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[关于艾滋病病毒控制与预防策略的讨论]

[Discussion of HIV control and prevention strategies].

作者信息

Lyu P

机构信息

National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2016 Oct 6;50(10):841-845. doi: 10.3760/cma.j.issn.0253-9624.2016.10.001.

Abstract

Expansion of HIV testing and ART treatment are core strategies for achieving the ambitious global goal of ending the HIV epidemic by the end of 2030, and achieving the "90-90-90" target by 2020. In China, great progress in HIV control and prevention has been made; however, there is room to enhance the effectiveness of HIV-related strategies. In addition, some implemented strategies have not achieved their expected output. To confront the challenge of sexual transmission of HIV, which is the main route of transmission in China, more targeted HIV prevention strategies that lead to their expected outcomes are essential. It is important to strengthen existing strategies that have been proved effective. However, it is also critical to create innovative strategies, and there are five approaches to achieve this. First, a holistic perspective should be adopted, to better understand the current situation and problems. This means intervention strategies should give serious consideration of how to meet the sociocultural needs of target populations rather than merely carry out behavioral interventions. Second, community-based HIV prevention settings should have more important roles in providing HIV-related health care services. Moreover, to improve the effectiveness of these strategies, a problem-led working style should be integrated into HIV prevention measures overall. Third, thoroughly analyzing characteristics of the current HIV epidemic using more evidence-based considerations must be undertaken, to better control HIV sexual transmission. Fourth, continued improvement of AIDS prevention and control mechanisms is needed, to ensure their sustainable development. Last, it is necessary to involve more NGOs in HIV prevention work by strengthening their management and working capacities to provide HIV-related services. Also needed is further improvement in both technical and management capacities, so as to build a stable basis for effective response.

摘要

扩大艾滋病毒检测和抗逆转录病毒治疗是实现到2030年底终结艾滋病毒流行这一宏伟全球目标以及到2020年实现“90-90-90”目标的核心战略。在中国,艾滋病毒防控工作已取得巨大进展;然而,提高与艾滋病毒相关战略的有效性仍有空间。此外,一些已实施的战略尚未达到预期成效。为应对在中国成为主要传播途径的艾滋病毒性传播挑战,制定更具针对性且能产生预期效果的艾滋病毒预防战略至关重要。加强已被证明有效的现有战略固然重要。然而,创新战略同样关键,实现这一点有五种途径。首先,应采取整体视角,以更好地了解现状和问题。这意味着干预战略应认真考虑如何满足目标人群的社会文化需求,而非仅仅进行行为干预。其次,可以在提供与艾滋病毒相关的医疗保健服务方面发挥更重要的作用。此外,为提高这些战略的有效性,应将以问题为导向的工作方式融入整体艾滋病毒预防措施中。第三,必须运用更多基于证据的考量深入分析当前艾滋病毒流行的特征,以更好地控制艾滋病毒性传播。第四,需要持续改进艾滋病防控机制,以确保其可持续发展。最后,有必要通过加强非政府组织提供与艾滋病毒相关服务的管理和工作能力,让更多非政府组织参与到艾滋病毒预防工作中。还需要进一步提高技术和管理能力,从而为有效应对奠定坚实基础。

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