Recommendations for Partner Services Programs for HIV Infection, Syphilis, Gonorrhea, and Chlamydial Infection
Recommendations for Partner Services Programs for HIV Infection, Syphilis, Gonorrhea, and Chlamydial Infection
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DOI：
10.1542/peds.2018-0939
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发表时间：
2008-11-07
期刊：
影响因子：
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通讯作者：
Tucker, Cynthia J.
中科院分区：
文献类型：
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作者：
Dooley, Samuel W.;Dubose, Odessa T.;Tucker, Cynthia J.
本报告提供了改善孕前健康和护理的建议。这些建议的目标是在第一次或后续怀孕之前改善妇女和夫妇的健康。自 20 世纪 90 年代初以来，指南就推荐了孕前护理，对以往研究的回顾评估了干预措施的证据，并记录了具体干预措施的证据。CDC 根据对已发表研究的回顾以及 CDC/ATSDR 孕前护理工作组和孕前护理精选小组专家的意见制定了这些建议。本报告中的 10 条建议基于美国人口的孕前保健，旨在实现四个目标：1）提高男性和女性与孕前健康相关的知识、态度和行为； 2) 确保美国所有育龄妇女接受孕前护理服务（即基于证据的风险筛查、健康促进和干预措施），使她们能够以最佳健康状态进入妊娠期； 3) 通过怀孕期间的干预措施降低先前不良妊娠结局所表明的风险，这可以预防或尽量减少母亲及其未来孩子的健康问题； 4) 减少不良妊娠结局的差异。建议重点关注消费者知识、临床实践、公共卫生计划、医疗保健融资以及数据和研究活动的变化。每项建议都附有一系列具体的行动步骤，实施后可在 2-5 年内产生成果。根据这些建议的实施，预计育龄男性和女性在获得护理的机会、护理的连续性、风险筛查、适当的干预措施以及健康行为方面将会有所改善。这些建议的实施将有助于实现健康人民 20 10 目标。这些建议和行动步骤是一项战略计划，可供个人、社区、公共卫生和临床提供者以及政府用来改善妇女、儿童及其家庭的健康。改善约 6200 万育龄妇女的孕前健康需要采取多战略、以行动为导向的举措。本报告更新了免疫实践咨询委员会 (ACIP) 2005 年关于使用流感疫苗和抗病毒药物的建议（CDC。预防和控制流感：免疫实践咨询委员会 [ACIP] 的建议。MMWR 2005； 54【没有。 RR-8]：1-44）。 2006 年的建议包括新的和更新的信息。主要变化包括 1) 建议为 24-59 个月的儿童及其家庭接触者和外出护理人员接种流感疫苗； 2) 强调对先前未接种疫苗的 6 个月至 9 岁儿童接种 2 剂流感疫苗的重要性； 3) 建议卫生保健提供者、计划组织活动的人员以及州和地方公共卫生机构 a) 制定扩大覆盖范围和基础设施的计划，以便为比上一年更多的人接种疫苗；b) 在疫苗供应延迟和/或减少的情况下，制定接种流感疫苗的时间和优先顺序的应急计划； 4) 提醒提供者应在整个流感季节定期向患者提供流感疫苗； 5) 建议在美国，在流行的甲型流感病毒中重新确定对这些抗病毒药物敏感的证据之前，不要使用金刚烷胺或金刚乙胺来治疗或化学预防甲型流感； 6)使用2006-07年三价流感疫苗病毒株：A/新喀里多尼亚/20/1999(HINI)样、A/威斯康星/67/2005(H3N2)样和B/马来西亚/2506/2004样抗原。对于A/Wisconsin/67/2005（H3N2）样抗原，制造商可以使用抗原等效的A/Hiroshima/52/2005病毒；对于B/Malaysia/2506/2004样抗原，制造商可以使用抗原等效的B/Ohio/1/2005病毒。本报告和其他信息的链接可访问 http://ww.cdc.gov/flu。本报告提供了向人类免疫缺陷病毒（HI 9 感染和其他三种性传播疾病 (STD)（即梅毒、淋病和衣原体感染）患者的伴侣提供的服务的最新综合建议，并取代了 CDC 2001 年计划操作 STD 预防合作伙伴服务指南和 1998 年 HIV 合作伙伴咨询和转介服务指南 (1,2)。这些建议适用于负责监督州和地方各级艾滋病毒感染和其他三种性传播疾病合作伙伴服务项目的卫生部门项目经理。这些建议还可能对艾滋病毒预防社区规划小组、性病项目咨询机构、技术援助提供者、社区组织和临床护理提供者有益。 控制梅毒和淋病的合作伙伴服务已被广泛接受。然而，艾滋病毒感染者的伴侣并未充分利用此类服务。根据这些服务的有效性和成本效益证据，疾病预防控制中心强烈建议所有新诊断或报告的艾滋病毒感染者或早期梅毒患者接受卫生部门积极参与的合作伙伴服务。被诊断患有淋病或报告患有淋病的人 衣原体感染或衣原体感染也适合合作伙伴服务，但是，资源限制和这些感染的大量病例可能会妨碍卫生部门在某些情况下的直接参与。卫生部门可能需要将淋病和衣原体感染合作伙伴服务的直接参与限制为选定的高优先级病例，并对其余病例使用其他策略（例如，快速合作伙伴治疗）。这些建议强调了项目合作和服务的重要性 整合合作伙伴服务的提供。由于同时感染艾滋病毒和一种或多种其他性传播疾病很常见，因此所有诊断为艾滋病毒的人都应接受其他类型性传播疾病的检测，反之亦然；近年来，艾滋病毒和梅毒的双重感染率特别高。许多面临这些感染风险的人也面临其他传染病的风险，例如结核病和病毒性肝炎，以及 各种其他健康状况。性病和艾滋病毒合作伙伴服务为性病、艾滋病毒和其他公共卫生项目提供了合作机会，为客户提供全面的服务，提高项目效率，并最大限度地提高对公共卫生的积极影响。
This report provides recommendations to improve both preconception health and care. The goal of these recommendations is to improve the health of women and couples, before conception of a first or subsequent pregnancy. Since the early 1990s, guidelines have recommended preconception care, and reviews of previous studies have assessed the evidence for interventions and documented the evidence for specific interventions.CDC has developed these recommendations based on a review of published research and the opinions of specialists from the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. The 10 recommendations in this report are based on preconception health care for the U.S. population and are aimed at achieving four goals to 1) improve the knowledge and attitudes and behaviors of men and women related to preconception health; 2) assure that all women of childbearing age in the United States receive preconception care services (i.e., evidence-based risk screening, health promotion, and interventions) that will enable them to enter pregnancy in optimal health; 3) reduce risks indicated by a previous adverse pregnancy outcome through interventions during the interconception period, which can prevent or minimize health problems for a mother and her future children; and 4) reduce the disparities in adverse pregnancy outcomes.The recommendations focus on changes in consumer knowledge, clinical practice, public health programs, health-care financing, and data and research activities. Each recommendation is accompanied by a series of specific action steps and, when implemented, can yield results within 2-5 years. Based on implementation of the recommendations, improvements in access to care, continuity of care, risk screening, appropriate delivery of interventions, and changes in health behaviors of men and women of childbearing age are expected to occur. The implementation of these recommendations will help achieve Healthy People 20 10 objectives. The recommendations and action steps are a strategic plan that can be used by persons, communities, public health and clinical providers, and governments to improve the health of women, their children, and their families. Improving preconception health among the approximately 62 million women of childbearing age will require multistrategic, action-oriented initiatives.This report updates the 2005 recommendations by the Advisory Committee on Immunization Practices (ACIP) regarding the use of influenza vaccine and antiviral agents (CDC. