2014-2018 年美国 33 个司法管辖区成人和青少年艾滋病毒护理结局趋势。
Trends in HIV Care Outcomes Among Adults and Adolescents-33 Jurisdictions, United States, 2014-2018.
机构信息
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, GA.
出版信息
J Acquir Immune Defic Syndr. 2021 Dec 1;88(4):333-339. doi: 10.1097/QAI.0000000000002778.
BACKGROUND
With significant improvements in the diagnosis and treatment of HIV, the number of people with HIV in the United States steadily increases. Monitoring trends in HIV-related care outcomes is needed to inform programs aimed at reducing new HIV infections in the United States.
SETTING
The setting is 33 United States jurisdictions that had mandatory and complete reporting of all levels of CD4 and viral load test results for each year during 2014-2018.
METHODS
Estimated annual percentage change and 95% confidence intervals were calculated to assess trends in stage of disease at time of diagnosis, linkage to HIV medical care within 1 month of HIV diagnosis, and viral suppression within 6 months after HIV diagnosis. Differences in percentages were analyzed by sex, age, race/ethnicity, and transmission category for persons with HIV diagnosed from 2014 to 2018.
RESULTS
Among 133,477 persons with HIV diagnosed during 2014-2018, the percentage of persons who received a diagnosis classified as stage 0 increased 13.7%, stages 1-2 (early infections) increased 2.9%, stage 3 (AIDS) declined 1.5%, linkage to HIV medical care within 1 month of HIV diagnosis increased 2.3%, and viral suppression within 6 months after HIV diagnosis increased 6.5% per year, on average. Subpopulations and areas that showed the least progress were persons aged 45-54 years, American Indian/Alaska Native persons, Asian persons, Native Hawaiian/other Pacific Islander persons, and rural areas with substantial HIV prevalence, respectively.
CONCLUSIONS
New infections will continue to occur unless improvements are made in implementing the Ending the HIV Epidemic: A Plan for America strategies of diagnosing, treating, and preventing HIV infection.
背景
随着 HIV 的诊断和治疗水平显著提高，美国的 HIV 感染者人数稳步增加。需要监测与 HIV 相关的护理结果趋势，以为旨在减少美国新的 HIV 感染的项目提供信息。
地点
33 个美国司法管辖区，这些地区在 2014-2018 年期间对所有 CD4 和病毒载量检测结果的各个水平都进行了强制性和完整的报告。
方法
计算了估计的年度百分比变化和 95%置信区间，以评估诊断时疾病阶段、在 HIV 诊断后 1 个月内与 HIV 医疗保健的衔接以及在 HIV 诊断后 6 个月内病毒抑制的趋势。对 2014 年至 2018 年期间诊断出的 HIV 感染者按性别、年龄、种族/族裔和传播类别分析了百分比差异。
结果
在 2014-2018 年期间诊断出的 133477 名 HIV 感染者中，诊断为 0 期的患者比例增加了 13.7%，1-2 期（早期感染）增加了 2.9%，3 期（艾滋病）减少了 1.5%，在 HIV 诊断后 1 个月内与 HIV 医疗保健的衔接增加了 2.3%，HIV 诊断后 6 个月内病毒抑制的比例每年平均增加 6.5%。进展最小的亚人群和地区分别是年龄在 45-54 岁的人群、美洲印第安人/阿拉斯加原住民、亚洲人、夏威夷原住民/其他太平洋岛民以及 HIV 流行率较高的农村地区。
结论
除非在实施《终结美国艾滋病流行计划：终结美国艾滋病流行的蓝图》的诊断、治疗和预防 HIV 感染战略方面取得进展，否则新的感染将继续发生。
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