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首页> 外文期刊>The Lancet >HIV prevention, treatment, and care services for people who inject drugs: a systematic review of global, regional, and national coverage.
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HIV prevention, treatment, and care services for people who inject drugs: a systematic review of global, regional, and national coverage.

机译：为注射毒品者提供的艾滋病毒预防，治疗和护理服务：对全球，区域和国家覆盖率的系统评价。

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BACKGROUND: Previous reviews have examined the existence of HIV prevention, treatment, and care services for injecting drug users (IDUs) worldwide, but they did not quantify the scale of coverage. We undertook a systematic review to estimate national, regional, and global coverage of HIV services in IDUs. METHODS: We did a systematic search of peer-reviewed (Medline, BioMed Central), internet, and grey-literature databases for data published in 2004 or later. A multistage process of data requests and verification was undertaken, involving UN agencies and national experts. National data were obtained for the extent of provision of the following core interventions for IDUs: needle and syringe programmes (NSPs), opioid substitution therapy (OST) and other drug treatment, HIV testing and counselling, antiretroviral therapy (ART), and condom programmes. We calculated national, regional, and global coverage of NSPs, OST, and ART on the basis of available estimates of IDU population sizes. FINDINGS: By 2009, NSPs had been implemented in 82 countries and OST in 70 countries; both interventions were available in 66 countries. Regional and national coverage varied substantially. Australasia (202 needle-syringes per IDU per year) had by far the greatest rate of needle-syringe distribution; Latin America and the Caribbean (0.3 needle-syringes per IDU per year), Middle East and north Africa (0.5 needle-syringes per IDU per year), and sub-Saharan Africa (0.1 needle-syringes per IDU per year) had the lowest rates. OST coverage varied from less than or equal to one recipient per 100 IDUs in central Asia, Latin America, and sub-Saharan Africa, to very high levels in western Europe (61 recipients per 100 IDUs). The number of IDUs receiving ART varied from less than one per 100 HIV-positive IDUs (Chile, Kenya, Pakistan, Russia, and Uzbekistan) to more than 100 per 100 HIV-positive IDUs in six European countries. Worldwide, an estimated two needle-syringes (range 1-4) were distributed per IDU per month, there were eight recipients (6-12) of OST per 100 IDUs, and four IDUs (range 2-18) received ART per 100 HIV-positive IDUs. INTERPRETATION: Worldwide coverage of HIV prevention, treatment, and care services in IDU populations is very low. There is an urgent need to improve coverage of these services in this at-risk population. FUNDING: UN Office on Drugs and Crime; Australian National Drug and Alcohol Research Centre, University of New South Wales; and Australian National Health and Medical Research Council.
机译：背景：以前的评论已经检查了全世界为注射吸毒者（IDU）提供的HIV预防，治疗和护理服务的存在，但并未量化覆盖范围。我们进行了系统的评估，以估计IDU中HIV服务的国家，地区和全球覆盖率。方法：我们对经过同行评审（Medline，BioMed Central），互联网和灰色文献数据库进行了系统的搜索，以查找2004年或以后发布的数据。联合国机构和国家专家参与了一个多阶段的数据请求和验证过程。获得了有关为注射毒品使用者提供以下核心干预措施的程度的国家数据：针头和注射器计划（NSP），阿片类药物替代疗法（OST）和其他药物治疗，HIV测试和咨询，抗逆转录病毒疗法（ART）以及避孕套计划。我们根据IDU人口规模的可用估算值计算了NSP，OST和ART的国家，地区和全球覆盖率。调查结果：到2009年，已经在82个国家实施了国家安全计划，在70个国家实施了OST。两种干预措施均在66个国家/地区提供。区域和国家的覆盖范围差异很大。澳大拉西亚（每个IDU每年202个针头注射器）的针头分布率最高。拉丁美洲和加勒比（每个IDU每年0.3针注射器），中东和北非（每个IDU每年0.5针注射器）和撒哈拉以南非洲（每年每个IDU 0.1针注射器）最低费率。 OST覆盖范围从中亚，拉丁美洲和撒哈拉以南非洲地区每100个注射毒品使用者少于或等于一个接收者，到西欧的很高水平（每100个注射毒品使用者61个接收者）。接受抗逆转录病毒疗法的注射吸毒者的数量从每100个HIV阳性吸毒者（智利，肯尼亚，巴基斯坦，俄罗斯和乌兹别克斯坦）不到1个，到六个欧洲国家的每100个HIV阳性吸毒者超过100个不等。在世界范围内，每个IDU每月分配大约两个针头注射器（范围1-4），每100个IDU接受八位（6-12位）OST接受者，每100个HIV接受4个IDU（范围2-18个）阳性IDU。解释：IDU人群中艾滋病预防，治疗和护理服务的全球覆盖率很低。迫切需要提高这些高风险人群对这些服务的覆盖范围。资金：联合国毒品和犯罪问题办公室;新南威尔士大学澳大利亚国家毒品和酒精研究中心;以及澳大利亚国家卫生与医学研究理事会。

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