Secondary prevention of HIV in the United States: past, current, and future perspectives.
Secondary prevention of HIV in the United States: past, current, and future perspectives.
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DOI：
10.1097/qai.0b013e3181fbca2f
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发表时间：
2010-12
期刊：
影响因子：
--
通讯作者：
Lenz EM
中科院分区：
文献类型：
--
作者：
Fisher JD;Smith LR;Lenz EM
提供美国过去、现在和潜在的下一代预防为阳性(PfP)干预方法的概要。由于各种原因，PfP干预措施直到2000年左右才在美国出现，其目的是限制艾滋病毒/艾滋病患者(PLWHA)向他人传播艾滋病毒，并保护PLWHA的健康。即使在今天，以证据为基础的PfP干预措施的数量和广度也非常有限。然而，荟萃分析证据表明，这种干预措施可能是有效的，甚至可能比针对未感染艾滋病毒的个人的干预措施更有效。我们回顾了早期和最近的PfP干预措施，并建议下一代PfP干预措施必须涉及行为和生物成分，并针对任何影响HIV危险行为和/或传染性的因素。下一代PfP应包括增加艾滋病毒检测，以确定更多的PLWHA，启动和维持艾滋病毒护理的组成部分，启动抗逆转录病毒疗法(ART)并促进遵守，减少性和注射毒品使用的危险行为，以及辅助治疗和转诊到服务机构。全面的下一代PfP，包括所有这些要素以及它们之间的有效联系，如图1所示。
To provide a synopsis of past, current, and potential next-generation approaches to prevention for positives (PfP) interventions in the United States. For a variety of reasons, PfP interventions, with the goals of limiting HIV transmission from people living with HIV/AIDS (PLWHA) to others, and protecting the health of PLWHA, did not appear with any frequency in the United States until about 2000. Even today, the number and breadth of evidence-based PfP interventions is very limited. Nevertheless, meta-analytic evidence demonstrates that such interventions can be effective, perhaps even more so than interventions targeting HIV-uninfected individuals. We review early and more recent PfP interventions and suggest that next-generation PfP interventions must involve behavioral and biologic components and target any element that affects HIV risk behavior and/or infectivity. Next generation PfP should include increased HIV testing to identify additional PLWHA, components to initiate and maintain HIV care, to initiate antiretroviral therapy (ART) and promote adherence, and to reduce sexual and injection drug use risk behavior, as well as ancillary treatments and referrals to services. Comprehensive next-generation PfP, including all of these elements and effective linkages among them, is depicted in Figure 1.