Department of Global Health, Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA, 02119, USA.
Health Economics and Epidemiology Research Office, Wits Health Consortium, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, GP, South Africa.
AIDS Behav. 2021 Dec;25(12):4209-4224. doi: 10.1007/s10461-021-03296-8. Epub 2021 May 25.
People on HIV treatment with undetectable virus cannot transmit HIV sexually (Undetectable = Untransmittable, U = U). However, the science of treatment-as-prevention (TasP) may not be widely understood by people with and without HIV who could benefit from this information. We systematically reviewed the global literature on knowledge and attitudes related to TasP and interventions providing TasP or U = U information. We included studies of providers, patients, and communities from all regions of the world, published 2008-2020. We screened 885 papers and abstracts and identified 72 for inclusion. Studies in high-income settings reported high awareness of TasP but gaps in knowledge about the likelihood of transmission with undetectable HIV. Greater knowledge was associated with more positive attitudes towards TasP. Extant literature shows low awareness of TasP in Africa where 2 in 3 people with HIV live. The emerging evidence on interventions delivering information on TasP suggests beneficial impacts on knowledge, stigma, HIV testing, and viral suppression.Review was pre-registered at PROSPERO: CRD42020153725.
接受抗逆转录病毒治疗且病毒载量检测不到的人（无法检测到病毒=无法传播病毒，U=U）不会通过性途径将 HIV 传播给他人。然而，治疗即预防（TasP）这一科学可能并未被所有能从该信息中受益的 HIV 感染者和非感染者广泛了解。我们系统性地回顾了全球与 TasP 相关的知识和态度以及提供 TasP 或 U=U 信息的干预措施的文献。我们纳入了来自世界各地的所有地区的提供者、患者和社区的研究，研究时间为 2008 年至 2020 年。我们筛选了 885 篇论文和摘要，确定了 72 篇纳入研究。在高收入国家开展的研究报告称，人们对 TasP 的认识度较高，但对 HIV 检测不到时传播可能性的了解存在差距。知识水平越高，对 TasP 的态度越积极。现有的关于在非洲开展的 TasP 干预措施的文献表明，该地区人们对 TasP 的认识度较低，而非洲有三分之二的 HIV 感染者居住在那里。关于传递 TasP 信息的干预措施的新出现证据表明，这些干预措施对知识、污名、HIV 检测和病毒抑制产生了有益影响。本综述已在 PROSPERO 进行了预注册：CRD42020153725。
