往往是因为这些单位想强调两种病毒感染的差异。决策者和个别治疗单位需要制定利用现有基础设施的战略，同时保持艾滋病毒和丙型肝炎病毒一级和二级预防工作的区别。
Hepatitis C virus (HCV) is the most prevalent blood-borne infectious disease in the United States, especially among drug users, and coinfection with HIV is common. Because drug users are often medically underserved, drug treatment units are important sites of opportunity for providing services for these infectious diseases. Given the commonalities in the routes of transmission of HIV and HCV, and the fact that many drug treatment units have established an infrastructure to provide HIV services, some have suggested integrating HCV services into those already established for HIV. Using data collected in a telephone survey with 89 drug treatment units throughout the United States, this paper examines the extent to which drug treatment units have expanded their HIV services to include those for HCV, and the extent to which this expansion was facilitated by having HIV services in place. Overall, a greater proportion of methadone maintenance than drug-free treatment units provided services for HIV and HCV. The majority of units in both modalities that provided HIV- and HCV-related services expanded their HIV service delivery to include similar HCV services, and one third expanded all of their HIV services. A large number of these units, however, indicated that having an HIV service infrastructure did not facilitate this expansion, often because the units wanted to emphasize differences in the two viral infections. Policy makers and individual treatment units need to develop strategies that capitalize on existing infrastructures while maintaining the distinction between HIV and HCV primary and secondary prevention efforts.