Crankshaw Tamaryn L, Smit Jennifer A, Beksinska Mags E
a Health Economics and HIV and AIDS Research Division (HEARD) , University of KwaZulu-Natal , Durban , South Africa.
b MatCH Research (Maternal, Adolescent, & Child Health Research) Unit, Department of Obstetrics and Gynaecology , Faculty of Health Sciences , University of the Witwatersrand , South Africa.
Afr J AIDS Res. 2016 Jul;15(2):157-62. doi: 10.2989/16085906.2016.1204330.
Over the past decade, the global response to the HIV epidemic has been unprecedented, and enormous progress has been made. Significant investment in the roll out of antiretroviral treatment (ART) and efforts to increase treatment coverage have greatly reduced the number of AIDS-related deaths worldwide. There are a growing number of promising innovations to expand the HIV prevention mix. However, the reach of these interventions is still very limited in adolescent girls and young women (15-24 years) and the full realisation of the intervention mandates has not yet been achieved. The HIV prevention field has been criticised for the tendency to adopt a narrow focus. The Fast-Track Strategy offers a unique opportunity for the HIV prevention field to broaden its gaze and to begin to identify synergies (and efficiencies) with prevention approaches from other global development priorities, namely sexual and reproductive health and rights (SRHR). This paper applies a SRHR lens to HIV prevention by highlighting the critical relationship between unintended pregnancy and HIV, and seeks to expand on earlier debates that prevention of HIV and prevention of unintended pregnancy are inextricably linked, complementary activities with interrelated and common goals. We call for the prioritisation of prevention of unintended pregnancy amongst two overlapping population groups - girls and young women (15-24 years old) and women living with HIV - as a key tactic to accomplish the Joint United Nations Programme on HIV/AIDS (UNAIDS) Fast-Track Strategy and as a way to fully realise existing HIV prevention efforts. We discuss the intersecting pathways between HIV prevention and unintended pregnancy prevention and build a case for contraception to be placed at the centre of the HIV prevention agenda.
在过去十年中,全球对艾滋病毒疫情的应对是前所未有的,并且已经取得了巨大进展。在抗逆转录病毒治疗(ART)推广方面的大量投资以及提高治疗覆盖率的努力,极大地减少了全球与艾滋病相关的死亡人数。扩大艾滋病毒预防手段的有前景的创新措施越来越多。然而,这些干预措施在少女和年轻女性(15 - 24岁)中的覆盖范围仍然非常有限,干预任务的全面落实尚未实现。艾滋病毒预防领域因倾向于狭隘关注而受到批评。快速通道战略为艾滋病毒预防领域提供了一个独特的机会,使其能够拓宽视野,并开始确定与其他全球发展优先事项(即性健康和生殖健康及权利,SRHR)的预防方法之间的协同作用(和效率)。本文通过强调意外怀孕与艾滋病毒之间的关键关系,运用性健康和生殖健康及权利视角来审视艾滋病毒预防,并试图扩展早期的辩论,即预防艾滋病毒和预防意外怀孕是紧密相连、相辅相成的活动,有着相互关联且共同的目标。我们呼吁将预防意外怀孕作为优先事项,在两个重叠的人群——少女和年轻女性(15 - 24岁)以及感染艾滋病毒的女性——中加以重视,这是实现联合国艾滋病规划署(UNAIDS)快速通道战略的关键策略,也是充分实现现有艾滋病毒预防工作的一种方式。我们讨论了艾滋病毒预防与意外怀孕预防之间相互交叉的途径,并论证将避孕措施置于艾滋病毒预防议程核心位置的必要性。