Department of Epidemiology, Department of Infectious Diseases, Department of Microbiology, and Center for Global Health, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA; Department of Epidemiology and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University of Baltimore, MD, USA; Department of Medicine, Division of Infectious Diseases, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa.
Makerere University-Johns Hopkins University (MUJHU) Research Collaboration, Kampala, Uganda.
Lancet HIV. 2023 Sep;10(9):e617-e622. doi: 10.1016/S2352-3018(23)00150-9. Epub 2023 Jul 25.
The massive scale-up of HIV treatment and prevention over the past two decades has resulted in important reductions in new infections and mortality globally. Reduction in HIV incidence, however, has been unequal, with worsening epidemics in regions where the reach and scale of HIV control programmes have been insufficient, especially in eastern Europe, central Asia, the Middle East, north Africa, and Latin America where HIV epidemics are concentrated among key populations, including people who inject drugs, men who have sex with men, transgender people, and some minority racial and ethnic groups. The global state of the HIV pandemic highlights disparities in HIV control efforts and provides a roadmap for what should be done, including investment to better implement the effective HIV prevention and treatment tools that are available, but whose adoption and scale-up are not yet sufficient to get us close to an AIDS-free generation. To achieve the full potential of global HIV control, we call for urgent, evidence-informed implementation at scale of our existing and novel HIV prevention and treatment strategies in ways that are better, faster, more efficient, and cost-effective, especially in key populations and regions where the HIV pandemic continues to expand.
在过去的二十年中，艾滋病毒治疗和预防工作的大规模扩展，在全球范围内导致新感染和死亡率的显著下降。然而，艾滋病毒发病率的下降并不均衡，在艾滋病毒控制规划的覆盖面和规模不足的地区，疫情恶化，特别是在艾滋病毒流行集中于关键人群（包括注射毒品者、男男性行为者、跨性别者以及一些少数种族和族裔群体）的东欧、中亚、中东、北非和拉丁美洲。艾滋病毒大流行的全球现状突显了艾滋病毒防控工作中的差距，并为应该采取的措施提供了路线图，包括投资以更好地实施现有的和新的艾滋病毒预防和治疗工具，这些工具已经被证明是有效的，但它们的采用和推广还不足以使我们接近无艾滋病世代。为了充分发挥全球艾滋病毒防控的潜力，我们呼吁紧急、循证地在现有和新的艾滋病毒预防和治疗策略方面扩大规模，采取更好、更快、更高效和更具成本效益的方式，特别是在艾滋病毒继续蔓延的关键人群和地区。
