Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT, USA.
Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT, USA.
Lancet HIV. 2018 Nov;5(11):e667-e670. doi: 10.1016/S2352-3018(18)30178-4. Epub 2018 Oct 9.
Although the HIV pandemic remains a global crisis, much progress has been made in implementing programmes to treat and prevent HIV infection. To guide prioritisation of efforts, the metric by which a country can declare its HIV epidemic as controlled has become increasingly relevant. Herein, we evaluate the merits of the four control criteria proposed by UNAIDS: percentage reduction in incidence over time; ratio of incidence to mortality; ratio of incidence to prevalence; and annual incidence. Using a transmission model to generate projections of demography, incidence, and mortality, we highlight potential pitfalls associated with each of the first three criteria. A definition of control based on annual incidence would provide clarity and consistency across settings.
尽管艾滋病大流行仍然是一个全球性危机，但在实施治疗和预防艾滋病毒感染的方案方面已经取得了很大进展。为了指导工作的重点，衡量一个国家宣布其艾滋病疫情得到控制的标准变得越来越重要。在此，我们评估了艾滋病规划署提出的四项控制标准的优点：随着时间的推移发病率的降低百分比；发病率与死亡率之比；发病率与流行率之比；以及年发病率。我们使用传播模型生成人口、发病率和死亡率的预测，突出了与前三个标准相关的潜在问题。基于年发病率的控制定义将在不同环境中提供清晰性和一致性。
