Towards achieving the fast-track targets and ending the epidemic of HIV/AIDS in Ethiopia: Successes and challenges
Towards achieving the fast-track targets and ending the epidemic of HIV/AIDS in Ethiopia: Successes and challenges
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DOI：
10.1016/j.ijid.2018.10.022
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发表时间：
2019-01-01
影响因子：
8.4
通讯作者：
Hill, Peter S.
中科院分区：
文献类型：
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作者：
Assefa, Yibeltal;Gilks, Charles F.;Hill, Peter S.
背景：埃塞俄比亚通过了结束艾滋病毒/艾滋病流行病的全球计划。这项研究的目的是评估在实现这一计划方面取得的进展。方法：回顾和分析全国人口为基础的调查，监测和常规程序数据执行。使用Excel 2016和Stata 14（StataCorp LP，学院站，TX，USA）进行数据分析。结果：2011年至2016年，艾滋病毒相关死亡人数下降了58%，而新感染艾滋病毒的人数仅下降了6%。歧视态度从2011年的77.9%（95%置信区间（CI）77.3-78.4%）显著下降到2016年的41.5%（95% CI 40.6-42.4%）。大约79%的成年艾滋病毒感染者（PLHIV）知道自己的艾滋病毒状况; 2016年，90%知道自己的艾滋病毒状况的艾滋病毒感染者正在接受抗逆转录病毒治疗（ART），88%接受ART的成年艾滋病毒感染者得到了病毒抑制。年龄在15-49岁之间的人群中，曾经接受过艾滋病毒检测并获得结果的比例从2011年的39.8%（95%CI 39.2-40.4%）上升到2016年的44.8%（95%CI 44.2-45.4%）。15岁以下儿童的这一比例非常低，仅为6.2%（95% CI 5.9-6.5%）。各区域的艾滋病毒检测覆盖率从13%到72%不等。女性性工作者的艾滋病毒检测（31%）和抗逆转录病毒疗法（70%）覆盖率低于全国成年人口的平均水平。国际社会对艾滋病毒的资助从2010-2012年的13亿多美元下降到2016-2018年的不到8亿美元。结论：埃塞俄比亚正在实现艾滋病毒检测、抗逆转录病毒疗法、病毒抑制和艾滋病相关死亡的目标，但在减少艾滋病毒新感染、歧视态度和公平方面却没有进展。要结束艾滋病毒/艾滋病的流行，就必须采取综合对策，包括针对关键人群和地点的预防和治疗，并增加供资。(c)2018作者由Elsevier Ltd代表国际传染病学会出版。
Background: Ethiopia has adopted the global plan to end the epidemic of HIV/ AIDS. The aim of this study was to assess the progress made towards achieving this plan. Methods: A review and analysis of national population-based surveys, surveillance, and routine programme data was executed. The data analysis was conducted using Excel 2016 and Stata 14 (StataCorp LP, College Station, TX, USA). Results: Between 2011 and 2016, the number of HIV-related deaths dropped by 58%, while that of new HIV infections dropped by only 6%. Discriminatory attitudes declined significantly from 77.9% (95% confidence interval (CI) 77.3-78.4%) in 2011 to 41.5% (95% CI 40.6-42.4%) in 2016. Around 79% of adult people living with HIV (PLHIV) were aware of their HIV status; 90% of PLHIV who were aware of their HIV status were taking antiretroviral treatment (ART) and 88% of adult PLHIV on ART had viral suppression in 2016. The proportion of people aged 15-49 years who had ever been tested for HIV and had received results increased from 39.8% (95% CI 39.2-40.4%) in 2011 to 44.8% (95% CI 44.2-45.4%) in 2016. This proportion was very low among children below age 15 years at only 6.2% (95% CI 5.9-6.5%). Among regions, HIV testing coverage varied from 13% to 72%. Female sex workers had lower coverage for HIV testing (31%) and ART (70%) than the national average in the adult population. International funding for HIV dropped from more than US$ 1.3 billion in 2010-2012 to less than US$ 800 million in 2016-2018. Conclusions: Ethiopia is on track to achieve the targets for HIV testing, ART, viral suppression, and AIDSrelated deaths, but not for reductions in new HIV infections, discriminatory attitudes, and equity. Ending the epidemic of HIV/ AIDS requires a combined response, including prevention and treatment, tailored to key populations and locations, as well as increased funding. (c) 2018 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.