Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205, USA.
AIDS Behav. 2012 Jul;16(5):1085-91. doi: 10.1007/s10461-012-0186-1.
The recent NIH HPTN 052 study of using HIV treatment to prevent HIV transmission in serostatus discordant heterosexual partnerships has garnered much attention. In subsequent discussions, however, the topic of HIV-related risk behavior has been nearly absent. Here, we identify the critical roles that HIV-related risk behavior plays in determining the unmet needs, optimal targeting, and ultimate impact of treatment as prevention. We describe the size of the population at risk of HIV and three subgroups of persons living with HIV (PLWH) based on awareness of serostatus and risk behavior, and the corresponding HIV transmission rates to seronegative partners. For each of the subgroups of PLWH, we identify which approach is most relevant ("testing and linkage to care," "treatment as prevention," and/or "treatment as clinical care"). We observe that the impact of "treatment as prevention" on HIV incidence will depend heavily on which subgroup of PLWH is targeted for services.
最近美国国立卫生研究院 HPTN 052 研究使用 HIV 治疗来预防血清学不一致的异性恋伴侣间 HIV 传播，引起了广泛关注。然而，在随后的讨论中，HIV 相关风险行为几乎没有被提及。在这里，我们确定了 HIV 相关风险行为在确定未满足的需求、最佳目标和治疗预防的最终影响方面的关键作用。我们描述了根据血清学状况和风险行为以及与 HIV 阴性伴侣的相应 HIV 传播率来确定感染 HIV 的风险人群的规模，以及三种 HIV 感染者亚组。对于 HIV 感染者的每个亚组，我们确定哪种方法最相关（“检测和链接到护理”、“治疗预防”和/或“治疗作为临床护理”）。我们观察到，“治疗预防”对 HIV 发病率的影响将在很大程度上取决于针对哪些 HIV 感染者亚组提供服务。
