Department of Paediatrics & Child Health and Ukwanda Centre for Rural Health, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa.
TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand.
Curr Opin HIV AIDS. 2018 May;13(3):170-178. doi: 10.1097/COH.0000000000000449.
The aim of this study was to summarize recent evidence on the global epidemiology of adolescents (age 10-19 years) living with HIV (ALHIV), the burden of HIV on the health of adolescents and HIV-associated mortality.
In 2016, there were an estimated 2.1 million (uncertainty bound 1.4-2.7 million) ALHIV; 770 000 younger (age 10-14 years) and 1.03 million older (age 15-19 years) ALHIV, 84% living in sub-Saharan Africa. The population of ALHIV is increasing, as more peri/postnatally infected ALHIV survive into older ages; an estimated 35% of older female ALHIV were peri/postnatally infected, compared with 57% of older male ALHIV. Although the numbers of younger ALHIV deaths are declining, deaths among older ALHIV have remained static since peaking in 2012. In 2015, HIV-associated mortality was the eighth leading cause of adolescent death globally and the fourth leading cause in African low and middle-income countries.
Needed investments into characterizing and improving adolescent HIV-related health outcomes include strengthening systems for nationally and globally disaggregated data by age, sex and mode of infection; collecting more granular data within routine programmes to identify structural, social and mental health challenges to accessing testing and care; and prioritizing viral load monitoring and adolescent-focused differentiated models of care.
本研究旨在总结青少年（10-19 岁）艾滋病病毒感染者（ALHIV）的全球流行病学、艾滋病对青少年健康的影响以及艾滋病相关死亡率的最新证据。
2016 年，全球估计有 210 万（不确定范围 140 万至 270 万）ALHIV；77 万年龄较小（10-14 岁）和 103 万年龄较大（15-19 岁）的 ALHIV，其中 84%生活在撒哈拉以南非洲。随着更多围产期感染的 ALHIV 存活到老年，ALHIV 的人数正在增加；与年龄较大的男性 ALHIV 相比，年龄较大的女性 ALHIV 中有 35%是围产期感染的，而 57%是围产期感染的。尽管年龄较小的 ALHIV 死亡人数正在下降，但年龄较大的 ALHIV 死亡人数自 2012 年达到峰值以来一直保持不变。2015 年，艾滋病相关死亡是全球青少年第八大死因，也是非洲中低收入国家青少年第四大死因。
需要对青少年艾滋病相关健康结果进行特征描述和改善，这包括加强按年龄、性别和感染途径进行国家和全球分类数据的系统；在常规方案中收集更详细的数据，以确定在接受检测和护理方面面临的结构性、社会和心理健康挑战；并优先考虑病毒载量监测和以青少年为重点的差异化护理模式。
