Strategic Intelligence and Analysis Division, UNAIDS, 20 Avenue Appia, 1211 Geneva, Switzerland.
Sex Transm Infect. 2010 Dec;86 Suppl 2(Suppl_2):ii72-ii83. doi: 10.1136/sti.2010.044933.
In 2001 the United Nations (UN) Declaration of Commitment was signed by 189 countries with a goal to reduce HIV prevalence among young people by 25% by 2010. Progress towards this target is assessed. In addition, changes in reported sexual behaviour among young people aged 15-24 years are investigated.
Thirty countries most affected by HIV were invited to participate in the study. Trends in HIV prevalence among young antenatal clinic (ANC) attendees were analysed using data from sites that were consistently included in surveillance between 2000 and 2008. Regression analysis was used to determine if the UN target had been reached. Trends in prevalence data from repeat national population-based surveys were also analysed. Trends in sexual behaviour were analysed using data from repeat standardised national population-based surveys between 1990 and 2008.
Seven countries showed a statistically significant decline of 25% or more in HIV prevalence among young ANC attendees by 2008, in rural or urban areas or in both: Botswana, Côte d'Ivoire, Ethiopia, Kenya, Malawi, Namibia and Zimbabwe. Three further countries showed a significant decline in HIV prevalence among young women (Zambia) or men (South Africa, Tanzania) in national surveys. Seven other countries are on track, whereas four are unlikely to reach the goal by 2010. Nine countries did not have adequate data to assess prevalence trends. Indications suggestive of changes towards less risky sexual behaviour were observed in the majority of countries. In eight countries with significant declines in HIV prevalence, significant changes were also observed in sexual behaviour in either men or women for at least two of the three sexual behaviour indicators.
Declines in HIV prevalence among young people were documented in the majority of countries with adequate data and in most cases were accompanied by changes in sexual behaviour. Further data, research and more rigorous analysis at country level are needed to understand the associations between programmatic efforts, reported behavioural changes and changes in prevalence and incidence of HIV.
2001 年，189 个国家签署了《联合国承诺宣言》，目标是到 2010 年将年轻人中的艾滋病毒流行率降低 25%。对这一目标的进展情况进行评估。此外，还调查了 15-24 岁年轻人报告的性行为变化。
邀请了受艾滋病毒影响最严重的 30 个国家参加这项研究。使用 2000 年至 2008 年期间一直纳入监测的地点的艾滋病毒流行率数据，对年轻产前诊所 (ANC) 就诊者的艾滋病毒流行率趋势进行分析。使用回归分析来确定是否达到了联合国的目标。还分析了来自重复的全国基于人口的调查的流行率数据趋势。使用 1990 年至 2008 年期间重复的标准化全国基于人口的调查的数据，分析性行为趋势。
到 2008 年，7 个国家在农村或城市地区或两者都显示出年轻 ANC 就诊者艾滋病毒流行率下降 25%或更多的统计显著下降：博茨瓦纳、科特迪瓦、埃塞俄比亚、肯尼亚、马拉维、纳米比亚和津巴布韦。另外 3 个国家在全国调查中显示年轻妇女（赞比亚）或男子（南非、坦桑尼亚）艾滋病毒流行率显著下降。另外 7 个国家正在按计划进行，而 4 个国家到 2010 年不太可能达到目标。9 个国家没有足够的数据来评估流行率趋势。在大多数国家都观察到了性行为向更安全方向转变的迹象。在艾滋病毒流行率显著下降的 8 个国家中，在至少两个性行为指标中，男性或女性的性行为也发生了显著变化。
在有足够数据的大多数国家中，都记录了年轻人中的艾滋病毒流行率下降，而且在大多数情况下，还伴随着性行为的变化。需要在国家一级进一步提供数据、进行研究和更严格的分析，以了解方案工作、报告的行为变化以及艾滋病毒流行率和发病率的变化之间的关联。
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