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2005; 54 [No. RR-8]:1-44). The 2006 recommendations include new and updated information. Principal changes include 1) recommending vaccination of children aged 24-59 months and their household contacts and out-of-home caregivers against influenza; 2) highlighting the importance of administering 2 doses of influenza vaccine for children aged 6 months-< 9years who were previously unvaccinated; 3) advising health-care providers, those planning organized campaigns, and state and local public health agencies to a) develop plans for expanding outreach and infrastructure to vaccinate more persons than the previous year and b) develop contingency plans for the timing and prioritization of administering influenza vaccine, if the supply of vaccine is delayed and/or reduced; 4) reminding providers that they should routinely offer influenza vaccine to patients throughout the influenza season; 5) recommending that neither amantadine nor rimantadine be used for the treatment or chemoprophylaxis of influenza A in the United States until evidence of susceptibility to these antiviral medications has been re-established among circulating influenza A viruses; and 6) using the 2006-07 trivalent influenza vaccine virus strains: A/New Caledonia/20/1999 (HINI)-like, A/Wisconsin/67/2005 (H3N2)-like, and B/Malaysia/2506/2004-like antigens. For the A/Wisconsin/67/2005 (H3N2)-like antigen, manufacturers may use the antigenically equivalent A/Hiroshima/52/2005 virus;for the B/Malaysia/2506/2004-like antigen, manufacturers may use the antigenically equivalent B/Ohio/1/2005 virus. A link to this report and other information can be accessed at http://ww.cdc.gov/flu.This report provides updated, integrated recommendations for services provided to partners of persons with human immunodeficiency virus (HI 9 infection and three other sexually transmitted diseases (STDs) (i.e., syphilis, gonorrhea, and chlamydial infection) and replaces the CDC 2001 Program Operations Guidelines for STD Prevention-Partner Services and the 1998 HIV Partner Counseling and Referral Services Guidance (1,2). These recommendations are intended for health department program managers responsible for overseeing partner services programs for HIV infection and the three other STDs at the state and local levels. The recommendations also might be beneficial for HIV prevention community planning groups, STD program advisory bodies, technical assistance providers, community-based organizations, and clinical care providers.The value of partner services in the control of syphilis and gonorrhea is widely accepted. However, such services are underused among partners of persons with HTV infection. On the basis of evidence of effectiveness and cost-effectiveness of these services, CDC strongly recommends that all persons with newly diagnosed or reported HIV infection or early syphilis receive partner services with active health department involvement. Persons with a diagnosis of, or who are reported with, gonorrhea or chlamydial infection also are suitable candidates for partner services, however, resource limitations and the numerous cases of these infections might preclude direct health department involvement in certain instances. Health departments might need to limit direct involvement in partner services for gonorrhea and chlamydial infection to selected high-priority cases and use other strategies for the remainder (e.g., expedited partner therapy).These recommendations highlight the importance of program collaboration and service integration in the provision of partner services. Because coinfection with HIV and one or more other STDs is common, all persons with a diagnosis of HIV should be tested for other types of STDs, and vice versa; rates of coinfection with HIV and syphilis have been particularly high in recent years. Many persons at risk for these infections also are at risk for other infectious diseases, such as tuberculosis and viral hepatitis, as well as various other health conditions. STD and HIV partner services offer STD, HIV, and other public health programs an opportunity for collaboration to deliver comprehensive services to clients, improve program efficiency, and maximize the positive effects on public health.