Smith Laramie R, Patterson Thomas L, Magis-Rodriguez Carlos, Ojeda Victoria D, Burgos Jose Luis, Rojas Sarah A, Zúñiga María Luisa, Strathdee Steffanie A
Division of Global Public Health, Department of Medicine, University of California, San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA.
Department of Psychiatry, University of California, San Diego, La Jolla, USA.
AIDS Behav. 2016 May;20(5):1017-25. doi: 10.1007/s10461-015-1186-8.
In Tijuana, Mexico, HIV is concentrated in sub-epidemics of key populations: persons who inject drugs (PWID), sex workers (SW), and men who have sex with men (MSM). To date, data on engagement in the HIV care continuum among these key populations, particularly in resource-constrained settings, are sparse. We pooled available epidemiological data from six studies (N = 3368) to examine HIV testing and treatment uptake in these key populations; finding an overall HIV prevalence of 5.7 %. Of the 191 identified HIV-positive persons, only 11.5 % knew their HIV-positive status and 3.7 % were on ART. Observed differences between these HIV-positive key populations suggest PWID (vs. non-PWID) were least likely to have previously tested or initiate HIV care. MSM (vs. non-MSM) were more likely to have previously tested but not more likely to know their HIV-positive status. Of persons aware of their HIV-positive status, SW (vs. non-SW) were more likely to initiate HIV care. Findings suggest engagement of key populations in HIV treatment is far below estimates observed for similarly resource-constrained generalized epidemics in sub-Saharan Africa. These data provide one of the first empirical-snapshots highlighting the extent of HIV treatment disparities in key populations.
在墨西哥蒂华纳，艾滋病病毒集中在关键人群的亚流行中：注射毒品者、性工作者和男男性行为者。迄今为止，关于这些关键人群中艾滋病病毒护理连续体参与情况的数据，尤其是在资源有限的环境中，非常稀少。我们汇总了六项研究（N = 3368）中可用的流行病学数据，以检查这些关键人群中的艾滋病病毒检测和治疗接受情况；发现总体艾滋病病毒流行率为5.7%。在191名确诊的艾滋病病毒阳性者中，只有11.5%知道自己的艾滋病病毒阳性状态，3.7%正在接受抗逆转录病毒治疗。这些艾滋病病毒阳性关键人群之间观察到的差异表明，注射毒品者（与非注射毒品者相比）以前检测或开始接受艾滋病病毒护理的可能性最小。男男性行为者（与非男男性行为者相比）以前检测的可能性更大，但知道自己艾滋病病毒阳性状态的可能性并不更大。在知道自己艾滋病病毒阳性状态的人中，性工作者（与非性工作者相比）更有可能开始接受艾滋病病毒护理。研究结果表明，关键人群参与艾滋病病毒治疗的程度远低于撒哈拉以南非洲类似资源有限的广泛流行中观察到的估计数。这些数据提供了首批实证快照之一，突出了关键人群中艾滋病病毒治疗差距的程度。
