Geretti A M, Loutfy M, D'Arminio Monforte A, Latysheva I, Pérez Elías M J, Rymer J, Boffito M
Institute of Infection & Global Health, University of Liverpool, Liverpool, UK.
Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Canada.
HIV Med. 2017 Sep;18 Suppl 2:3-17. doi: 10.1111/hiv.12533.
Around half of the global adult HIV-positive population are women, yet historically women have been under-represented in clinical studies of antiretroviral therapy (ART) and there has been minimal exploration of gender-specific factors related to the response to and appropriateness of treatment choices in women living with HIV (WLWH). There are several key issues pertaining to the cascade of HIV care that make it important to differentiate WLWH from men living with HIV. Factors that are gender specific may impact on the status of WLWH, affecting access to diagnosis and treatment, optimal clinical management, ART outcomes, retention in care, and the overall long-term wellbeing of WLWH. In this review, we discuss the results of recently reported women-only clinical trials and highlight the key unmet needs of WLWH as they pertain to the cascade of HIV care across World Health Organization European Region countries. As significant knowledge gaps remain, the review identifies key areas where further research is required, in order to support improved management of WLWH and guide informed clinical decision-making, including addressing psychosocial factors as part of comprehensive care.
全球约一半的成年HIV阳性人群为女性，但在抗逆转录病毒疗法（ART）的临床研究中，女性的代表性历来不足，而且对于与HIV感染女性（WLWH）治疗反应及治疗选择适宜性相关的性别特异性因素，几乎没有进行过探索。在HIV诊疗流程中，有几个关键问题使得区分WLWH和HIV感染男性很重要。性别特异性因素可能会影响WLWH的状况，影响其获得诊断和治疗的机会、最佳临床管理、ART疗效、治疗依从性以及WLWH的整体长期健康状况。在本综述中，我们讨论了最近报告的仅针对女性的临床试验结果，并强调了WLWH在世界卫生组织欧洲区域国家的HIV诊疗流程中尚未满足的关键需求。由于仍然存在重大的知识空白，本综述确定了需要进一步研究的关键领域，以支持改善对WLWH的管理并指导明智的临床决策，包括将心理社会因素作为综合护理的一部分加以解决。
