Figueroa J Peter, Duncan Jacqueline P, Bailey Althea, Skyers Nicola
The University of the West Indies, Mona Kingston Jamaica The University of the West Indies, Mona, Kingston, Jamaica.
Ministry of Health and Wellness Kingston Jamaica Ministry of Health and Wellness, Kingston, Jamaica.
Rev Panam Salud Publica. 2020 Nov 20;44:e157. doi: 10.26633/RPSP.2020.157. eCollection 2020.
To assess the status of the HIV epidemic and programmatic implementation in Jamaica while identifying strategies for achieving effective HIV control.
The assessment included a review of the core indicators of the UNAIDS Global Monitoring Framework, a desk review of program reports, and unstructured interviews of stakeholders.
HIV prevalence among adults in Jamaica was 1.5% in 2018 with an estimated 32 617 persons living with HIV (PLHIV) and 27 324 persons (83.8%) diagnosed with HIV; 12 711 (39.0% of all PLHIV or 46.5% aware of their status) were on anti-retroviral therapy (ART) in the public health sector and 61.8% PLHIV on ART were virally suppressed. HIV prevalence among men who have sex with men remains high (31.4% in 2011, 29.6% in 2017) but has declined among female sex workers (12% in 1990, 2% in 2017). HIV prevalence among public sexually transmitted infection clinic attendees, prison inmates and the homeless has increased in recent years. During 2018 approximately 200 000 persons (14% of the population 15-49 years) were tested with 1 165 newly diagnosed PLHIV, indicating that many of the estimated 1 600 newly infected persons in 2018 were unaware of their status.
Critical policy initiatives are needed to reduce barriers to HIV services, ensure young persons have access to condoms and contraceptives, affirm the rights of the marginalized, reduce stigma and discrimination, and introduce pre-exposure prophylaxis. While HIV spread in Jamaica has slowed, the UNAIDS Fast Track goals are lagging. The HIV program must be strengthened to effectively control the epidemic.
评估牙买加的艾滋病疫情状况及项目实施情况，同时确定实现有效控制艾滋病的策略。
评估包括审查联合国艾滋病规划署全球监测框架的核心指标、对项目报告进行案头审查以及对利益相关者进行非结构化访谈。
2018年牙买加成年人中的艾滋病病毒流行率为1.5%，估计有32617人感染艾滋病病毒（艾滋病毒感染者），其中27324人（83.8%）被诊断出感染艾滋病病毒；公共卫生部门有12711人（占所有艾滋病毒感染者的39.0%或知晓自身感染状况者的46.5%）正在接受抗逆转录病毒治疗（ART），接受ART治疗的艾滋病毒感染者中有61.8%的病毒得到抑制。男男性行为者中的艾滋病病毒流行率仍然很高（2011年为31.4%，2017年为29.6%），但女性性工作者中的流行率有所下降（1990年为12%，2017年为2%）。近年来，公共性传播感染诊所就诊者、监狱囚犯和无家可归者中的艾滋病病毒流行率有所上升。2018年期间，约20万人（占15 - 49岁人口的14%）接受了检测，有1165人新诊断为艾滋病毒感染者，这表明2018年估计的1600名新感染者中许多人不知道自己的感染状况。
需要采取关键政策举措，以减少获得艾滋病服务的障碍，确保年轻人能够获得避孕套和避孕药具，维护边缘化群体的权利，减少耻辱感和歧视，并引入暴露前预防措施。虽然牙买加的艾滋病传播速度有所放缓，但联合国艾滋病规划署的快速通道目标仍滞后。必须加强艾滋病项目以有效控制疫情。
