Abstract：
We conducted a medical record review for healthcare utilization, risk factors, and clinical data among people who inject drugs (PWID) in Massachusetts to aid HIV outbreak response decision-making and strengthen public health practice.
Two large community health centers (CHCs) that provide HIV and related services in northeastern Massachusetts.
Between May and July 2018, we reviewed medical records for 88 people with HIV (PWH) connected to the outbreak. The review period included care received from May 1, 2016, through the date of review. Surveillance data were used to establish date of HIV diagnosis and assess viral suppression.
Sixty-nine (78%) people had HIV infection diagnosed during the review period, including 10 acute infections. Persons had a median of 3 primary care visits after HIV diagnosis and zero before diagnosis. During the review period, 72% reported active drug or alcohol use, 62% were prescribed medication assisted treatment, and 41% were prescribed antidepressants. The majority (68, 77%) had a documented ART prescription. HIV viral suppression at < 200 copies/mL was more frequent (73%) than the overall across the State (65%); it did not correlate with any of the sociodemographic characteristics studied in our population. Over half (57%) had been hospitalized at least once during the review period, and 36% had a bacterial infection at hospitalization.
Medical record review with a field investigation of an outbreak provided data about patterns of health care utilization and comorbidities not available from routine HIV surveillance or case interviews. Integration of HIV screening with treatment for HIV and SUD can strengthen prevention and care services for PWID in northeastern Massachusetts.
Two large community health centers (CHCs) that provide HIV and related services in northeastern Massachusetts.
Between May and July 2018, we reviewed medical records for 88 people with HIV (PWH) connected to the outbreak. The review period included care received from May 1, 2016, through the date of review. Surveillance data were used to establish date of HIV diagnosis and assess viral suppression.
Sixty-nine (78%) people had HIV infection diagnosed during the review period, including 10 acute infections. Persons had a median of 3 primary care visits after HIV diagnosis and zero before diagnosis. During the review period, 72% reported active drug or alcohol use, 62% were prescribed medication assisted treatment, and 41% were prescribed antidepressants. The majority (68, 77%) had a documented ART prescription. HIV viral suppression at < 200 copies/mL was more frequent (73%) than the overall across the State (65%); it did not correlate with any of the sociodemographic characteristics studied in our population. Over half (57%) had been hospitalized at least once during the review period, and 36% had a bacterial infection at hospitalization.
Medical record review with a field investigation of an outbreak provided data about patterns of health care utilization and comorbidities not available from routine HIV surveillance or case interviews. Integration of HIV screening with treatment for HIV and SUD can strengthen prevention and care services for PWID in northeastern Massachusetts.
摘要：
我们进行了医疗记录审查，危险因素，以及马萨诸塞州注射毒品（PWID）人群的临床数据，以帮助做出HIV爆发应对决策并加强公共卫生实践。
马萨诸塞州东北部的两个大型社区健康中心（CHC）提供艾滋病毒和相关服务。
在2018年5月至7月期间，我们审查了与疫情有关的88名HIV感染者（PWH）的医疗记录。审查期包括从2016年5月1日起至审查日期的护理。监测数据用于确定HIV诊断日期并评估病毒抑制。
在审查期间，有69人(78%)被诊断出感染艾滋病毒。包括10例急性感染。在HIV诊断后，患者的初级保健就诊中位数为3次，在诊断前为零。在审查期间，72%报告使用活性药物或酒精，62%的人接受处方药物辅助治疗，41%是处方抗抑郁药。大多数（68，77％）有记录的ART处方。<200拷贝/mL的HIV病毒抑制频率（73％）高于全州整体（65％）；它与我们人群中研究的任何社会人口统计学特征均不相关。超过一半（57％）在审查期间至少住院一次，36%的患者在住院时出现细菌感染.
通过对疫情的实地调查，医疗记录审查提供了常规HIV监测或病例访谈中无法获得的有关医疗保健利用模式和合并症的数据。将艾滋病毒筛查与艾滋病毒和SUD的治疗相结合，可以加强马萨诸塞州东北部PWID的预防和护理服务。
马萨诸塞州东北部的两个大型社区健康中心（CHC）提供艾滋病毒和相关服务。
在2018年5月至7月期间，我们审查了与疫情有关的88名HIV感染者（PWH）的医疗记录。审查期包括从2016年5月1日起至审查日期的护理。监测数据用于确定HIV诊断日期并评估病毒抑制。
在审查期间，有69人(78%)被诊断出感染艾滋病毒。包括10例急性感染。在HIV诊断后，患者的初级保健就诊中位数为3次，在诊断前为零。在审查期间，72%报告使用活性药物或酒精，62%的人接受处方药物辅助治疗，41%是处方抗抑郁药。大多数（68，77％）有记录的ART处方。<200拷贝/mL的HIV病毒抑制频率（73％）高于全州整体（65％）；它与我们人群中研究的任何社会人口统计学特征均不相关。超过一半（57％）在审查期间至少住院一次，36%的患者在住院时出现细菌感染.
通过对疫情的实地调查，医疗记录审查提供了常规HIV监测或病例访谈中无法获得的有关医疗保健利用模式和合并症的数据。将艾滋病毒筛查与艾滋病毒和SUD的治疗相结合，可以加强马萨诸塞州东北部PWID的预防和护理服务。
