British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Curr Opin HIV AIDS. 2012 Mar;7(2):151-6. doi: 10.1097/COH.0b013e32834f9927.
The use of highly active antiretroviral therapy (HAART) as a strategy to prevent the transmission of HIV infection is of substantial international interest. Injection drug users (IDUs) are an important population with respect to HIV treatment as prevention because they are often less likely to access HAART in comparison with other risk groups.
A recent multicentre randomized clinical trial demonstrated a 96% reduction in HIV transmission among heterosexual serodiscordant couples prescribed early HAART. Consistent with these results, independent observational studies from Baltimore and Vancouver have demonstrated that population level rates of HAART use among IDUs are associated with reduced rates of HIV incidence. In addition, impact assessments of HAART delivery to IDUs have generally demonstrated no negative effects of HAART use on rates of unsafe sex or syringe sharing.
HAART prevents HIV transmission because it dramatically decreases HIV-1 RNA levels in biological fluids. This is relevant to vertical and sexual HIV transmission and also to blood-borne HIV transmission, as it is often the case among IDUs. Efforts to expand HAART to IDUs should be redoubled in an effort to realize both the individual and public health benefits of HAART.
使用高效抗逆转录病毒疗法（HAART）作为预防 HIV 感染传播的策略具有重要的国际意义。注射吸毒者（IDUs）是 HIV 治疗即预防方面的一个重要人群，因为与其他风险群体相比，他们通常不太可能获得 HAART。
最近一项多中心随机临床试验表明，对于接受早期 HAART 治疗的异性恋血清不一致夫妇，HIV 传播减少了 96%。与这些结果一致，来自巴尔的摩和温哥华的独立观察性研究表明，IDUs 中人群水平的 HAART 使用与 HIV 发病率降低相关。此外，对 IDUs 提供 HAART 的影响评估通常表明，HAART 使用对不安全性行为或共用注射器的比率没有负面影响。
HAART 可预防 HIV 传播，因为它可显著降低生物体液中的 HIV-1 RNA 水平。这与垂直和性 HIV 传播以及 IDUs 中常见的血液传播 HIV 传播有关。应加倍努力扩大 HAART 对 IDUs 的使用，以实现 HAART 的个人和公共卫生效益。
