同伴互助远程医疗治疗丙型肝炎的减低伤害效果:随机对照试验的次要结果

Viruses Pub Date : 2024-09-13 DOI:10.3390/v16091455
Hunter Spencer, Devin Gregoire, Gillian Leichtling, Megan Herink, Andrew Seaman, P. Todd Korthuis, Ryan Cook
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引用次数: 0

摘要

对吸毒者(PWUD)进行丙型肝炎(HCV)治疗可减少注射吸毒和注射设备共用。在一项随机试验中,我们比较了在农村吸毒者中采用同伴辅助远程医疗进行丙型肝炎病毒治疗(TeleHCV)和同伴辅助常规护理进行丙型肝炎病毒治疗后注射吸毒和共用注射器具的变化。我们假设 TeleHCV 会减少危险行为,而同伴会促进这种改变。我们采用混合效应逻辑回归法来描述参与者(n = 203)注射吸毒和注射器共用与随机分组、同伴接触频率、HCV 治疗启动、HCV 治愈和时间之间的关联。在基线以及完成 HCV 治疗 12 周和 36 周后,对危险行为进行了调查。随着时间的推移,TeleHCV 参与者与对照组相比,在 12 周(调整赔率 [aOR] = 0.42,95% CI 0.20-0.87,p = 0.02)和 36 周(aOR = 0.48,95% CI 0.21-1.08,p = 0.076)时,注射吸毒的减少幅度更大。同伴互动次数越多,注射毒品的使用率下降越多,在 12 周时,同伴互动次数处于第三四分位数的参与者的使用率下降幅度超过同伴互动次数处于第一四分位数的参与者(aOR = 0.75,95% CI 0.57-0.99,p = 0.04)。同样,随着时间的推移,注射器共用的情况也在减少,在 36 周时,第 3 个四分位数参与者共用注射器的情况超过了第 1 个四分位数参与者共用注射器的情况(aOR = 0.08,95% CI 0.01-0.97,p = 0.047)。同伴辅助远程医疗治疗丙型肝炎病毒可减少注射吸毒和注射设备共用;同伴有助于产生这种效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Harm Reduction in Peer-Assisted Telemedicine for Hepatitis C: Secondary Outcomes of a Randomized Controlled Trial
Hepatitis C (HCV) treatment for people who use drugs (PWUD) decreases injection drug use and injection equipment sharing. We examined changes in injection drug use and injection equipment sharing following HCV treatment in a randomized trial comparing peer-assisted telemedicine for HCV treatment (TeleHCV) versus peer-assisted usual care in rural PWUD. We hypothesize that TeleHCV reduces risky behaviors and peers facilitate this change. We used mixed-effects logistic regression to describe participant-level (n = 203) associations between both injection drug use and injection equipment sharing and randomized groups, frequency of peer contact, HCV treatment initiation, HCV cure, and time. Risky behaviors were surveyed at baseline and 12 and 36 weeks after HCV treatment completion. Injection drug use declined more over time in TeleHCV participants vs. control at 12 weeks (adjusted odds ratio [aOR] = 0.42, 95% CI 0.20–0.87, p = 0.02) and 36 weeks (aOR = 0.48, 95% CI 0.21–1.08, p = 0.076). Injection drug use decreased more with a greater number of peer interactions, with reductions among participants in the 3rd quartile exceeding those in the 1st quartile of peer interactions at 12 weeks (aOR = 0.75, 95% CI 0.57–0.99, p = 0.04). Similarly, injection equipment sharing decreased over time, with reductions among participants in the 3rd quartile exceeding those in the 1st quartile of peer interactions at 36 weeks (aOR = 0.08, 95% CI 0.01–0.97, p = 0.047). Peer-assisted telemedicine for HCV treatment decreases injection drug use and injection equipment sharing; peers contribute to this effect.
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