Jhpiego, Nairobi, Kenya.
Jhpiego, Nairobi, Kenya.
Lancet HIV. 2021 Aug;8(8):e511-e520. doi: 10.1016/S2352-3018(21)00129-6. Epub 2021 Jul 12.
Following WHO's 2015 recommendation, countries in sub-Saharan Africa have progressively scaled up oral pre-exposure prophylaxis (PrEP) as part of combination HIV prevention. PrEP has potential to significantly reduce new HIV infections in sub-Saharan Africa if it is widely available, accessible, and effectively used. Initial scale-up efforts have generated progress, drawing lessons from existing HIV interventions, such as antiretroviral therapy and biomedical prevention. However, beset by unprepared health systems, scale-up has been slow, resulting in suboptimal coverage among priority groups at higher risk of HIV acqusition. Using the WHO health system building blocks framework, this Review synthesises literature on essential considerations for PrEP scale-up in sub-Saharan Africa, highlighting the importance of health system adaptability and responsiveness.
根据世界卫生组织（WHO）2015 年的建议，撒哈拉以南非洲国家逐步扩大了作为艾滋病毒综合预防措施的一部分的口服暴露前预防（PrEP）。如果 PrEP 广泛可得、可及且有效使用，它有可能显著减少撒哈拉以南非洲的新艾滋病毒感染。最初的扩大规模努力取得了进展，借鉴了现有艾滋病毒干预措施（如抗逆转录病毒疗法和生物医学预防措施）的经验教训。然而，由于卫生系统准备不足，扩大规模的速度缓慢，导致高艾滋病毒感染风险的重点人群的覆盖范围不理想。本综述利用世界卫生组织卫生系统组成部分框架，综合了撒哈拉以南非洲 PrEP 扩大规模的基本考虑因素方面的文献，强调了卫生系统适应性和响应能力的重要性。
