针对血清学不一致伴侣的艾滋病预防进展。
Advances in HIV prevention for serodiscordant couples.
作者信息
Muessig Kathryn E, Cohen Myron S
机构信息
Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,
出版信息
Curr HIV/AIDS Rep. 2014 Dec;11(4):434-46. doi: 10.1007/s11904-014-0225-9.
Serodiscordant couples play an important role in maintaining the global HIV epidemic. This review summarizes biobehavioral and biomedical HIV prevention options for serodiscordant couples focusing on advances in 2013 and 2014, including World Health Organization guidelines and best evidence for couples counseling, couple-based interventions, and the use of antiviral agents for prevention. In the past few years, marked advances have been made in HIV prevention for serodiscordant couples and numerous ongoing studies are continuously expanding HIV prevention tools, especially in the area of pre-exposure prophylaxis. Uptake and adherence to antiviral therapy remains a key challenge. Additional research is needed to develop evidence-based interventions for couples, and especially for male-male couples. Randomized trials have demonstrated the prevention benefits of antiretroviral-based approaches among serodiscordant couples; however, residual transmission observed in recognized serodiscordant couples represents an important and resolvable challenge in HIV prevention.
血清学不一致的伴侣在全球艾滋病流行的持续传播中起着重要作用。本综述总结了血清学不一致伴侣的生物行为学和生物医学艾滋病预防选择，重点关注2013年和2014年的进展，包括世界卫生组织的指南以及伴侣咨询、基于伴侣的干预措施和使用抗病毒药物进行预防的最佳证据。在过去几年中，血清学不一致伴侣的艾滋病预防取得了显著进展，众多正在进行的研究不断扩展艾滋病预防工具，尤其是在暴露前预防领域。抗病毒治疗的接受度和依从性仍然是一个关键挑战。需要开展更多研究，以制定基于证据的针对伴侣的干预措施，特别是针对男男性伴侣的措施。随机试验已证明基于抗逆转录病毒疗法的方法对血清学不一致伴侣具有预防益处；然而，在已确认的血清学不一致伴侣中观察到的残余传播是艾滋病预防中一个重要且可解决的挑战。
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