Myer Landon, Rabkin Miriam, Abrams Elaine J, Rosenfield Allan, El-Sadr Wafaa M
Columbia University, Mailman School of Public Health, New York, NY, USA.
Reprod Health Matters. 2005 May;13(25):136-46. doi: 10.1016/s0968-8080(05)25185-6.
Despite important advances in expanding access to antiretroviral therapy in the countries most heavily affected by HIV/AIDS, there has been little consideration of the connections between HIV prevention, care and treatment programmes and reproductive health services. In this paper, we explore the integration of reproductive health services into HIV care and treatment programmes. We review the design and progress of the MTCT-Plus Initiative, which provides HIV care and treatment services to HIV positive women as well as their HIV positive children and partners. By emphasising the long-term follow-up of families and the provision of comprehensive care across the spectrum of HIV disease, MTCT-Plus highlights the potential synergies in linking reproductive health services to HIV care and treatment programmes. While HIV care and treatment programmes in resource-limited settings may not be able to integrate all reproductive health services into a single service delivery model, there is a clear need to include basic reproductive health services, such as access to appropriate contraception and counselling and management of unplanned pregnancies. The integration of these services would be facilitated by greater insight into the reproductive choices of HIV positive women and men, and into how health care providers influence access to reproductive health services of people with HIV and AIDS.
尽管在受艾滋病毒/艾滋病影响最严重的国家，在扩大抗逆转录病毒疗法的可及性方面取得了重要进展，但对于艾滋病毒预防、护理和治疗方案与生殖健康服务之间的联系却很少有人考虑。在本文中，我们探讨将生殖健康服务纳入艾滋病毒护理和治疗方案的问题。我们回顾了“预防母婴传播强化服务倡议”（MTCT-Plus）的设计与进展情况，该倡议为艾滋病毒呈阳性的妇女及其艾滋病毒呈阳性的子女和伴侣提供艾滋病毒护理和治疗服务。通过强调对家庭的长期随访以及提供涵盖艾滋病毒疾病各个阶段的全面护理，“预防母婴传播强化服务倡议”突出了将生殖健康服务与艾滋病毒护理和治疗方案相联系的潜在协同效应。虽然资源有限环境下的艾滋病毒护理和治疗方案可能无法将所有生殖健康服务整合到单一的服务提供模式中，但显然有必要纳入基本的生殖健康服务，如提供适当的避孕措施以及对意外怀孕的咨询和管理。对艾滋病毒呈阳性的妇女和男子的生殖选择以及医疗保健提供者如何影响艾滋病毒感染者和艾滋病患者获得生殖健康服务有更深入的了解，将有助于这些服务的整合。
