A strengths-based case management intervention to link HIV-positive people who inject drugs in Russia to HIV care

被引:20
作者
Samet, Jeffrey H. [1 ,2 ]
Blokhina, Elena [3 ]
Cheng, Debbie M. [4 ]
Walley, Alexander Y. [1 ]
Lioznov, Dmitry [3 ,5 ]
Gnatienko, Natalia [6 ]
Quinn, Emily K. [7 ]
Bridden, Carly [6 ]
Chaisson, Christine E. [4 ]
Toussova, Olga [3 ]
Gifford, Allen L. [8 ,9 ,10 ]
Raj, Anita [1 ,11 ]
Krupitsky, Evgeny [3 ,12 ]
机构
[1] Boston Univ, Dept Med, Clin Addict Res & Educ Unit, Sect Gen Internal Med,Sch Med,Boston Med Ctr, 801 Massachusetts Ave,2nd Floor, Boston, MA 02118 USA
[2] Boston Univ, Sch Publ Hlth, Dept Community Hlth Sci, Boston, MA 02118 USA
[3] First Pavlov State Med Univ St Petersburg, St Petersburg, Russia
[4] Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02118 USA
[5] Pasteur Res Inst Epidemiol & Microbiol, St Petersburg, Russia
[6] Boston Med Ctr, Dept Med, Clin Addict Res & Educ Unit, Sect Gen Internal Med, Boston, MA USA
[7] Boston Univ, Biostat & Epidemiol Data Analyt Ctr, Sch Publ Hlth, Boston, MA 02118 USA
[8] Boston Univ, Sch Med, Boston, MA 02118 USA
[9] Boston Univ, Sch Publ Hlth, Boston, MA 02118 USA
[10] VA Boston Healthcare Syst, Ctr Healthcare Org & Implementat Res, Boston, MA USA
[11] Univ Calif San Diego, Sch Med, Dept Med, Ctr Gender Equ & Hlth, La Jolla, CA 92093 USA
[12] Natl Bekhterev Med Res Ctr Psychiat & Neurol, St Petersburg, Russia
关键词
HIV; HIV treatment; linkage to care; peer case managers; Russia; substance use; ANTIRETROVIRAL THERAPY; USERS; ADHERENCE; RELIABILITY; FEDERATION; INITIATION; INFECTION; BARRIERS; VALIDITY;
D O I
10.1097/QAD.0000000000002230
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Objective: To determine whether the Linking Infectious and Narcology Care strengths-based case management intervention was more effective than usual care for linking people who inject drugs (PWID) to HIV care and improving HIV outcomes. Design: Two-armed randomized controlled trial. Setting: Participants recruited from a narcology hospital in St. Petersburg, Russia. Participants: A total of 349 HIV-positive PWID not on antiretroviral therapy (ART). Intervention: Strengths-based case management over 6 months. Main outcome measures: Primary outcomes were linkage to HIV care and improved CD4(+) cell count. We performed adjusted logistic and linear regression analyses controlling for past HIV care using the intention-to-treat approach. Results: Participants (N = 349) had the following baseline characteristics: 73% male, 12% any past ART use, and median values of 34.0 years of age and CD4(+) cell count 311 cells/mu l. Within 6 months of enrollment 51% of the intervention group and 31% of controls linked to HIV care (adjusted odds ratio 2.34; 95% confidence interval: 1.49-3.67; P < 0.001). Mean CD4(+) cell count at 12 months was 343 and 354 cells/mu l in the intervention and control groups, respectively (adjusted ratio of means 1.14; 95% confidence interval: 0.91, 1.42, P = 0.25). Conclusion: The Linking Infectious and Narcology Care strengths-based case management intervention was more effective than usual care in linking Russian PWID to HIV care, but did not improve CD4(+) cell count, likely due to low overall ART initiation. Although case management can improve linkage to HIV care, specific approaches to initiate and adhere to ART are needed to improve clinical outcomes (e.g., increased CD4(+) cell count) in this population. Copyright (C) 2019 The Author(s). Published by Wolters Kluwer Health, Inc.
引用
收藏
页码:1467 / 1476
页数:10
相关论文
共 58 条
[1]   Effects of a multicomponent intervention to streamline initiation of antiretroviral therapy in Africa: a stepped-wedge cluster-randomised trial [J].
Amanyire, Gideon ;
Semitala, Fred C. ;
Namusobya, Jennifer ;
Katuramu, Richard ;
Kampiire, Leatitia ;
Wallenta, Jeanna ;
Charlebois, Edwin ;
Camlin, Carol ;
Kahn, James ;
Chang, Wei ;
Glidden, David ;
Kamya, Moses ;
Havlir, Diane ;
Geng, Elvin .
LANCET HIV, 2016, 3 (11) :E539-E548
[2]   People with HIV in HAART-Era Russia: Transmission Risk Behavior Prevalence, Antiretroviral Medication-Taking, and Psychosocial Distress [J].
Amirkhanian, Yuri A. ;
Kelly, Jeffrey A. ;
Kuznetsova, Anna V. ;
DiFranceisco, Wayne J. ;
Musatov, Vladimir B. ;
Pirogov, Dmitry G. .
AIDS AND BEHAVIOR, 2011, 15 (04) :767-777
[3]  
[Anonymous], ADV PREV MED
[4]  
[Anonymous], 2016, HIV INFECT IMMUNOSUP
[5]  
[Anonymous], TOG WE WILL END AIDS
[6]  
Bandura A., 1986, Social cognitive theory: Social foundations of thought and action
[7]   Enhancing treatment fidelity in health behavior change studies: Best practices and recommendations from the NIH behavior change consortium [J].
Bellg, AJ ;
Borrelli, B ;
Resnick, B ;
Hecht, J ;
Minicucci, DS ;
Ory, M ;
Ogedegbe, G ;
Orwig, D ;
Ernst, D ;
Czajkowski, S .
HEALTH PSYCHOLOGY, 2004, 23 (05) :443-451
[8]   The expanding epidemic of HIV-1 in the Russian Federation [J].
Beyrer, Chris ;
Wirtz, Andrea L. ;
O'Hara, George ;
Leon, Nolwenn ;
Kazatchkine, Michel .
PLOS MEDICINE, 2017, 14 (11)
[9]  
Brooks D.J., 2010, Handbook of HIV and social work: Principles, practice, and populations, P77
[10]   Evaluating the drug-abusing probationer - Clinical interview versus self-administered assessment [J].
Broome, KM ;
Knight, K ;
Joe, GW ;
Simpson, DD .
CRIMINAL JUSTICE AND BEHAVIOR, 1996, 23 (04) :593-606