A call to action for comprehensive HIV services for men who have sex with men.
A call to action for comprehensive HIV services for men who have sex with men.
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DOI：
10.1016/s0140-6736(12)61022-8
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发表时间：
2012-07-28
期刊：
影响因子：
168.9
通讯作者：
Mayer, Kenneth H.
中科院分区：
文献类型：
--
作者：
Beyrer, Chris;Sullivan, Patrick S.;Sanchez, Jorge;Dowdy, David;Altman, Dennis;Trapence, Gift;Collins, Chris;Katabira, Elly;Kazatchkine, Michel;Sidibe, Michel;Mayer, Kenneth H.
在进行监测的地方，监测结果表明，男男性行为者承担了不成比例的艾滋病毒负担。然而，由于耻辱、歧视和刑事定罪，他们仍然被排除在艾滋病毒服务之外，有时是系统性的。如果要实现对艾滋病毒流行病的全球控制，这种情况就必须改变。从公共卫生和人权的角度来看，扩大对男男性行为者的艾滋病毒预防、治疗和护理是当务之急。有效的预防和治疗相结合的办法是可行的，即使在权利受到挑战的环境中，也可以发展文化上胜任的护理。在全球范围内，为男男性行为者提供安全套和润滑剂具有很高的成本效益。基于抗逆转录病毒的预防以及全球男男性行为者获得抗逆转录病毒治疗也具有成本效益，但可能需要在高收入国家大幅降低药品成本才可行。解决男男性行为者的艾滋病毒问题需要持续的研究、政治意愿、结构改革、社区参与以及战略规划和方案编制，但这是可以而且必须做到的。
Where surveillance has been done, it has shown that men (MSM) who have sex with men bear a disproportionate burden of HIV. Yet they continue to be excluded, sometimes systematically, from HIV services because of stigma, discrimination, and criminalisation. This situation must change if global control of the HIV epidemic is to be achieved. On both public health and human rights grounds, expansion of HIV prevention, treatment, and care to MSM is an urgent imperative. Effective combination prevention and treatment approaches are feasible, and culturally competent care can be developed, even in rights-challenged environments. Condom and lubricant access for MSM globally is highly cost effective. Antiretroviral-based prevention, and antiretroviral access for MSM globally, would also be cost effective, but would probably require substantial reductions in drug costs in high-income countries to be feasible. To address HIV in MSM will take continued research, political will, structural reform, community engagement, and strategic planning and programming, but it can and must be done.