Digital Epidemiology Laboratory, Digital Futures, University of Cincinnati, Cincinnati, OH, USA.
Center for Rural Health Research, College of Public Health, East Tennessee State University, Johnson City, TN, USA.
Lancet HIV. 2024 Jul;11(7):e479-e488. doi: 10.1016/S2352-3018(24)00102-4. Epub 2024 Jun 6.
The HIV epidemic in sub-Saharan Africa displays a varied geographical distribution, with particular regions termed as HIV hotspots due to a higher prevalence of infection. Addressing these hotspots is essential for controlling the epidemic. However, these regions, influenced by historical factors, challenge standard interventions. Legacy effects-the lasting impact of past events-play a substantial role in the persistence of these hotspots. To address this challenge of the standard interventions, we propose a shift towards the UNAIDS 95-95-95 targets. Spatial analysis of HIV viral load and antiretroviral therapy coverage can provide a more comprehensive perspective on the epidemic's dynamics. Studies in Zambia and Zimbabwe, using this approach, have revealed disparities in HIV care metrics across regions. By focusing on the UNAIDS 95-95-95 targets, more effective control strategies can be designed, with consideration of both historical and current factors. This approach would offer a solution-oriented strategy, emphasising tailored interventions based on specific regional needs.
撒哈拉以南非洲的艾滋病毒流行呈现出多样化的地理分布，由于感染率较高，特定地区被称为艾滋病毒热点地区。解决这些热点地区的问题对于控制疫情至关重要。然而，这些地区受到历史因素的影响，对标准干预措施构成挑战。遗留效应——过去事件的持久影响——在这些热点地区的持续存在中起着重要作用。为了解决标准干预措施的这一挑战，我们建议转向艾滋病规划署的 95-95-95 目标。艾滋病毒病毒载量和抗逆转录病毒疗法覆盖率的空间分析可以更全面地了解疫情动态。赞比亚和津巴布韦的研究采用这种方法揭示了区域间艾滋病毒护理指标的差异。通过关注艾滋病规划署的 95-95-95 目标，可以制定更有效的控制策略，同时考虑到历史和当前因素。这种方法将提供一种以解决方案为导向的策略，强调根据特定区域的需求制定有针对性的干预措施。
