An integrated supervised injecting program within a care facility for HIV-positive individuals: a qualitative evaluation
An integrated supervised injecting program within a care facility for HIV-positive individuals: a qualitative evaluation
复制标题
DOI：
10.1080/09540120802385645
复制
发表时间：
2009-01-01
影响因子：
1.7
通讯作者：
Kerr, Thomas
中科院分区：
文献类型：
--
作者：
Krusi, Andrea;Small, Will;Kerr, Thomas
虽然人们对艾滋病毒/艾滋病患者的综合治疗和护理模式越来越感兴趣，但很少有人注意监督注射方案在增加艾滋病毒阳性注射吸毒者获得预防和护理服务方面可能发挥的作用。我们进行了22个半结构化的采访，艾滋病毒阳性注射吸毒者的监督注射程序集成在一个艾滋病毒为重点的护理设施被称为彼得博士中心（DPC）。我们还采访了七名在该设施内监督注射的工作人员。所有访谈都进行了录音和逐字记录，并进行了专题分析。参与者和工作人员的报告表明，综合监督注射方案通过与工作人员建立更加开放和信任的关系，促进参与更安全的注射教育和改善注射相关感染的管理，影响了注射吸毒者获得护理的机会。参与者和工作人员认为，该计划通过调解过量风险，减少现场惩罚性管理药物使用的必要性，并减少在场所遇到使用过的注射器的风险，从而促进了护理的提供。然而，对于一些参与者来说，与他们的药物使用有关的羞耻感和对判断的恐惧限制了该计划的最初吸收。我们的研究结果确定了综合监督注射计划可能有助于更好地促进艾滋病毒阳性注射吸毒者获得和提供全面护理的机制，并强调了在综合医疗保健模式的背景下解决艾滋病毒阳性注射吸毒者吸毒问题的好处。
While there has been growing interest in comprehensive models of treatment and care for individuals living with HIV/AIDS, little attention has been given to the potential role that supervised injecting programs could play in increasing access to prevention and care services for HIV-positive injection drug users (IDU). We conducted 22 semi-structured interviews with HIV-positive IDU regarding a supervised injection program integrated in an HIV focused care facility known as the Dr. Peter Centre (DPC). We also interviewed seven staff members who supervise injections within the facility. All interviews were audio recorded, transcribed verbatim, and a thematic analysis was conducted. Participant and staff reports indicated that the integrated supervised injection program influenced IDUs' access to care by building more open and trusting relationships with staff, facilitating engagement in safer injection education and improving the management of injection-related infections. Participants and staff viewed the program as facilitating the delivery of care through mediating overdose risks, reducing the need to punitively manage drug use onsite and reducing the risks of encountering used syringes on the premises. For some participants, however, feelings of shame and fear of judgment in relation to their drug use limited initial uptake of the program. Our findings identify mechanisms through which integrated supervised injection programs may serve to better facilitate access and delivery of comprehensive care for HIV-positive IDU and highlight the benefits of addressing HIV-positive IDUs' drug use in the context of comprehensive models of healthcare.