Office of the US Global AIDS Coordinator, Department of State, Washington, DC, USA.
Health Aff (Millwood). 2012 Jul;31(7):1585-92. doi: 10.1377/hlthaff.2012.0255.
The President's Emergency Plan for AIDS Relief (PEPFAR), which began in 2003, initially responded to the global AIDS epidemic by applying lessons learned in treating the disease in the United States to addressing the emergency abroad. As the program expanded, it evolved to support interventions increasingly tailored to local needs in countries receiving PEPFAR assistance. This global experience has created a knowledge base of how to provide HIV/AIDS prevention, care, and treatment services in low-resource settings. It underscored the importance of treatment adherence, family-centered care, and integration of HIV into broader health care delivery systems. Applying these lessons can help US policy makers address existing gaps in HIV care in the United States, where the availability of HIV treatment has at times masked the continued need for testing, early diagnosis, targeted prevention for key populations, and a solid array of social services for people living with HIV/AIDS and their families. This article identifies PEPFAR practices that merit further exploration for adoption in the United States, including strategies to increase adherence to drug treatment regimens and to ensure that HIV services are broadly integrated with other aspects of health care.
总统艾滋病紧急救援计划（PEPFAR）始于 2003 年，最初通过将在美国治疗该疾病的经验应用于解决国外的紧急情况来应对全球艾滋病疫情。随着该计划的扩大，它逐渐发展为支持在接受 PEPFAR 援助的国家根据当地需求进行越来越有针对性的干预。这一全球经验为如何在资源匮乏的环境中提供艾滋病毒/艾滋病预防、护理和治疗服务创建了一个知识库。它强调了治疗依从性、以家庭为中心的护理以及将艾滋病毒纳入更广泛的医疗保健提供系统的重要性。应用这些经验可以帮助美国政策制定者解决美国艾滋病毒护理方面现存的差距，在那里，艾滋病毒治疗的可及性有时掩盖了对测试、早期诊断、针对关键人群的有针对性预防以及为艾滋病毒感染者和艾滋病患者及其家人提供一系列坚实的社会服务的持续需求。本文确定了 PEPFAR 的一些做法，值得在美国进一步探索采用，包括提高药物治疗方案依从性的策略，以及确保艾滋病毒服务与医疗保健的其他方面广泛整合。
