Oster Alexandra M, Lyss Sheryl B, McClung R Paul, Watson Meg, Panneer Nivedha, Hernandez Angela L, Buchacz Kate, Robilotto Susan E, Curran Kathryn G, Hassan Rashida, Ocfemia M Cheryl Bañez, Linley Laurie, Perez Stephen M, Phillip Stanley A, France Anne Marie
Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia; U.S. Public Health Service, Atlanta, Georgia.
Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia; U.S. Public Health Service, Atlanta, Georgia.
Am J Prev Med. 2021 Nov;61(5 Suppl 1):S130-S142. doi: 10.1016/j.amepre.2021.05.029.
The Respond pillar of the Ending the HIV Epidemic in the U.S. initiative, which consists of activities also known as cluster and outbreak detection and response, offers a framework to guide tailored implementation of proven HIV prevention strategies where transmission is occurring most rapidly. Cluster and outbreak response involves understanding the networks in which rapid transmission is occurring; linking people in the network to essential services; and identifying and addressing gaps in programs and services such as testing, HIV and other medical care, pre-exposure prophylaxis, and syringe services programs. This article reviews the experience gained through 30 HIV cluster and outbreak responses in North America during 2000-2020 to describe approaches for implementing these core response strategies. Numerous jurisdictions that have implemented these response strategies have demonstrated success in improving outcomes related to HIV care and viral suppression, testing, use of prevention services, and reductions in transmission or new diagnoses. Efforts to address important gaps in service delivery revealed by cluster and outbreak detection and response can strengthen prevention efforts broadly through multidisciplinary, multisector collaboration. In this way, the Respond pillar embodies the collaborative, data-guided approach that is critical to the overall success of the Ending the HIV Epidemic in the U.S. initiative.
美国“终结艾滋病流行”倡议中的“应对”支柱，包括也被称为聚集性疫情检测与应对的活动，提供了一个框架，以指导在传播最为迅速的地方量身定制实施经过验证的艾滋病预防策略。聚集性疫情应对包括了解快速传播发生的网络；将网络中的人连接到基本服务；识别并解决检测、艾滋病毒及其他医疗护理、暴露前预防以及注射器服务项目等项目和服务中的差距。本文回顾了2000年至2020年期间在北美通过30次艾滋病毒聚集性疫情应对所获得的经验，以描述实施这些核心应对策略的方法。许多实施了这些应对策略的司法管辖区已在改善与艾滋病毒护理和病毒抑制、检测、预防服务使用以及传播或新诊断减少相关的结果方面取得成功。通过聚集性疫情检测与应对揭示的解决服务提供方面重要差距的努力，可以通过多学科、多部门合作广泛加强预防工作。通过这种方式，“应对”支柱体现了对美国“终结艾滋病流行”倡议总体成功至关重要的协作性、数据驱动方法。
