Joulaei Hassan, Shooshtarian Sowgol, Dianatinasab Mostafa
Health Policy Research Center, Iran.
Shiraz HIV/AIDS Research Centre, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
AIDS Rev. 2018 Apr-Jun;20(2):83-93. doi: 10.24875/AIDSRev.M18000020.
Middle East and North Africa (MENA) region is lagging far behind the global average to reach 90-90-90 targets. This study uses the UNAIDS 90-90-90 program to evaluate the HIV current situation in MENA countries, and understand the challenges that exist in the way of approaching the program goals. All articles and publications were searched based on the 90-90-90 program indexes among national and international data resources such as official national reports and online scientific databases such as PubMed, Medline, and Scopus up to December 2017. The data were categorized into four main stages: (1) estimated number of HIV-positive people (people living with HIV [PLWH]); (2) PLWH who know their status; (3) PLWH receiving antiretroviral therapy (ART); and (4) virally suppressed PLWH. A total of 41 papers were included in the study. 19 out of 24 MENA countries have met the inclusion criteria. The proportion of diagnosed people ranges from 6% in Pakistan to 76% in Algeria. The percentage of diagnosed people receiving ART ranges between 7% in Pakistan and 86% in Algeria. Viral suppression levels vary from 4% to 72% in Pakistan and Kuwait, respectively. Lack of appropriate surveillance systems, low access to HIV-care facilities along with complicated socioeconomic and geopolitical situation of the region have made it challenging for MENA countries to reach 90-90-90 goals by 2020. To achieve these goals, the foremost strategy is global effort to establish peace in this region and rebuild the infrastructure in the countries involved in war and to setup comprehensive surveillance systems in the majority of the MENA countries.
中东和北非（MENA）地区在实现“90-90-90”目标方面远远落后于全球平均水平。本研究采用联合国艾滋病规划署的“90-90-90”项目来评估中东和北非国家的艾滋病毒现状，并了解在实现该项目目标的道路上存在的挑战。截至2017年12月，在国家官方报告等国家和国际数据资源以及PubMed、Medline和Scopus等在线科学数据库中，根据“90-90-90”项目指标搜索了所有文章和出版物。数据分为四个主要阶段：（1）艾滋病毒阳性者（艾滋病毒感染者[PLWH]）估计人数；（2）知晓自身感染状况的艾滋病毒感染者；（3）接受抗逆转录病毒疗法（ART）的艾滋病毒感染者；（4）病毒得到抑制的艾滋病毒感染者。该研究共纳入41篇论文。24个中东和北非国家中有19个符合纳入标准。已诊断人群的比例从巴基斯坦的6%到阿尔及利亚的76%不等。接受抗逆转录病毒疗法的已诊断人群百分比在巴基斯坦为7%，在阿尔及利亚为86%。巴基斯坦和科威特的病毒抑制水平分别从4%到72%不等。缺乏适当的监测系统、获得艾滋病毒护理设施的机会有限，以及该地区复杂的社会经济和地缘政治状况，使得中东和北非国家在2020年前实现“90-90-90”目标面临挑战。为实现这些目标，首要战略是全球共同努力在该地区建立和平，重建战乱国家的基础设施，并在大多数中东和北非国家建立全面的监测系统。
