aDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia bDepartment of Epidemiology and Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Curr Opin HIV AIDS. 2014 Mar;9(2):199-205. doi: 10.1097/COH.0000000000000039.
The epidemiology of HIV epidemics provides the roadmap for prioritization of programmes and serves over time to evaluate broadly the successes and challenges in prevention. The purpose of this review was to summarize recent information about the epidemiology of HIV in high-income countries with concentrated HIV epidemics.
Data from 26 countries were organized and analysed, and a systematic review of published literature relating to epidemiology in these countries was conducted. Our major findings illustrated strong patterns in epidemiology by mode of HIV acquisition: in most high-income countries, new HIV diagnoses attributable to male-female sex have been stable or decreasing, whereas new HIV diagnoses attributable to male-male sex have been stable or increasing. Late diagnoses of HIV infection are common. Prevalence of HIV in high-income countries has risen over the past 5 years as death rates have been stable or decreasing. Reports of the epidemiology of HIV among sex workers and transgendered persons are rare.
The epidemiology of HIV in high-income countries in 2013 depicts both the successes and challenges of HIV prevention. The stable to decreasing death rates and stable or declining trends in heterosexual populations are likely attributable, at least in part, to the broader availability of effective treatments for HIV and relatively broad availability of antiretroviral treatment in these countries. However, late diagnoses undermine the individual and public health value of antiretroviral treatment, and epidemics of HIV among MSM remain largely uncontrolled despite broad availability and coverage of treatment.
HIV 流行的流行病学提供了项目优先级排序的路线图，并随着时间的推移，广泛评估预防工作的成功与挑战。本综述的目的是总结关于高收入国家集中流行 HIV 的流行病学的最新信息。
对 26 个国家的数据进行了组织和分析，并对这些国家的相关流行病学文献进行了系统综述。我们的主要发现说明了 HIV 获得途径的流行病学中的强烈模式：在大多数高收入国家，新诊断的男性-女性性传播 HIV 保持稳定或下降，而新诊断的男性-男性性传播 HIV 保持稳定或上升。HIV 感染的晚期诊断很常见。过去 5 年来，高收入国家的 HIV 流行率上升，而死亡率保持稳定或下降。关于性工作者和跨性别者中 HIV 流行病学的报告很少。
2013 年高收入国家 HIV 的流行病学描绘了 HIV 预防的成功与挑战。死亡率保持稳定或下降，异性恋人群中的稳定或下降趋势可能部分归因于更广泛地提供有效的 HIV 治疗以及这些国家中更广泛地提供抗逆转录病毒治疗。然而，晚期诊断削弱了抗逆转录病毒治疗对个人和公共卫生的价值，男男性行为者中的 HIV 流行仍然基本失控，尽管广泛提供和覆盖了治疗。
