Combination HIV prevention: significance, challenges, and opportunities.
Combination HIV prevention: significance, challenges, and opportunities.
复制标题
DOI：
10.1007/s11904-010-0063-3
复制
发表时间：
2011-03
影响因子：
4.6
通讯作者：
Wasserheit, Judith N
中科院分区：
文献类型：
--
作者：
Kurth, Ann E;Celum, Connie;Baeten, Jared M;Vermund, Sten H;Wasserheit, Judith N
任何单一的艾滋病毒预防战略都不足以控制艾滋病毒大流行。然而，越来越多的干预措施在部分预防艾滋病毒传播和感染方面显示出希望，包括艾滋病毒血清学知识、减少行为风险、避孕套、男性包皮环切术、针头交换、可治愈的性传播感染的治疗以及艾滋病毒感染者和非感染者使用全身和局部抗逆转录病毒药物。设计与目标人群流行病学特征相匹配的最佳干预方案，在人群层面提供该方案，并评估安全性、可接受性、覆盖率和有效性，所有这些都涉及方法学挑战。尽管如此，开发“一揽子预防方案”的机会是前所未有的，这些方案结合了各种循证战略，针对不同亚群的需要量身定做，目标是实现高覆盖率，可衡量地减少人口层面的艾滋病毒传播。应扩大和评估结合部分有效干预措施的艾滋病毒预防战略。
No single HIV prevention strategy will be sufficient to control the HIV pandemic. However, a growing number of interventions have shown promise in partially protecting against HIV transmission and acquisition, including knowledge of HIV serostatus, behavioral risk reduction, condoms, male circumcision, needle exchange, treatment of curable sexually transmitted infections, and use of systemic and topical antiretroviral medications by both HIV-infected and uninfected persons. Designing the optimal package of interventions that matches the epidemiologic profile of a target population, delivering that package at the population level, and evaluating safety, acceptability, coverage, and effectiveness, all involve methodological challenges. Nonetheless, there is an unprecedented opportunity to develop “prevention packages” that combine various arrays of evidence-based strategies, tailored to the needs of diverse subgroups and targeted to achieve high coverage for a measurable reduction in population-level HIV transmission. HIV prevention strategies that combine partially effective interventions should be scaled up and evaluated.