Một Đánh Giá Hệ Thống và Phân Tích Tổng Hợp về Các Can Thiệp Tâm Lý Xã Hội nhằm Giảm Hành Vi Rủi Ro Lây Truyền Virus Máu qua Đường Tiêm Chích và Tình Dục trong Giữa Những Người Tiêm Chích Ma Túy

Springer Science and Business Media LLC - Tập 21 - Trang 1791-1811 - 2017
Gail Gilchrist1,2, Davina Swan1, Kideshini Widyaratna1, Julia Elena Marquez-Arrico3, Elizabeth Hughes4, Noreen Dadirai Mdege5, Marrissa Martyn-St James6, Judit Tirado-Munoz7
1National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
2Department of General Practice, University of Melbourne, Parkville, Australia
3Department of Psychiatry and Clinical Psychobiology, School of PsychologyUniversity of Barcelona, Barcelona, Spain
4University of Huddersfield, Huddersfield, UK
5Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, UK
6School for Health and Related Research, University of Sheffield, Sheffield, UK
7Addiction Research Group, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Institute of Neuropsychiatry and Addictions, Parc de Salut Mar de Barcelona, Barcelona, Spain

Tóm tắt

Điều trị thay thế thuốc phiện và các chương trình trao đổi kim tiêm đã giảm sự lây truyền virus qua đường máu (BBV) trong số những người tiêm chích ma túy (PWID). Các can thiệp tâm lý xã hội có thể còn ngăn ngừa BBV hơn nữa. Một đánh giá hệ thống và phân tích tổng hợp đã xem xét các can thiệp tâm lý xã hội (ví dụ: CBT, đào tạo kỹ năng) so với các can thiệp kiểm soát nhằm giảm thiểu hành vi rủi ro liên quan đến BBV trong số PWID. Trong đánh giá và phân tích tổng hợp, lần lượt có 32 và 24 thử nghiệm ngẫu nhiên đối chứng (từ năm 2000 đến tháng 5 năm 2015 trong MEDLINE, PsycINFO, CINAHL, Tổ chức Cochrane và Thử nghiệm lâm sàng, với cập nhật trong MEDLINE đến tháng 12 năm 2016). Các can thiệp tâm lý xã hội dường như làm giảm: việc chia sẻ kim/ống tiêm so với giáo dục/thông tin (SMD −0.52; 95% CI −1.02 đến −0.03; I2 = 10%; p = 0.04) hoặc xét nghiệm tư vấn HIV (SMD −0.24; 95% CI −0.44 đến −0.03; I2 = 0%; p = 0.02); việc chia sẻ các dụng cụ tiêm chích khác (SMD −0.24; 95% CI −0.42 đến −0.06; I2 = 0%; p < 0.01) và quan hệ tình dục không được bảo vệ (SMD −0.44; 95% CI −0.86 đến −0.01; I2 = 79%; p = 0.04) so với các can thiệp có thời gian/intensity thấp hơn, tuy nhiên, đã ghi nhận sự khác biệt vừa đến cao. Các can thiệp như vậy có thể được kết hợp với các phương pháp giảm thiểu tác hại khác nhằm ngăn ngừa sự lây truyền BBV trong số PWID.

Từ khóa

#can thiệp tâm lý xã hội #hành vi rủi ro #virus máu #người tiêm chích ma túy #đánh giá hệ thống

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