Cuffe Kendra M, Esie Precious, Leichliter Jami S, Gift Thomas L
MMWR Morb Mortal Wkly Rep. 2017 Apr 7;66(13):355-358. doi: 10.15585/mmwr.mm6613a2.
The incidence of human immunodeficiency virus (HIV) infection in the United States is higher among persons with other sexually transmitted diseases (STDs), and the incidence of other STDs is increased among persons with HIV infection (1). Because infection with an STD increases the risk for HIV acquisition and transmission (1-4), successfully treating STDs might help reduce the spread of HIV among persons at high risk (1-4). Because health department STD programs provide services to populations who are at risk for HIV, ensuring service integration and coordination could potentially reduce the incidence of STDs and HIV. Program integration refers to the combining of STD and HIV prevention programs through structural, service, or policy-related changes such as combining funding streams, performing STD and HIV case matching, or integrating staff members (5). Some STD programs in U.S. health departments are partially or fully integrated with an HIV program (STD/HIV program), whereas other STD programs are completely separate. To assess the extent of provision of HIV services by state and local health department STD programs, CDC analyzed data from a sample of 311 local health departments and 56 state and directly funded city health departments derived from a national survey of STD programs. CDC found variation in the provision of HIV services by STD programs at the state and local levels. Overall, 73.1% of state health departments and 16.1% of local health departments matched STD case report data with HIV data to analyze possible syndemics (co-occurring epidemics that exacerbate the negative health effects of any of the diseases) and overlaps. Similarly, 94.1% of state health departments and 46.7% of local health departments performed site visits to HIV care providers to provide STD information or public health updates. One fourth of state health departments and 39.4% of local health departments provided HIV testing in nonclinical settings (field testing) for STD contacts, and all of these programs linked HIV cases to care. STD programs are providing some HIV services; however, delivery of certain specific services could be improved.
在美国，其他性传播疾病（STD）患者中人类免疫缺陷病毒（HIV）感染的发生率较高，而HIV感染者中其他STD的发生率也有所增加（1）。由于感染STD会增加感染和传播HIV的风险（1 - 4），成功治疗STD可能有助于减少HIV在高危人群中的传播（1 - 4）。由于卫生部门的STD项目为有HIV感染风险的人群提供服务，确保服务的整合与协调可能会降低STD和HIV的发病率。项目整合是指通过结构、服务或政策相关的变革，如合并资金流、进行STD和HIV病例匹配或整合工作人员等，将STD和HIV预防项目结合起来（5）。美国卫生部门的一些STD项目部分或完全与HIV项目整合（STD/HIV项目），而其他STD项目则完全独立。为了评估州和地方卫生部门STD项目提供HIV服务的程度，美国疾病控制与预防中心（CDC）分析了来自311个地方卫生部门以及56个州和直接资助的城市卫生部门样本的数据，这些数据源自一项全国性的STD项目调查。CDC发现，州和地方层面的STD项目在提供HIV服务方面存在差异。总体而言，73.1%的州卫生部门和16.1%的地方卫生部门将STD病例报告数据与HIV数据进行匹配，以分析可能的共病情况（同时发生的流行病，会加剧任何一种疾病对健康的负面影响）和重叠情况。同样，94.1%的州卫生部门和46.7%的地方卫生部门对HIV护理提供者进行实地考察，以提供STD信息或公共卫生最新情况。四分之一的州卫生部门和39.4%的地方卫生部门在非临床环境（现场检测）中为STD接触者提供HIV检测，并且所有这些项目都将HIV病例与护理相联系。STD项目正在提供一些HIV服务；然而，某些特定服务的提供情况仍有待改善。
