A comprehensive response to the HIV/AIDS epidemic in Jamaica: a review of the past 20 years.
A comprehensive response to the HIV/AIDS epidemic in Jamaica: a review of the past 20 years.
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牙买加艾滋病毒/艾滋病流行的综合应对措施：过去 20 年回顾。
DOI：
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发表时间：
2008
影响因子：
0.1
通讯作者：
A. Brathwaite
中科院分区：
文献类型：
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作者：
J. Figueroa;J. Duncan;L. Byfield;K. Harvey;Y. Gebre;T. Hylton;F. Hamer;E. Williams;D. Carrington;A. Brathwaite
牙买加有一个完善的、全面的国家人体免疫缺陷病毒（艾滋病毒）方案，该方案减缓了艾滋病毒的流行并减轻了其影响。自1996年以来，成人艾滋病毒流行率一直稳定在1.5%左右。艾滋病毒感染率在高危人群中很高，如性工作者（9%）和男男性行为者（31.8%）。成年艾滋病患者的危险行为包括多个性伴侣（80%）、性传播感染史（51.1%）、商业性行为（23.9%）和快克/可卡因（8.0%）。在所有报告的艾滋病病例中，约有20%（主要是妇女）没有任何感染艾滋病毒的常见危险因素的病史。国家方案以卫生部为基础。自1988年以来，牙买加制定了一项指导其艾滋病毒防治工作的国家计划。1988年成立了一个国家艾滋病委员会，负责领导多部门应对工作。预防方法包括信息、教育和交流运动、避孕套推广、性传播感染控制、有针对性的干预措施、文化方法、外联和同伴教育、工作场所规划以及艾滋病毒咨询和检测。为减少对艾滋病毒的污名化和歧视作出了协调一致的努力。2001年开始采用抗逆转录病毒疗法（ARV）预防母婴传播，2004年开始实施公众获得治疗方案。2005年，议会一致通过了一项国家艾滋病政策。2007-2012年国家战略计划使牙买加承诺实现普遍获得艾滋病毒预防、治疗和护理。尽管对神话的信仰仍然很强烈，但对艾滋病毒及其预防方法的认识几乎是普遍的。避孕套市场已从1985年的约250万个增加到2006年的1200万个，同时避孕套的使用也有显著增长，近75%的男性和65%的女性报告在最后一次与非固定伴侣发生性关系时使用了避孕套。15-24岁的女性报告曾接受过艾滋病毒检测的比例从2004年的29.8%增加到2008年的48.9%。艾滋病毒母婴传播已从2000年以前的25%下降到2007年的不到8%。截至2008年9月，已有4450人（估计占晚期艾滋病毒和艾滋病患者的68.5%）接受了抗逆转录病毒药物治疗，导致艾滋病毒死亡率和发病率显著下降
Jamaica has a well-established, comprehensive National Human Immunodeficiency Virus (HIV) programme that has slowed the HIV epidemic and mitigated its impact. Adult HIV prevalence has been stable at approximately 1.5% since 1996. HIV rates are high among those most at risk such as sex-workers (9%) and men who have sex with men [MSM] (31.8%). Risk behaviour among adults with AIDS includes multiple sexual partners (80%), a history of a sexually transmitted infection [STI] (51.1%), commercial sex (23.9%) and crack/cocaine (8.0%). Approximately 20% of all reported AIDS cases, mainly women, give no history of any of the usual risk factors for HIV infection. The national programme is based in the Ministry of Health. Since 1988, Jamaica has had a national plan to guide its HIV response. A National AIDS Committee was established in 1988 to lead the multi-sectoral response. Prevention approaches have included information, education and communication campaigns, condom promotion, sexually transmitted infections (STI) control, targeted interventions, cultural approaches, outreach and peer education, workplace programmes and HIV counselling and testing. Concerted efforts have been made to reduce HIV stigma and discrimination. Antiretroviral therapy (ARV) was introduced for prevention of mother-to-child transmission in 2001 and a public access treatment programme introduced in 2004. A national HIV/AIDS Policy was adopted unanimously in parliament in 2005. The National Strategic plan 2007-2012 commits Jamaica to achieving universal access to HIVprevention, treatment and care. Awareness of HIV and how to prevent it is near universal though belief in myths remains strong. The condom market has increased from approximately 2.5 million in 1985 to 12 million in 2006 while condom use has grown significantly with nearly 75% of men and 65% of women reporting condom use at last sex with a non-regular partner The proportion of women 15-24 years reporting ever having a HIV test increased from 29.8% in 2004 to 48.9% in 2008. HIV transmission from mother-to-child has declined from 25% prior to 2000 to less than 8% in 2007. As of September 2008, 4450 persons or an estimated 68.5% of persons with advanced HIV and AIDS have been placed on ARV treatment resulting in a significant decline in mortality and morbidity due to HIV