Hospitalization is a missed opportunity for HIV screening, pre-exposure prophylaxis, and treatment.

IF 3.7 2区医学 Q1 SUBSTANCE ABUSE Addiction Science & Clinical Practice Pub Date : 2024-03-26 DOI:10.1186/s13722-024-00451-z

William Bradford, Hana Akselrod, John Bassler, Kelly W Gagnon, Greer Burkholder, Joseph Edward Carpenter, Alaina Steck, Jillian Catalanotti, Irene Kuo, Keanan McGonigle, William Mai, Melissa Notis, Christopher Brokus, Sarah Kattakuzhy, Elana Rosenthal, Ellen F Eaton

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Abstract

Background: Hospitalization is a "reachable moment" for people who inject drugs (PWID), but preventive care including HIV testing, prevention and treatment is rarely offered within inpatient settings.

Methods: We conducted a multisite, retrospective cohort study of patients with opioid use disorder with infectious complications of injection drug use hospitalized between 1/1/2018-12/31/2018. We evaluated HIV care continuum outcomes using descriptive statistics and hypothesis tests for intergroup differences.

Results: 322 patients were included. Of 300 patients without known HIV, only 2 had a documented discussion of PrEP, while only 1 was prescribed PrEP on discharge. Among the 22 people with HIV (PWH), only 13 (59%) had a viral load collected during admission of whom all were viremic and 10 (45%) were successfully linked to care post-discharge. Rates of readmission, Medicaid or uninsured status, and unstable housing were high in both groups.

Discussion: We observed poor provision of HIV testing, PrEP and other HIV services for hospitalized PWID across multiple U.S. medical centers. Future initiatives should focus on providing this group with comprehensive HIV testing and treatment services through a status neutral approach.

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住院治疗会错过 HIV 筛查、接触前预防和治疗的机会。

背景：对于注射吸毒者（PWID）来说，住院是 "触手可及的时刻"：对于注射吸毒者（PWID）来说，住院是一个 "触手可及的时刻"，但包括 HIV 检测、预防和治疗在内的预防性护理很少在住院环境中提供：我们对 2018 年 1 月 1 日至 2018 年 12 月 31 日期间住院的因注射毒品而感染并发症的阿片类药物使用障碍患者进行了一项多站点回顾性队列研究。我们使用描述性统计和组间差异假设检验评估了艾滋病护理的连续性结果：共纳入 322 名患者。在 300 名不知晓艾滋病毒的患者中，只有 2 人有关于 PrEP 的讨论记录，而只有 1 人在出院时获得了 PrEP 处方。在 22 名艾滋病病毒感染者（PWH）中，只有 13 人（59%）在入院时采集了病毒载量，其中所有人都是病毒携带者，10 人（45%）在出院后成功接受了护理。两组患者的再入院率、医疗补助或无保险状况以及住房不稳定的比例都很高：讨论：我们观察到，美国多家医疗中心为住院的吸毒者提供的 HIV 检测、PrEP 和其他 HIV 服务并不完善。未来的工作重点应该是通过一种中立的方式为这一群体提供全面的 HIV 检测和治疗服务。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction Science & Clinical Practice Psychology-Clinical Psychology

CiteScore

3.90

自引率

10.80%

发文量

审稿时长

28 weeks

期刊介绍： Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings. Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use. Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations. Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.