Division of HIV and STD Programs, Los Angeles County Department of Public Health, Los Angeles, CA 90005, USA.
Am J Public Health. 2013 Jun;103(6):e14-23. doi: 10.2105/AJPH.2013.301273. Epub 2013 Apr 18.
Despite the HIV "test-and-treat" strategy's promise, questions about its clinical rationale, operational feasibility, and ethical appropriateness have led to vigorous debate in the global HIV community. We performed a systematic review of the literature published between January 2009 and May 2012 using PubMed, SCOPUS, Global Health, Web of Science, BIOSIS, Cochrane CENTRAL, EBSCO Africa-Wide Information, and EBSCO CINAHL Plus databases to summarize clinical uncertainties, health service challenges, and ethical complexities that may affect the test-and-treat strategy's success. A thoughtful approach to research and implementation to address clinical and health service questions and meaningful community engagement regarding ethical complexities may bring us closer to safe, feasible, and effective test-and-treat implementation.
尽管 HIV“检测即治疗”策略前景广阔，但该策略在临床原理、操作可行性和伦理适宜性方面存在诸多问题，在全球 HIV 学界引发了激烈的辩论。我们检索了 2009 年 1 月至 2012 年 5 月间发表的文献，通过 PubMed、SCOPUS、Global Health、Web of Science、BIOSIS、Cochrane CENTRAL、EBSCO Africa-Wide Information 和 EBSCO CINAHL Plus 数据库进行系统综述，以总结可能影响“检测即治疗”策略实施成败的临床不确定性、卫生服务挑战和伦理复杂性。如果我们能以深思熟虑的方式开展研究和实施工作，解决临床和卫生服务方面的问题，并就伦理复杂性问题与社区进行有意义的互动，那么我们就能更安全、更有效地实施“检测即治疗”策略。
