An outbreak of human immunodeficiency virus (HIV) among people who inject drugs in Glasgow, Scotland started in 2014. We describe 156 cases over 5 years and evaluate the impact of clinical interventions using virological and phylogenetic analysis. We established (1) HIV services within homeless health facilities, including outreach nurses, and (2) antiretroviral therapy (ART) via community pharmacies. Implementation of the new model reduced time to ART initiation from 264 to 23 days and increased community viral load suppression rates to 86%. Phylogenetic analysis demonstrated that 2019 diagnoses were concentrated within a single network. Traditional HIV care models require adaptation for this highly complex population.

中文翻译：

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从医院到社区：重新设计人类免疫缺陷病毒 (HIV) 临床服务模式以应对注射药物人群中的 HIV 爆发。

2014 年在苏格兰格拉斯哥的注射吸毒者中爆发了人类免疫缺陷病毒 (HIV)。我们在 5 年内描述了 156 例病例，并使用病毒学和系统发育分析评估了临床干预的影响。我们在无家可归者医疗机构中建立了 (1) 艾滋病毒服务，包括外展护士，以及 (2) 通过社区药房提供抗逆转录病毒治疗 (ART)。新模型的实施将开始 ART 的时间从 264 天缩短到 23 天，并将社区病毒载量抑制率提高到 86%。系统发育分析表明，2019 年的诊断集中在一个网络中。传统的 HIV 护理模式需要适应这一高度复杂的人群。