印度米佐拉姆邦的艾滋病毒疫情:为未来应对措施提供信息的快速回顾。

HIV epidemic in Mizoram, India: A rapid review to inform future responses.

作者信息

Rao Amrita, Mamulwar Megha, Shahabuddin Sheikh Mohammed, Roy Tarun, Lalnuntlangi Nunui, Panda Samiran

机构信息

Division of Clinical Sciences, ICMR-National AIDS Research Institute (NARI), Maharashtra, India.

Data Management, Information Technology & Biostatistics, ICMR-National AIDS Research Institute (NARI), Maharashtra, India.

出版信息

Indian J Med Res. 2022 Aug;156(2):203-217. doi: 10.4103/ijmr.ijmr_1453_22.

Abstract

BACKGROUND & OBJECTIVES: Mizoram, a northeastern State of India bordering Myanmar, is home to several tribal clans under the ethnic group Mizo: Renthelei, Ralte, Paite, Lai, Hmar, Lusei, Mara, Thado and Kuki. Mizos also reside in the neighbouring northeastern States of Tripura, Assam, Manipur and Nagaland. The majority of Mizo people outside India live across the border in the neighbouring Chin State and Sagaing Region of Myanmar. Over the last decade, Mizoram witnessed a concerning level of rise in HIV prevalence among the general population. The present rapid review was conducted to identify various interventions that could help curb this rising trend.

METHODS

An electronic search strategy with broad domains of 'HIV/AIDS', 'key population', 'community engagement' and 'interventions in Mizoram' using PubMed, Embase and Cochrane was adopted; grey literature were also accessed. Evidence, thus gleaned, were synthesized.

RESULTS

Twenty eight resource materials comprising articles, reports and dissertations contributed to the current review. Changing tribal social support structure, early initiation of drugs, sexual debut at an early age and drug-sex interface were identified as factors associated with the progression of HIV epidemic in the State. Issues pertaining to the migration of people across the borders and easy access to drugs continue to be of concern. Churches and youth leaders have a strong influence on the society, at times even constraining access of key population groups to HIV prevention and care services. Tackling stigma and discrimination, ensuring uninterrupted HIV services and creation of an enabling environment in this context seems urgently needed. Incarcerated people in the State have been found with a high level of HIV infection and their linkages with prevention and care services need strengthening.

INTERPRETATION & CONCLUSIONS: This review underscores the importance of drawing upon successful intervention examples from the past such as 'Friends on Friday' and Red Ribbon Clubs. Active engagement of community-based organizations in programme planning, implementation and monitoring is essential. Establishment of harm reduction interventions for general and key populations paired with strategic communication appear to be the need of the hour.

摘要

背景与目标

米佐拉姆邦是印度东北部一个与缅甸接壤的邦,是米佐族几个部落的聚居地,这些部落包括伦泰莱、拉尔泰、派特、莱、赫马尔、卢塞伊、马拉、萨多和库基。米佐人也居住在邻近的东北部邦特里普拉、阿萨姆、曼尼普尔和那加兰。印度境外的大多数米佐人生活在边境对面缅甸的钦邦和实皆地区。在过去十年里,米佐拉姆邦普通人群中的艾滋病毒感染率出现了令人担忧的上升。进行本次快速综述是为了确定有助于遏制这一上升趋势的各种干预措施。

方法

采用电子检索策略,在PubMed、Embase和Cochrane上搜索“艾滋病毒/艾滋病”、“关键人群”、“社区参与”和“米佐拉姆邦的干预措施”等广泛领域;还查阅了灰色文献。对收集到的证据进行了综合分析。

结果

28份包括文章、报告和论文在内的资料为本次综述提供了信息。部落社会支持结构的变化、药物的早期使用、过早开始性行为以及药物与性的关联被确定为该邦艾滋病毒疫情蔓延的相关因素。与跨境人口流动和容易获得毒品相关的问题仍然令人担忧。教会和青年领袖对社会有很大影响,有时甚至限制关键人群获得艾滋病毒预防和护理服务。在这种情况下,迫切需要解决耻辱感和歧视问题,确保艾滋病毒服务不间断,并创造有利环境。该邦被监禁者的艾滋病毒感染率很高,他们与预防和护理服务的联系需要加强。

解读与结论

本综述强调借鉴过去成功的干预范例,如“周五之友”和红丝带俱乐部的重要性。社区组织积极参与项目规划、实施和监测至关重要。为普通人群和关键人群建立减少伤害干预措施并辅以战略沟通似乎是当务之急。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd3f/10057371/cdb7d2ea9939/IJMR-156-203-g001.jpg

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