Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC.
MMWR Morb Mortal Wkly Rep. 2019 Mar 22;68(11):267-272. doi: 10.15585/mmwr.mm6811e1.
In 2016, an estimated 1.1 million persons had human immunodeficiency virus (HIV) infection in the United States; 38,700 were new infections. Knowledge of HIV infection status, behavior change, and antiretroviral therapy (ART) all prevent HIV transmission. Persons who achieve and maintain viral suppression (achieved by most persons within 6 months of starting ART) can live long, healthy lives and pose effectively no risk of HIV transmission to their sexual partners.
A model was used to estimate transmission rates in 2016 along the HIV continuum of care. Data for sexual and needle-sharing behaviors were obtained from National HIV Behavioral Surveillance. Estimated HIV prevalence, incidence, receipt of care, and viral suppression were obtained from National HIV Surveillance System data.
Overall, the HIV transmission rate was 3.5 per 100 person-years in 2016. Along the HIV continuum of care, the transmission rates from persons who were 1) acutely infected and unaware of their infection, 2) non-acutely infected and unaware, 3) aware of HIV infection but not in care, 4) receiving HIV care but not virally suppressed, and 5) taking ART and virally suppressed were 16.1, 8.4, 6.6, 6.1, and 0 per 100 person-years, respectively. The percentages of all transmissions generated by each group were 4.0%, 33.6%, 42.6%, 19.8%, and 0%, respectively.
Approximately 80% of new HIV transmissions are from persons who do not know they have HIV infection or are not receiving regular care. Going forward, increasing the percentage of persons with HIV infection who have achieved viral suppression and do not transmit HIV will be critical for ending the HIV epidemic in the United States.
2016 年，美国估计有 110 万人感染了人类免疫缺陷病毒（HIV），其中 38700 人为新感染病例。对 HIV 感染状况的了解、行为改变和抗逆转录病毒治疗（ART）都能预防 HIV 传播。大多数人在开始接受 ART 治疗后 6 个月内即可实现并维持病毒抑制，从而能过上长寿、健康的生活，并且实际上不会对性伴侣造成 HIV 传播的风险。
使用模型估计 2016 年沿着 HIV 护理连续体的传播率。性和针具共享行为的数据来自国家 HIV 行为监测。从国家 HIV 监测系统的数据中获得估计的 HIV 流行率、发病率、获得护理和病毒抑制情况。
总体而言，2016 年 HIV 传播率为每 100 人年 3.5 例。沿着 HIV 护理连续体，从以下人群中传播的 HIV 率分别为：1）急性感染且不知道自己感染了 HIV 的人；2）非急性感染且不知道自己感染了 HIV 的人；3）知道自己感染了 HIV 但未接受治疗的人；4）接受 HIV 治疗但未实现病毒抑制的人；5）接受 ART 治疗且病毒抑制的人，分别为 16.1、8.4、6.6、6.1 和 0 例每 100 人年。每个群体产生的所有传播的百分比分别为 4.0%、33.6%、42.6%、19.8%和 0%。
大约 80%的新 HIV 传播来自不知道自己感染了 HIV 或未接受定期护理的人。今后，提高实现病毒抑制且不传播 HIV 的 HIV 感染者的比例，对于结束美国的 HIV 流行至关重要。
Zotero 插件