The HIV treatment cascade and care continuum: updates, goals, and recommendations for the future.
The HIV treatment cascade and care continuum: updates, goals, and recommendations for the future.
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DOI：
10.1186/s12981-016-0120-0
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发表时间：
2016
影响因子：
2.2
通讯作者：
Mugavero MJ
中科院分区：
文献类型：
--
作者：
Kay ES;Batey DS;Mugavero MJ
艾滋病毒护理连续体是一个框架，模拟艾滋病毒护理的动态阶段。这一连续体包括五个主要步骤，在人口一级，这五个步骤被描述为艾滋病毒治疗级联。这些步骤包括诊断、护理联系（LTC）、继续护理（RiC）、坚持抗逆转录病毒治疗（ART）和病毒抑制。虽然艾滋病毒治疗级联被描述为一个线性、单向的框架，但艾滋病毒感染者（PLWH）往往以一种不那么精简的方式经历护理连续体，完全跳过步骤，甚至在一段时间内退出连续体并退回到早期阶段。PLWH的比例在级联的每一个连续步骤中都在下降，从估计的86%被诊断出来开始，急剧下降到美国病毒抑制的PLWH的大约30%。在当前的问题审查中，我们描述了级联中的每一步，讨论了解决连续体中弱点的有针对性的干预措施，审查了有助于形成和指导艾滋病毒护理战略的国内和国际政策，并为艾滋病毒提供者和政策制定者提出了建议和未来方向。虽然我们主要研究在美国国内艾滋病护理相关的问题，我们也讨论了国际应用的连续体，以提供更广泛的背景。
The HIV care continuum is a framework that models the dynamic stages of HIV care. The continuum consists of five main steps, which, at the population level, are depicted cross-sectionally as the HIV treatment cascade. These steps include diagnosis, linkage to care (LTC), retention in care (RiC), adherence to antiretroviral therapy (ART), and viral suppression. Although the HIV treatment cascade is represented as a linear, unidirectional framework, persons living with HIV (PLWH) often experience the care continuum in a less streamlined fashion, skip steps altogether, or even exit the continuum for a period of time and regress to an earlier stage. The proportion of PLWH decreases at each successive step of the cascade, beginning with an estimated 86% who are diagnosed and dropping dramatically to approximately 30% of PLWH who are virally suppressed in the United States (US). In this current issues review, we describe each step in the cascade, discuss targeted interventions that address weak points in the continuum, review domestic and international policies that help shape and direct HIV care strategies, and conclude with recommendations and future directions for HIV providers and policymakers. While we primarily examine issues related to domestic HIV care in the US, we also discuss international applications of the continuum in order to provide broader context.
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影响因子：
16.1
作者：
Barnabas, Ruanne V.;van Rooyen, Heidi;Tumwesigye, Elioda;Murnane, Pamela M.;Baeten, Jared M.;Humphries, Hilton;Turyamureeba, Bosco;Joseph, Philip;Krows, Meighan;Hughes, James P.;Celum, Connie
通讯作者：
Celum, Connie
影响因子：
3.7
作者：
Hall HI;Tang T;Westfall AO;Mugavero MJ
通讯作者：
Mugavero MJ
影响因子：
12.7
作者：
Cahill, Sean R.;Mayer, Kenneth H.;Boswell, Stephen L.
通讯作者：
Boswell, Stephen L.
影响因子：
12.7
作者：
Gray, Kristen Mahle;Tang, Tian;Hall, H. Irene
通讯作者：
Hall, H. Irene
影响因子：
3.7
作者：
Heffernan, Alastair;Barber, Ella;Cori, Anne
通讯作者：
Cori, Anne