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首页> 外文期刊>The International journal of drug policy >An international perspective on using opioid substitution treatment to improve hepatitis C prevention and care for people who inject drugs: Structural barriers and public health potential
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An international perspective on using opioid substitution treatment to improve hepatitis C prevention and care for people who inject drugs: Structural barriers and public health potential

机译：关于使用阿片类药物替代疗法改善丙型肝炎预防和注射毒品者的国际观点：结构性障碍和公共卫生潜力

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People who inject drugs (PWID) are central to the hepatitis C virus (HCV) epidemic. Opioid substitution treatment COST) of opioid dependence has the potential to play a significant role in the public health response to HCV by serving as an HCV prevention intervention, by treating non-injection opioid dependent people who might otherwise transition to non-sterile drug injection, and by serving as a platform to engage HCV infected PWID in the HCV care continuum and link them to HCV treatment. This paper examines programmatic, structural and policy considerations for using OST as a platform to improve the HCV prevention and care continuum in 3 countries-the United States, Estonia and Viet Nam. In each country a range of interconnected factors affects the use OST as a component of HCV control. These factors include (1) that OST is not yet provided on the scale needed to adequately address illicit opioid dependence, (2) inconsistent use of OST as a platform for HCV services, (3) high costs of HCV treatment and health insurance policies that affect access to both OST and HCV treatment, and (4) the stigmatization of drug use. We see the following as important for controlling HCV transmission among PWID: (1) maintaining current HIV prevention efforts, (2) expanding efforts to reduce the stigmatization of drug use, (3) expanding use of OST as part of a coordinated public health approach to opioid dependence, HIV prevention, and HCV control efforts, (4) reductions in HCV treatment costs and expanded health system coverage to allow population level HCV treatment as prevention and OST as needed. The global expansion of OST and use of OST as a platform for HCV services should be feasible next steps in the public health response to the HCV epidemic, and is likely to be critical to efforts to eliminate or eradicate HCV. (C) 2015 Elsevier B.V. All rights reserved.
机译：注射毒品（PWID）的人是丙型肝炎病毒（HCV）流行的中心。阿片类药物依赖的阿片类药物替代治疗（COST）可能通过作为HCV预防干预措施，治疗非注射类阿片类药物依赖者而可能在其他方面转变为非无菌药物注射，从而在对HCV的公共卫生反应中发挥重要作用，并通过一个平台将HCV感染的PWID纳入HCV护理连续体，并将其与HCV治疗联系起来。本文研究了在美国，爱沙尼亚和越南这3个国家中使用OST作为改善HCV预防和护理连续性的平台的计划，结构和政策因素。在每个国家/地区，一系列相互联系的因素都会影响将OST用作HCV控制的组成部分。这些因素包括：（1）尚未以充分解决非法阿片类药物依赖所需的规模提供OST;（2）不一致将OST用作HCV服务的平台;（3）HCV治疗和医疗保险政策的高成​​本影响获得OST和HCV治疗的机会，以及（4）滥用药物。我们认为以下内容对于控制PWID之间的HCV传播很重要：（1）维持当前的艾滋病毒预防工作;（2）扩大努力以减少对药物使用的污名化;（3）扩大OST的使用作为协调公共卫生方法的一部分关于阿片类药物依赖，HIV预防和HCV控制的努力，（4）降低HCV治疗成本并扩大卫生系统的覆盖范围，以使人群水平的HCV治疗成为预防和必要的OST。 OST的全球扩展以及将OST用作HCV服务的平台应该是应对HCV流行的公共卫生措施中可行的下一步措施，并且对于消除或消除HCV可能至关重要。 （C）2015 Elsevier B.V.保留所有权利。

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