Singh Sonia, Bradley Heather, Hu Xiaohong, Skarbinski Jacek, Hall H Irene, Lansky Amy
MMWR Morb Mortal Wkly Rep. 2014 Sep 26;63(38):829-33.
Gay, bisexual, and other men who have sex with men (MSM) represent approximately 2% of the United States population, yet are the risk group most affected by human immunodeficiency virus (HIV). In 2010, among persons newly infected with HIV, 63% were MSM; among persons living with HIV, 52% were MSM. The three goals of the National HIV/AIDS Strategy are to reduce new HIV infections, to increase access to care and improve health outcomes for persons living with HIV, and to reduce HIV-related health disparities. In July 2013, the HIV Care Continuum Initiative was established by executive order to mobilize and accelerate federal efforts to increase HIV testing, services, and treatment along the continuum. To meet the 2015 targets of the National HIV/AIDS Strategy, 85% of MSM diagnosed with HIV should be linked to care, 80% should be retained in care, and the proportion with an undetectable viral load (VL) should be increased by 20%. To assess progress toward meeting these targets, CDC assessed the level at each step of the continuum of care for MSM by age and race/ethnicity. CDC analyzed data from the National HIV Surveillance System (NHSS) and the Medical Monitoring Project (MMP) for MSM with diagnosed HIV infection. The results indicated that 77.5% were linked to care, 50.9% were retained in care, 49.5% were prescribed antiretroviral therapy (ART), and 42.0% had achieved viral suppression. Younger MSM and black/African American MSM had lower levels of care compared with older MSM and those of all other races/ethnicities. Interventions aimed at MSM are needed that increase linkage to care, retention in care, and ART use, particularly among MSM aged <25 years and black/African American MSM.
男同性恋者、双性恋者以及其他与男性发生性行为的男性(MSM)约占美国人口的2%,但却是受人类免疫缺陷病毒(HIV)影响最严重的风险群体。2010年,在新感染HIV的人群中,63%为MSM;在HIV感染者中,52%为MSM。《国家HIV/AIDS战略》的三个目标是减少新的HIV感染、增加HIV感染者获得治疗的机会并改善其健康状况,以及减少与HIV相关的健康差距。2013年7月,通过行政命令设立了HIV治疗连续统一体倡议,以调动并加速联邦政府在整个连续过程中增加HIV检测、服务和治疗的努力。为实现《国家HIV/AIDS战略》的2015年目标,85%被诊断感染HIV的MSM应接受治疗,80%应持续接受治疗,病毒载量(VL)检测不到的比例应提高20%。为评估在实现这些目标方面取得的进展,美国疾病控制与预防中心(CDC)按年龄和种族/族裔评估了MSM在治疗连续统一体各阶段的水平。CDC分析了来自国家HIV监测系统(NHSS)和医疗监测项目(MMP)中被诊断感染HIV的MSM的数据。结果表明,77.5%的人接受了治疗,50.9%的人持续接受治疗,49.5%的人接受了抗逆转录病毒治疗(ART),42.0%的人实现了病毒抑制。与年龄较大的MSM以及所有其他种族/族裔的MSM相比,年轻MSM和黑人/非裔美国MSM的治疗水平较低。需要针对MSM开展干预措施,以增加接受治疗的比例、持续接受治疗的比例以及ART的使用,尤其是在年龄小于25岁的MSM和黑人/非裔美国MSM中。