Mobility and its Effects on HIV Acquisition and Treatment Engagement: Recent Theoretical and Empirical Advances
Mobility and its Effects on HIV Acquisition and Treatment Engagement: Recent Theoretical and Empirical Advances
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DOI：
10.1007/s11904-019-00457-2
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发表时间：
2019-08-01
影响因子：
4.6
通讯作者：
Charlebois, Edwin D.
中科院分区：
文献类型：
--
作者：
Camlin, Carol S.;Charlebois, Edwin D.
回顾的目的我们回顾了多个学科的文献，以描述艾滋病毒研究中人口流动性测量的问题，并总结了将流动性与艾滋病毒感染风险和治疗参与联系起来的因果途径的证据，重点是撒哈拉以南非洲。最近的研究表明，人们开始更加关注衡量标准和性别问题。理论和启发式模型的流动性和艾滋病毒的收购和治疗结果的研究已经出版，但很少有研究采用纵向设计，明确的风险和因果关系的测量结果的确定途径。尽管存在这些局限性，但不断积累的证据表明，流动性与艾滋病毒发病率较高有关，而且它对最佳的治疗参与提出了挑战。性别问题仍然很重要：虽然男子比妇女更移动的，但妇女的流动性特别增加了她们感染艾滋病毒的风险。最近在社区中寻找、检测和治疗最有可能持续在当地传播艾滋病毒的个人的大规模努力受到了流动性的严重挑战。新的干预措施，政策和卫生系统的改善是迫切需要充分参与移动的个人在艾滋病毒的护理和prevention.SummaryInterventions针对艾滋病毒的预防和护理需求的移动的人口仍然很少，迫切需要。
Purpose of ReviewWe reviewed literature across multiple disciplines to describe issues with the measurement of population mobility in HIV research and to summarize evidence of causal pathways linking mobility to HIV acquisition risks and treatment engagement, with a focus on sub-Saharan Africa.Recent FindingsWhile the literature on mobility and HIV remains hampered by problems and inconsistency in measures of mobility, the recent research reveals a turn towards a greater attentiveness to measurement and gender. Theoretical and heuristic models for the study of mobility and HIV acquisition and treatment outcomes have been published, but few studies have used longitudinal designs with clear ascertainment of exposures and outcomes for measurement of causal pathways. Notwithstanding these limitations, evidence continues to accumulate that mobility is linked to higher HIV incidence, and that it challenges optimal treatment engagement. Gender continues to be important: while men are more mobile than women, women's mobility particularly heightens their HIV acquisition risks. Recent large-scale efforts to find, test, and treat the individuals in communities who are most at risk of sustaining local HIV transmission have been severely challenged by mobility. Novel interventions, policies, and health systems improvements are urgently needed to fully engage mobile individuals in HIV care and prevention.SummaryInterventions targeting the HIV prevention and care needs of mobile populations remain few in number and urgently needed.