Rice Brian D, Yin Zheng, Brown Alison E, Croxford Sara, Conti Stefano, De Angelis Daniela, Delpech Valerie C
Facility of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
Department of HIV and STIs, Public Health England, 61 Colindale Avenue, Colindale, London, NW9 5EQ, UK.
AIDS Behav. 2017 Jul;21(Suppl 1):83-90. doi: 10.1007/s10461-016-1604-6.
We report on measures used to monitor the response to the UK HIV epidemic. We present analyses of routine data on HIV testing, diagnosis and care, and of CD4 back-calculation models to estimate country of HIV acquisition and incidence. Over the past decade, HIV and AIDS diagnoses and deaths declined while HIV testing coverage increased. Linkage into care, retention in care, and viral suppression was high with few socio-demographic differences. However, in 2013, incidence among MSM, and undiagnosed infection, also remained high, and more than half of heterosexuals newly diagnosed with HIV (the majority of whom were born-abroad) probably acquired HIV in the UK and were diagnosed late. HIV care following diagnosis is excellent in the UK. Improvements in testing and prevention are required to reduce undiagnosed infection, incidence and late diagnoses. Routinely collected laboratory and clinic data is a low cost, robust and timely mechanism to monitor the public health response to national HIV epidemics.
我们报告了用于监测英国艾滋病疫情应对情况的措施。我们对艾滋病病毒检测、诊断和治疗的常规数据，以及用于估计艾滋病病毒感染来源国和发病率的CD4反向推算模型进行了分析。在过去十年中，艾滋病病毒和艾滋病的诊断及死亡人数有所下降，而艾滋病病毒检测覆盖率有所提高。接受治疗的关联率、治疗留存率和病毒抑制率都很高，社会人口统计学差异很小。然而，2013年，男男性行为者中的发病率以及未被诊断出的感染率仍然很高，新诊断出感染艾滋病病毒的异性恋者中，超过一半（其中大多数在国外出生）可能是在英国感染了艾滋病病毒，而且诊断较晚。在英国，确诊后的艾滋病治疗情况良好。需要改进检测和预防措施，以减少未被诊断出的感染、发病率和延迟诊断情况。常规收集的实验室和临床数据是监测国家艾滋病疫情公共卫生应对情况的一种低成本、可靠且及时的机制。
Ann Intern Med. 2018-3-20
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