Gaps and opportunities: measuring the key population cascade through surveys and services to guide the HIV response.
Gaps and opportunities: measuring the key population cascade through surveys and services to guide the HIV response.
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DOI：
10.1002/jia2.25119
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发表时间：
2018-07
影响因子：
6
通讯作者：
Garcia Calleja JM
中科院分区：
文献类型：
--
作者：
Hakim AJ;MacDonald V;Hladik W;Zhao J;Burnett J;Sabin K;Prybylski D;Garcia Calleja JM
联合国艾滋病规划署的90 - 90 - 90目标是诊断90%的艾滋病毒感染者，使其中90%的人接受治疗，并使其中90%的人抑制病毒载量，这使国际艾滋病毒应对工作的重点是到2030年消除艾滋病毒的目标。它们也是衡量实现这一目标进展的建设性工具，但它们的实用性取决于数据的可用性。虽然超过25%的新感染发生在关键人群（KP）中-性工作者，男男性行为者，变性人，注射毒品者和囚犯-以及他们的性伴侣，但KP缺乏治疗级联数据。我们评估级联数据的可用性，并审查生物行为和方案数据提供的机会，为艾滋病毒应对提供信息。在流行率较高的国家，强调在一般人群中收集治疗级联数据，但这并未导致金伯利进程级联数据的可用性出现类似的增加。金伯利进程现有的有限数据突出表明，在整个级联中，特别是在对艾滋病毒状况的认识的前90个阶段，在服务接受方面存在巨大差距。生物行为调查（BBS）与相关的人口规模估计，提供基于人口的治疗级联数据，应每两到三年在有KP服务的地区进行一次。由于纳入了病毒载量检测，这些调查能够监测金伯利进程中的整个治疗级联，无论这些人口是否获得针对一般人口或金伯利进程的艾滋病毒服务。BBS还向获得服务的人和没有获得服务的人进行宣传，从而提供了一个独特的机会，了解获得服务的障碍，包括耻辱和歧视。与此同时，高质量的计划数据可以在识别错过的机会方面发挥补充作用，这些机会可以在真实的时间内得到解决。数据对于指导艾滋病毒应对工作实现90 - 90 - 90目标和消除艾滋病毒比以往任何时候都更加重要，特别是在艾滋病毒特别是金伯利进程资金减少的情况下。及时的高质量BBS数据可以与高质量的方案数据进行三角测量，以全面了解金伯利进程的流行病应对情况。
The UNAIDS 90‐90‐90 targets to diagnose 90% of people living with HIV, put 90% of them on treatment, and for 90% of them to have suppressed viral load have focused the international HIV response on the goal of eliminating HIV by 2030. They are also a constructive tool for measuring progress toward reaching this goal but their utility is dependent upon data availability. Though more than 25% of new infections are among key populations (KP)‐ sex workers, men who have sex with men, transgender people, people who inject drugs, and prisoners‐ and their sex partners, there is a dearth of treatment cascade data for KP. We assess the availability of cascade data and review the opportunities offered by biobehavioral and programme data to inform the HIV response. The emphasis on the collection of treatment cascade data among the general population in higher prevalence countries has not led to a similar increase in the availability of cascade data for KP. The limited data available for KP highlight large gaps in service uptake across the cascade, particularly in the first 90, awareness of HIV status. Biobehavioral surveys (BBS), with linked population size estimation, provide population‐based data on the treatment cascade and should be conducted every two to three years in locations with services for KP. With the inclusion of viral load testing, these surveys are able to monitor the entire treatment cascade among KP regardless of whether these populations access HIV services targeting the general population or KP. BBS also reach people accessing services and those who do not, thereby providing a unique opportunity to learn about barriers to service uptake including stigma and discrimination. At the same time high‐quality programme data can play a complementary role in identifying missed opportunities that can be addressed in real‐time. Data are more important than ever for guiding the HIV response toward reaching 90‐90‐90 targets and eliminating HIV, particularly in the face of decreased funding for HIV and specifically for KP. Timely high‐quality BBS data can be triangulated with high‐quality programme data to provide a comprehensive picture of the epidemic response for KP.
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影响因子：
11.8
作者：
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通讯作者：
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DOI：
10.1080/09540121.2016.1191606
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