Global Prevention of HIV Infection for Neglected Populations: Men Who Have Sex with Men
Global Prevention of HIV Infection for Neglected Populations: Men Who Have Sex with Men
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DOI：
10.1086/651481
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发表时间：
2010-05-15
影响因子：
11.8
通讯作者：
Beyrer, Chris
中科院分区：
文献类型：
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作者：
Beyrer, Chris
男男性行为者（MSM）中人类免疫缺陷病毒（HIV）感染的全球流行病学表明，自2000年以来，在资源充足的国家，HIV在男性中重新出现传播，在资源有限的国家，HIV在MSM中出现流行病。这两种流行情况都证明了目前在MSM中预防艾滋病毒感染的局限性。一系列基于证据的预防干预措施存在，但很少有新的干预措施在男男性行为者中显示出有效性。包皮环切术尚未被调查的男男性接触者。需要新的干预措施。暴露前预防的试验正在进行中，可能会显著改变预防前景。对于发展中国家的男男性行为者来说，预防艾滋病毒感染的基本服务尚未惠及绝大多数男子。仇视同性恋和歧视限制了男男性行为者获得预防服务的机会，并显著增加了脆弱性，将同性行为定为犯罪也是如此。同性行为的非刑事化是预防艾滋病毒感染的一种结构性干预措施，最近已被联合国的一项非约束性声明所接受。
The global epidemiology of human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) suggests both reemergent spread among men in resource-sufficient countries since 2000 and emerging epidemics among MSM in resource-limited countries. Both epidemic contexts are evidence of the current limits of prevention of HIV infection in MSM. A range of evidence-based preventive interventions exist, but few new interventions have shown efficacy among MSM. Circumcision has not been investigated for MSM. New interventions are needed. Trials of preexposure prophylaxis are pending and may markedly alter the prevention landscape. For MSM in developing countries, basic services for prevention of HIV infection have yet to reach the large majority of men. Homophobia and discrimination limit access of MSM to prevention services and markedly increase vulnerability, as does criminalization of same-sex behavior. Decriminalization of same-sex behavior is a structural intervention for prevention of HIV infection and has recently been embraced by a nonbinding statement from the United Nations.