HIV prevention 6 - Coming to terms with complexity: a call to action for HIV prevention
HIV prevention 6 - Coming to terms with complexity: a call to action for HIV prevention
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DOI：
10.1016/s0140-6736(08)60888-0
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发表时间：
2008-09-06
期刊：
影响因子：
168.9
通讯作者：
Mane, Purnima
中科院分区：
文献类型：
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作者：
Piot, Peter;Bartos, Michael;Mane, Purnima
四分之一个世纪的艾滋病防治工作创造了大量关于艾滋病毒传播和如何预防艾滋病毒的知识，但世界各地每天仍有近7000人感染艾滋病毒。虽然艾滋病毒预防是复杂的，但不应使人感到神秘。地方和国家在遏制这一流行病方面取得了无数的成就，并创造了一系列关于有效措施的证据，但这些成功的方法尚未得到充分应用。基本方案和服务没有足够的覆盖面;它们往往缺乏足够的资金，无法以足够的质量和强度实施。行动和供资不一定针对流行病所在地或流行病的驱动因素，很少有方案处理易受艾滋病毒感染的问题和流行病的结构性决定因素。尚未充分动员预防群体来刺激对艾滋病毒预防的需求。没有出现自信和统一的领导，以确定艾滋病毒预防工作需要什么，以及如何克服实现这一目标的政治、社会文化和后勤障碍。我们利用现有的证据和我们在艾滋病毒预防方面的成功和失败的经验教训，讨论加强艾滋病毒预防所需的综合解决办法。
A quarter of a century of AIDS responses has created a huge body of knowledge about HIV transmission and how to prevent it, yet every day, around the world, nearly 7000 people become infected with the virus. Although HIV prevention is complex, it ought not to be mystifying. Local and national achievements in curbing the epidemic have been myriad, and have created a body of evidence about what works, but these successful approaches have not yet been fully applied. Essential programmes and services have not had sufficient coverage; they have often lacked the funding to be applied with sufficient quality and intensity. Action and funding have not necessarily been directed to where the epidemic is or to what drives it. Few programmes address vulnerability to HIV and structural determinants of the epidemic. A prevention constituency has not been adequately mobilised to stimulate the demand for HIV prevention. Confident and unified leadership has not emerged to assert what is needed in HIV prevention and how to overcome the political, sociocultural, and logistic barriers in getting there. We discuss the combination of solutions which are needed to intensify HIV prevention, using the existing body of evidence and the lessons from our successes and failures in HIV prevention.