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确定终结艾滋病流行的重点地区:美国计划。

Identifying Regions of Greatest Need for Ending the HIV Epidemic: A Plan for America.

机构信息

Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA.

Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.

出版信息

J Acquir Immune Defic Syndr. 2020 Dec 1;85(4):395-398. doi: 10.1097/QAI.0000000000002477.


DOI:10.1097/QAI.0000000000002477
PMID:33136735
Abstract

BACKGROUND: In the 2019 State of the Union Address, President Trump announced a plan for "Ending the HIV Epidemic" in the United States, with a goal to reduce new HIV infections by 90% by 2030. Phase I of the plan set an intermediate goal of a 75% reduction within 5 years, focusing on select states and counties. METHODS: We assessed the feasibility of the first phase of the plan by estimating the fraction of HIV diagnoses that occur within the targeted region, using a statistical model to predict new HIV cases in each county. We suggested new areas that should be added to the current plan, prioritizing by both a "Density Metric" of new HIV cases and a "Gap Metric" quantifying shortcomings in antiretroviral therapy and pre-exposure prophylaxis uptake. RESULTS: We found the current plan targets less than 60% of new diagnoses. The plan should be expanded to Puerto Rico, Florida, Georgia, Louisiana, and Maryland as well as parts of New York, North Carolina, Texas, and Virginia, areas which were prioritized by both metrics. CONCLUSION: Many of the highest priority areas, both by density of HIV cases and by lack of viral suppression and pre-exposure prophylaxis use, were not covered by the original plan, particularly in the South. The current plan to end the HIV epidemic must be expanded to these areas to feasibly allow for a 75% reduction in new HIV cases within 5 years.

摘要

背景:在 2019 年国情咨文中,特朗普总统宣布了一项在美国“终结艾滋病疫情”的计划,目标是到 2030 年将新感染艾滋病的人数减少 90%。该计划的第一阶段设定了一个 5 年内减少 75%的中期目标,重点关注选定的州和郡。

方法:我们通过使用统计模型预测每个县的新艾滋病病例,评估了该计划第一阶段的可行性,该模型用于估计目标区域内发生的艾滋病诊断比例。我们建议在当前计划中增加新的区域,优先考虑新艾滋病病例的“密度指标”和量化抗逆转录病毒治疗和暴露前预防药物使用不足的“差距指标”。

结果:我们发现当前的计划目标是不到 60%的新诊断病例。该计划应扩大到波多黎各、佛罗里达、佐治亚、路易斯安那和马里兰州,以及纽约、北卡罗来纳、得克萨斯和弗吉尼亚州的部分地区,这两个指标都对这些地区进行了优先排序。

结论:许多最高优先级的地区,无论是艾滋病病例密度还是病毒抑制和暴露前预防药物使用不足,都没有被原始计划涵盖,特别是在南部。要想在 5 年内切实减少 75%的新艾滋病病例,目前终结艾滋病疫情的计划必须扩大到这些地区。

相似文献

[1]
Identifying Regions of Greatest Need for Ending the HIV Epidemic: A Plan for America.

J Acquir Immune Defic Syndr. 2020-12-1

[2]
America's HIV Epidemic Analysis Dashboard: Protocol for a Data Resource to Support Ending the HIV Epidemic in the United States.

JMIR Public Health Surveill. 2022-2-10

[3]
The Time Is Now to End the HIV Epidemic.

Am J Public Health. 2019-11-14

[4]
Roles for Pharmacists in the "Ending the HIV Epidemic: A Plan for America" Initiative.

Public Health Rep. 2020-8-11

[5]
Simulating the End of AIDS in New York: Using Participatory Dynamic Modeling to Improve Implementation of the Ending the Epidemic Initiative.

Public Health Rep. 2020

[6]
Implementing the Trump Administration's "Ending the HIV Epidemic" Plan in the Southern United States.

Am J Public Health. 2020-1

[7]
Methods for county-level estimation of pre-exposure prophylaxis coverage and application to the U.S. Ending the HIV Epidemic jurisdictions.

Ann Epidemiol. 2020-1-13

[8]
Changes in HIV Preexposure Prophylaxis Awareness and Use Among Men Who Have Sex with Men - 20 Urban Areas, 2014 and 2017.

MMWR Morb Mortal Wkly Rep. 2019-7-12

[9]
Leveraging Medicaid to Enhance Preexposure Prophylaxis Implementation Efforts and Ending the HIV Epidemic.

Am J Public Health. 2020-1

[10]
The Broader Context of "Ending the HIV Epidemic: A Plan for America" Initiative.

Am J Public Health. 2020-1

引用本文的文献

[1]
How Can Progress Toward Ending the Human Immunodeficiency Virus Epidemic in the United States Be Monitored?

Clin Infect Dis. 2022-8-24

[2]
HIV Infection Prevalence Significantly Intersects With COVID-19 Infection At the Area Level: A US County-Level Analysis.

J Acquir Immune Defic Syndr. 2021-10-1

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