a National Center for Disease Control and Prevention , Yerevan , Armenia.
b Victor Babes Clinical Hospital for Infectious Diseases, Carol Davila University of Medicine and Pharmacy , Bucharest , Romania.
Infect Dis (Lond). 2019 Apr;51(4):277-286. doi: 10.1080/23744235.2019.1565415. Epub 2019 Feb 21.
BACKGROUND/OBJECTIVES: Inadequate HIV care for hard-to-reach populations may result in failing the UNAIDS 90-90-90 goal. Therefore, we aimed to review the HIV continuum of care and hard-to-reach populations for each step of the continuum in Central, Eastern and South Eastern Europe.
Euro-guidelines in Central and Eastern Europe (ECEE) Network Group were created in February 2016. The aim of the network was to review the standards of HIV care in the countries of the region. Information about each stage of HIV continuum of care and hard-to-reach populations for each stage was collected through on-line surveys. Respondents were ECEE members chosen based on their expertise and involvement in national HIV care. Data sources (year 2016) used by respondents included HIV Clinics electronic databases, Institutes of Public Health, Centres for AIDS Prevention, and HIV Programme Reviews.
The percentage of people living with HIV (PLHIV) linked to HIV care after HIV diagnosis was ranged between 80% and 96% in Central Europe, 51% and 92% in Eastern Europe and 80% and 100% in South-Eastern Europe. The percentage of PLHIV who are on ART was ranged from 80% to 93% in Central Europe, 18% to 92% in Eastern Europe and 80% to 100% in South-Eastern Europe. The percentage of people virologically suppressed while on ART was reported as 70-95%, 12-95% and 62-97% in Central, Eastern, and South Eastern Europe, respectively. All three regions reported people who inject drugs (PWID) as hard-to-reach population across all HIV continuum stages. Migrants were the second most reported hard-to-reach population. The proportion of late presenters among newly diagnosed ranged between 20% and 55%, 40% and 55% and 48% and 60% in Central, Eastern and South Eastern Europe, respectively. Four countries reported ARVs' delivery delays resulting in treatment interruptions in 2016: two (25%) in South-Eastern, one (20%) in Central and 1 (16.7%) in Eastern Europe.
Irrespective of the diversity in national HIV epidemics, countries from all three regions reported PWIDs as hard-to-reach population across all HIV continuum stages. Some countries are close to the UNAIDS 2020 goals, others need to strive for progress. However, differences in data sources and variations in definitions limit the utility of continuum of care as a comparative tool.
背景/目的：难以接触的人群若无法获得充分的艾滋病毒护理，可能导致无法实现联合国艾滋病规划署的 90-90-90 目标。因此，我们旨在审查中、东欧和东南欧艾滋病毒护理连续体以及每个连续体阶段的难以接触人群。
2016 年 2 月成立了中、东欧 Euro-guidelines 网络小组。该网络的目的是审查该地区各国的艾滋病毒护理标准。通过在线调查收集有关艾滋病毒护理连续体各个阶段以及每个阶段难以接触人群的信息。根据其专业知识和参与国家艾滋病毒护理的情况，选择网络小组成员作为答卷人。答卷人使用的数据来源（2016 年）包括艾滋病毒诊所电子数据库、公共卫生研究所、艾滋病预防中心和艾滋病毒方案审查。
艾滋病毒确诊后与艾滋病毒护理建立联系的艾滋病毒感染者（PLHIV）比例在中欧为 80%至 96%，东欧为 51%至 92%，东南欧为 80%至 100%。接受抗逆转录病毒治疗的 PLHIV 比例在中欧为 80%至 93%，东欧为 18%至 92%，东南欧为 80%至 100%。报告称，在接受抗逆转录病毒治疗的患者中，病毒学抑制率为 70-95%、12-95%和 62-97%，分别为中欧、东欧和东南欧。所有三个地区都报告说，在所有艾滋病毒连续体阶段，注射毒品者（PWID）都是难以接触的人群。移民是第二大报告的难以接触人群。新确诊的晚期患者比例在中欧为 20%至 55%，东欧为 40%至 55%，东南欧为 48%至 60%。2016 年有四个国家报告称，抗逆转录病毒药物的交付延迟导致治疗中断：东南欧两个（25%）、中欧一个（20%）和东欧一个（16.7%）。
无论国家艾滋病毒流行情况如何，所有三个地区的国家都报告说，PWID 是所有艾滋病毒连续体阶段难以接触的人群。一些国家接近联合国艾滋病规划署 2020 年的目标，而其他国家则需要努力取得进展。然而，数据来源的差异和定义的变化限制了连续体护理作为比较工具的效用。
