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艾滋病流行中的社会决定因素与预防策略:美国国家艾滋病毒/艾滋病、病毒性肝炎、性传播疾病和结核病预防中心(NCHHSTP)数据库分析

Social Determinants and Prevention Strategies in the HIV Epidemic: The National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) Database Analysis.

作者信息

Ekarika Edediong, Iheagwara Charity, Amadi Adaora T, Ezeamii Patra C, Oluwalana Michael O, Ihuoma Linda C, Nnabude Ogechukwu H, Gopep Nenrot S, Okobi Okelue E, Emejuru Nnenna B

机构信息

Public Health, Emory University, Rollins School of Public Health, Atlanta, USA.

Medicine, All Saints University School of Medicine, Roseau, DMA.

出版信息

Cureus. 2025 May 20;17(5):e84456. doi: 10.7759/cureus.84456. eCollection 2025 May.

Abstract

BACKGROUND

The human immunodeficiency virus (HIV) epidemic remains a significant public health challenge, with social determinants and prevention strategies playing a crucial role in disease outcomes. While advancements in treatment and prevention have led to improvements in viral suppression and healthcare access, disparities in healthcare remain, particularly among vulnerable populations.

AIM

This study analyzes HIV epidemiological trends, healthcare access, and social determinants influencing the HIV epidemic in the United States from 2018 to 2022, using data from the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) database.

METHOD

A retrospective analysis of national surveillance data was conducted to assess trends in HIV-related mortality, viral suppression, incidence, prevalence, and healthcare access. Key indicators such as knowledge of HIV status, PrEP coverage, linkage to care, HIV stigma, and unstable housing were evaluated. Data were analyzed for temporal trends, with a focus on the impact of the COVID-19 pandemic on HIV outcomes.

RESULTS

The findings indicate a reduction in new HIV infections and an increase in HIV prevalence, suggesting improvements in diagnosis and treatment. Although AIDS-related and HIV-related deaths spiked during the COVID-19 pandemic, viral suppression rates steadily improved. Healthcare access remained stable, with increased PrEP coverage and linkage to care. However, persistent barriers such as HIV stigma and unstable housing continued to affect health outcomes.

CONCLUSION

The study highlights significant progress in HIV prevention and care but underscores the need for targeted interventions addressing social determinants. Continued investment in equitable healthcare access, stigma reduction, and housing stability is essential for sustaining control of the HIV epidemic.

摘要

背景

人类免疫缺陷病毒(HIV)流行仍然是一项重大的公共卫生挑战,社会决定因素和预防策略在疾病结局中起着至关重要的作用。尽管治疗和预防方面的进展已使病毒抑制和医疗服务可及性得到改善,但医疗保健方面的差距依然存在,尤其是在弱势群体中。

目的

本研究利用美国国家艾滋病毒/艾滋病、病毒性肝炎、性传播疾病和结核病预防中心(NCHHSTP)数据库的数据,分析2018年至2022年期间影响美国HIV流行的HIV流行病学趋势、医疗服务可及性和社会决定因素。

方法

对国家监测数据进行回顾性分析,以评估与HIV相关的死亡率、病毒抑制、发病率、患病率和医疗服务可及性的趋势。对诸如HIV感染状况知晓率、暴露前预防(PrEP)覆盖率、与医疗服务的联系、HIV污名化和住房不稳定等关键指标进行了评估。分析数据的时间趋势,重点关注COVID-19大流行对HIV结局的影响。

结果

研究结果表明新的HIV感染有所减少,HIV患病率有所上升,这表明诊断和治疗有所改善。尽管在COVID-19大流行期间与艾滋病相关和与HIV相关的死亡人数激增,但病毒抑制率稳步提高。医疗服务可及性保持稳定,PrEP覆盖率和与医疗服务的联系有所增加。然而,诸如HIV污名化和住房不稳定等持续存在的障碍继续影响健康结局。

结论

该研究突出了HIV预防和护理方面的重大进展,但强调了针对社会决定因素采取有针对性干预措施的必要性。持续投资于公平的医疗服务可及性、减少污名化和住房稳定对于维持对HIV流行的控制至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be59/12177844/6d8d2cf4b8f9/cureus-0017-00000084456-i01.jpg

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