Dee Jacob, Garcia Calleja Jesus M, Marsh Kimberly, Zaidi Irum, Murrill Christopher, Swaminathan Mahesh
Division of Global HIV and TB, US Centers for Disease Control and Prevention, Atlanta, GA, United States.
HIV Strategic Information and Planning, World Health Organization, Geneva, Switzerland.
JMIR Public Health Surveill. 2017 Dec 5;3(4):e85. doi: 10.2196/publichealth.8000.
Since the late 1980s, human immunodeficiency virus (HIV) sentinel serosurveillance among pregnant women attending select antenatal clinics (ANCs) based on unlinked anonymous testing (UAT) has provided invaluable information for tracking HIV prevalence and trends and informing global and national HIV models in most countries with generalized HIV epidemics. However, increased coverage of HIV testing, prevention of mother-to-child transmission (PMTCT), and antiretroviral therapy has heightened ethical concerns about UAT. PMTCT programs now routinely collect demographic and HIV testing information from the same pregnant women as serosurveillance and therefore present an alternative to UAT-based ANC serosurveillance. This paper reports on the evolution and current direction of the global approach to HIV surveillance among pregnant women attending ANCs, including the transition away from traditional UAT-based serosurveillance and toward new guidance from the World Health Organization and the Joint United Nations Programme on HIV/AIDS on the implementation of surveillance among pregnant women attending ANCs based on routine PMTCT program data.
自20世纪80年代末以来，基于不关联匿名检测（UAT），在选定的产前诊所对孕妇开展人类免疫缺陷病毒（HIV）哨点血清学监测，为追踪HIV流行率和趋势以及为大多数HIV广泛流行的国家提供全球和国家HIV模型提供了宝贵信息。然而，HIV检测、预防母婴传播（PMTCT）和抗逆转录病毒疗法覆盖面的扩大，引发了对不关联匿名检测的更多伦理担忧。PMTCT项目现在通常从与血清学监测相同的孕妇那里收集人口统计学和HIV检测信息，因此成为基于UAT的产前诊所血清学监测的一种替代方法。本文报告了在产前诊所就诊的孕妇中进行HIV监测的全球方法的演变和当前方向，包括从传统的基于UAT的血清学监测向世界卫生组织和联合国艾滋病规划署关于根据常规PMTCT项目数据对在产前诊所就诊的孕妇实施监测的新指南的转变。
