Choi Jae-Phil, Seo Bo Kyeong
Division of infectious diseases, Seoul Medical Center, Seoul, Korea.
Department of Cultural Anthropology, College of Social Sciences, Yonsei University, Seoul, Korea.
Infect Chemother. 2021 Dec;53(4):661-675. doi: 10.3947/ic.2021.0127.
Since the introduction of effective antiretroviral therapy (ART) in the late 1990s, the prognosis for people living with human immunodeficiency virus (HIV) (PLWH) has dramatically improved. High-income countries like South Korea have had rapid declines in HIV-related deaths. Scientific advancements including pre-exposure prophylaxis (PrEP) and "undetectable equals untransmittable (U = U)" knowledge have contributed progress towards the goal of ending the acquired immune deficiency syndrome epidemic by 2030. However, the application of these advancements has been limited in South Korea. Evidence shows that HIV-related stigma and discrimination in healthcare settings remain strong in this region. We review key principles for stigma reduction and people-centered approaches in the era of U = U and identify three priorities: 1) immediate intervention in HIV stigma drivers in healthcare settings; 2) social stigma reduction on multiple levels; and 3) collaboration with key populations.
自20世纪90年代末引入有效的抗逆转录病毒疗法（ART）以来，人类免疫缺陷病毒（HIV）感染者（PLWH）的预后有了显著改善。像韩国这样的高收入国家，与HIV相关的死亡人数迅速下降。包括暴露前预防（PrEP）和“检测不到即不具传染性（U=U）”知识在内的科学进步，为实现到2030年终结获得性免疫缺陷综合征流行的目标做出了贡献。然而，这些进步在韩国的应用有限。有证据表明，该地区医疗环境中与HIV相关的耻辱感和歧视仍然很强。我们回顾了在U=U时代减少耻辱感和以人为本方法的关键原则，并确定了三个优先事项：1）立即干预医疗环境中HIV耻辱感的驱动因素；2）在多个层面减少社会耻辱感；3）与关键人群合作。
