The HIV Epidemic in Eastern Europe and Central Asia
The HIV Epidemic in Eastern Europe and Central Asia
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DOI：
10.1007/s11904-014-0202-3
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发表时间：
2014-06-01
影响因子：
4.6
通讯作者：
El-Bassel, Nabila
中科院分区：
文献类型：
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作者：
DeHovitz, Jack;Uuskula, Anneli;El-Bassel, Nabila
东欧和中亚是全球艾滋病毒感染率持续上升的少数区域之一。例如，在东欧，每100 000人中艾滋病毒感染的确诊病例率从2004年的11.7例增加到2011年的22.5例。最初由注射吸毒推动的异性传播现已成为该区域新感染的主要驱动因素。尽管如此，药物使用仍然是一个重要因素，其控制受到扩大减少危害努力方面的挑战的限制。虽然大多数国家已经实施了阿片类药物替代治疗计划，但其规模仍然非常有限。同样，该区域针头注射器方案的覆盖面也各不相同。非注射药物的出现和抗逆转录病毒疗法的不足使艾滋病毒控制工作复杂化。此外，对艾滋病毒感染者的结构性障碍和耻辱感可能导致很高比例的艾滋病毒治疗延迟。最后，在艾滋病毒流行之后，丙型肝炎感染和结核病的发病率很高。
Eastern Europe and Central Asia represent one of the few regions globally where there is a continued increase in the incidence of HIV infection. For example, in Eastern Europe the rate of diagnosed cases of HIV infection per 100 000 population has increased from 11.7 in 2004 to 22.5 in 2011. Initially propelled by injection drug use, heterosexual transmission has now become a major driver of new infections in the region. Nonetheless substance use remains an important factor, with its control limited by challenges in scaling up harm reduction efforts. While most countries have implemented opioid substitution therapy programs, their scale remains very limited. Similarly, coverage of needles syringe programs across the region is variable. Complicating the control of HIV has been the emergence of non-injection drugs and inadequate access to antiretroviral therapy. In addition, structural barriers and stigma toward HIV infected people may contribute to the high proportion of late presentations for HIV care. Finally in the wake of the HIV epidemic, high rates of hepatitis C infection and tuberculosis have been noted.