An invisible barrier to integrating HIV primary care with harm reduction services: Philosophical clashes between the harm reduction and medical models
An invisible barrier to integrating HIV primary care with harm reduction services: Philosophical clashes between the harm reduction and medical models
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DOI：
10.1177/003335490411900109
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发表时间：
2004-01-01
影响因子：
3.3
通讯作者：
Cunningham, C
中科院分区：
文献类型：
--
作者：
Heller, D;McCoy, K;Cunningham, C
近年来，美国的艾滋病死亡率总体上有所下降，但并非所有人口的下降都是一致的。由于在护理方面存在一系列障碍，少数群体和经常使用药物的穷人没有像其他人那样从艾滋病毒疾病治疗的进展中受益。解决这一问题的一种方法是将艾滋病毒初级保健纳入已经有效服务于这一人群的减少伤害计划。然而，这种合作很难启动和维持。医疗模式和减少伤害模式之间的哲学差异是造成这些困难的根本原因，而有关各方往往看不到这种差异。本文通过描述纽约州布朗克斯的CitiWide Harm Reduction Inc.（CitiWideHR）和Montefiore医疗中心。它特别关注模型之间的哲学差异的来源，并简要评估了这种成功合作的潜力。
Overall AIDS mortality in the United States has declined in recent years, but declines have not been consistent across all populations. Due to an array of barriers to care, minorities and poor people who are active substance users have not benefited as others have from advances in the treatment of HIV disease. One way to address this problem is to integrate HIV primary care into harm reduction programs that already effectively serve this population. Such collaborations, however, are difficult to initiate and sustain. Philosophical differences between the medical model and the harm reduction model, which often remain invisible to the parties involved, underlie these difficulties. This article addresses the issue by describing a partnership in the Bronx, NY, between CitiWide Harm Reduction Inc. (CitiWideHR) and the Montefiore Medical Center. It focuses specifically on the sources of philosophical differences between models, and briefly assesses the potential for successful collaborations of this sort.