关于艾滋病毒感染、梅毒、淋病和衣原体感染的性伴服务项目的建议。

Recommendations for partner services programs for HIV infection, syphilis, gonorrhea, and chlamydial infection.

出版信息

MMWR Recomm Rep. 2008 Nov 7;57(RR-9):1-83; quiz CE1-4.

DOI:
Abstract

This report provides updated, integrated recommendations for services provided to partners of persons with human immunodeficiency virus (HIV) 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. 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 HIV 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.

摘要

本报告为向感染人类免疫缺陷病毒(HIV)者以及其他三种性传播疾病(即梅毒、淋病和衣原体感染)患者的性伴提供的服务提供了更新的综合建议,并取代了美国疾病控制与预防中心(CDC)2001年的《性传播疾病预防项目操作指南——性伴服务》以及1998年的《HIV性伴咨询与转介服务指南》。这些建议针对负责在州和地方层面监督HIV感染及其他三种性传播疾病性伴服务项目的卫生部门项目管理人员。这些建议可能对HIV预防社区规划小组、性传播疾病项目咨询机构、技术援助提供者、社区组织和临床护理提供者也有益处。性伴服务在梅毒和淋病控制中的价值已得到广泛认可。然而,此类服务在HIV感染者的性伴中未得到充分利用。基于这些服务有效性和成本效益的证据,CDC强烈建议所有新诊断或报告感染HIV或早期梅毒的人在卫生部门积极参与下接受性伴服务。被诊断为或报告感染淋病或衣原体感染的人也是性伴服务的合适对象;然而,资源限制以及这些感染的大量病例可能在某些情况下使卫生部门无法直接参与。卫生部门可能需要将淋病和衣原体感染性伴服务的直接参与限于选定的高优先级病例,并对其余病例采用其他策略(例如加速性伴治疗)。这些建议强调了项目协作和服务整合在提供性伴服务中的重要性。由于HIV与一种或多种其他性传播疾病合并感染很常见,所有诊断为HIV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,HIV与梅毒的合并感染率一直特别高。许多有这些感染风险的人也有感染其他传染病的风险,如结核病和病毒性肝炎,以及各种其他健康问题。性传播疾病和HIV性伴服务为性传播疾病、HIV及其他公共卫生项目提供了合作机会,以便为客户提供全面服务、提高项目效率并最大化对公共卫生的积极影响。

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