Department of HIV/AIDS, World Health Organization, Geneva, Switzerland.
Clin Infect Dis. 2015 Jun 1;60 Suppl 3:S159-60. doi: 10.1093/cid/civ091.
There is a clear convergence toward an overarching strategic use of antiretroviral drugs to prevent human immunodeficiency virus (HIV) infection. Four interventions-immediate antiretroviral therapy (ART) for the infected partner in a serodiscordant couple, preexposure prophylaxis (PrEP), prevention of mother-to-child transmission (PMTCT), and postexposure prophylaxis (PEP)-are all strongly recommended by the World Health Organization as effective ways to prevent HIV infection. For HIV-infected individuals, ART to protect an HIV-uninfected partner and PMTCT are both part of an expanding list of recommendations for starting ART immediately to both treat and prevent HIV infection. For HIV-uninfected individuals, PrEP and PEP are increasingly being seen as related interventions, and there are compelling reasons to consider the provision of PEP as a potential gateway to PrEP. The effectiveness of each of these interventions depends on overcoming barriers to seeking services, adequate community understanding and engagement, high levels of access and uptake of services including HIV testing and counselling, and high levels of adherence.
目前,人们越来越倾向于采用抗逆转录病毒药物来进行总体战略防控,以此预防人体免疫缺陷病毒(HIV)感染。世界卫生组织强烈推荐四项干预措施,即:针对血清学不一致的伴侣中已感染的一方进行即刻抗逆转录病毒治疗(ART)、暴露前预防(PrEP)、母婴传播预防(PMTCT)和暴露后预防(PEP),这些措施都是预防 HIV 感染的有效方法。对于 HIV 感染者,ART 既可以保护 HIV 阴性的伴侣,也属于扩大立即开始 ART 治疗和预防 HIV 感染建议范围的一部分。对于 HIV 阴性个体,PrEP 和 PEP 越来越被视为相关干预措施,而且有充分的理由考虑提供 PEP,将其作为 PrEP 的潜在切入点。这些干预措施的有效性取决于能否克服寻求服务的障碍、社区的充分理解和参与、服务(包括 HIV 检测和咨询)的高获取率和接受率以及高的依从性。
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