Gant Zanetta, Bradley Heather, Hu Xiaohong, Skarbinski Jacek, Hall H Irene, Lansky Amy
MMWR Morb Mortal Wkly Rep. 2014 Oct 10;63(40):886-90.
The goals of the National HIV/AIDS Strategy are to reduce new human immunodeficiency virus (HIV) infections, increase access to care and improve health outcomes for persons living with HIV, and reduce HIV-related health disparities. In July 2013, by presidential executive order, the HIV Care Continuum Initiative was established, focusing on accelerating federal efforts to increase HIV testing, care, and treatment. Hispanics or Latinos are disproportionately affected by HIV infection; the annual rate of HIV diagnosis among Hispanics or Latinos is approximately three times that of non-Hispanic whites. To achieve the goals of the National HIV/AIDS Strategy, and to be consistent with the HIV Care Continuum Initiative, Hispanics or Latinos living with HIV infection need improved levels of care and viral suppression. Achieving these goals calls for 85% of Hispanics or Latinos with diagnosed HIV to be linked to care, 80% to be retained in care, and the proportion with an undetectable viral load (VL) to increase 20% by 2015. Analysis of data from the National HIV Surveillance System (NHSS) and the Medical Monitoring Project (MMP) regarding progress along the HIV care continuum during 2010 for Hispanics or Latinos with diagnosed HIV infection indicated that 80.3% of HIV-diagnosed Hispanics or Latinos were linked to care, 54.4% were retained in care, 44.4% were prescribed antiretroviral therapy (ART), and 36.9% had achieved viral suppression (VL result of ≤200 copies/mL). Among Hispanic or Latino males and females, the percentages that were linked to care, were prescribed ART, and had achieved viral suppression were similar; however, the percentage retained in care was lower among males compared with females. The levels of linkage to care and viral suppression were lower among Hispanics or Latinos with HIV infection attributed to injection drug use than among those with HIV infection attributed to heterosexual or male-to-male sexual contact. These data demonstrate the need for implementation of interventions and public health strategies that increase linkage to care, retention in care, and consistent ART among Hispanics or Latinos, particularly Hispanics or Latinos who inject drugs.
《国家艾滋病毒/艾滋病战略》的目标是减少新的人类免疫缺陷病毒(HIV)感染,增加获得护理的机会并改善艾滋病毒感染者的健康状况,以及减少与艾滋病毒相关的健康差距。2013年7月,通过总统行政命令,设立了“艾滋病毒护理连续统一体倡议”,重点是加快联邦政府在增加艾滋病毒检测、护理和治疗方面的努力。西班牙裔或拉丁裔受艾滋病毒感染的影响尤为严重;西班牙裔或拉丁裔的艾滋病毒年度诊断率约为非西班牙裔白人的三倍。为实现《国家艾滋病毒/艾滋病战略》的目标,并与“艾滋病毒护理连续统一体倡议”保持一致,感染艾滋病毒的西班牙裔或拉丁裔需要提高护理水平和病毒抑制率。要实现这些目标,需要使85%的确诊感染艾滋病毒的西班牙裔或拉丁裔与护理机构建立联系,80%的人持续接受护理,到2015年,病毒载量(VL)检测不到的比例提高20%。对国家艾滋病毒监测系统(NHSS)和医疗监测项目(MMP)中关于2010年确诊感染艾滋病毒的西班牙裔或拉丁裔在艾滋病毒护理连续统一体方面进展情况的数据进行分析表明,80.3%确诊感染艾滋病毒的西班牙裔或拉丁裔与护理机构建立了联系,54.4%的人持续接受护理,44.4%的人接受了抗逆转录病毒疗法(ART)治疗,36.9%的人实现了病毒抑制(VL结果≤200拷贝/毫升)。在西班牙裔或拉丁裔男性和女性中,与护理机构建立联系、接受ART治疗并实现病毒抑制的比例相似;然而,男性持续接受护理的比例低于女性。因注射毒品感染艾滋病毒的西班牙裔或拉丁裔与护理机构建立联系和实现病毒抑制的水平低于因异性或男男性接触感染艾滋病毒的人群。这些数据表明,需要实施干预措施和公共卫生战略,以增加西班牙裔或拉丁裔,特别是注射毒品的西班牙裔或拉丁裔与护理机构的联系、持续接受护理的比例以及持续接受ART治疗的比例。