College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
Department of Global Health, University of Washington, Seattle, WA, USA.
Nat Med. 2020 May;26(5):655-664. doi: 10.1038/s41591-020-0872-x. Epub 2020 May 11.
Following recommendations by the World Health Organization in 2015, and key clinical trials, countries in sub-Saharan Africa, the region with the highest burden of human immunodeficiency virus (HIV), developed policies that incorporate pre-exposure prophylaxis (PrEP) into national HIV-prevention strategies. By the end of 2019, more than one third of people receiving PrEP globally were in Africa. Crucial understandings gained from early rollout among at-risk populations, such as HIV-serodiscordant couples, adolescent girls and young women, female sex workers, and men who have sex with men, include the importance of strategies for maintaining persistent adherence to PrEP and novel approaches to making PrEP services accessible, simplified and efficient. This Perspective will discuss the current status of these programs and how to further widen their implementation.
根据世界卫生组织 2015 年的建议和关键临床试验,撒哈拉以南非洲地区是艾滋病毒(HIV)负担最重的地区,该地区制定了将暴露前预防(PrEP)纳入国家艾滋病毒预防战略的政策。到 2019 年底,接受 PrEP 治疗的全球人数中有超过三分之一来自非洲。在 HIV 血清不一致的夫妇、青少年女孩和年轻妇女、性工作者以及男男性行为者等高危人群中早期推出 PrEP 所获得的重要认识包括:维持 PrEP 持续坚持性的策略的重要性,以及使 PrEP 服务可及、简化和高效的新方法。本观点将讨论这些项目的现状以及如何进一步扩大其实施范围。