Institute of HIV Research and Innovation, 319 Phayathai Road, Pathumwan, Bangkok, 10330, Thailand.
Mplus Foundation, 142 Chiang Mai Hod Road, Muang, Chiang Mai, 50200, Thailand.
Curr HIV/AIDS Rep. 2020 Oct;17(5):422-430. doi: 10.1007/s11904-020-00516-z.
Globally, "undetectable equals untransmittable (U=U)" and "pre-exposure prophylaxis (PrEP)" have become crucial elements in HIV treatment and prevention programs. We reviewed the implementation of U=U and PrEP among countries in the Asia-Pacific region.
U=U and PrEP uptakes were limited and slow in the Asia-Pacific. Inadequate knowledge among health care practitioners and pervasive stigma towards individuals living with HIV and their sexual lives are key barriers for the integration of U=U into clinical practice. Paternalistic and hierarchical health care systems are major obstacles in PrEP implementation and scale-up. Countries with the most advanced PrEP implementation all use community-based, nurse-led, and key population-led service delivery models. To advance U=U and PrEP in the Asia-Pacific, strategies targeting changes to practice norm through wide-scale stakeholders' training and education, making use of online health care professional influencers, and utilizing financial mechanism should be further explored through implementation research.
在全球范围内，“检测不到等于不传播（U=U）”和“暴露前预防（PrEP）”已成为 HIV 治疗和预防规划的重要内容。我们对亚太地区国家实施 U=U 和 PrEP 的情况进行了综述。
在亚太地区，U=U 和 PrEP 的采用率有限且缓慢。医护人员知识不足，对 HIV 感染者及其性生活的普遍污名化，是将 U=U 纳入临床实践的主要障碍。家长式和等级制的医疗保健系统是 PrEP 实施和扩大的主要障碍。实施 PrEP 最先进的国家均采用以社区为基础、护士主导和重点人群主导的服务提供模式。为了在亚太地区推进 U=U 和 PrEP，应通过实施研究进一步探索通过广泛的利益攸关方培训和教育、利用在线医疗保健专业影响者以及利用财务机制来改变实践规范的策略。
