HIV感染を予防するための生物医学的な介入:証拠,課題,前進の道
Nancy S Padian1, Anne Buvé, Jennifer Balkus
1Women's Global Health Imperative, RTI International, San Francisco, CA, USA.
Lancet (London, England)
|August 9, 2008
まとめ
効果的なHIVワクチンの開発は依然として困難です. しかし,男性用コンドーム,割礼,抗レトロウイルス薬などの生物医学的な介入は,HIV感染の減少に有望であることが示されています.
科学分野:
- * バイオメディカルサイエンス
- *公衆衛生について
- * 感染症に関する研究
背景:
- *20年以上にわたる集中的な研究が,有効なHIVワクチンを生み出すことができなかった.
- *HIV予防のための生物医学介入の進展は一貫していない.
- *既存の証拠は,HIV感染を減らすために男性用コンドームと割礼を行うことを支持しています.
研究 の 目的:
- * HIV予防のための様々な生物医学介入の有効性を検討する.
- * 生物医学的なHIV予防戦略の実施における課題と検討を特定する.
- * 生物医学,行動,構造的介入を組み合わせた統合的アプローチの必要性を強調する.
主な方法:
- *HIV予防方法に関する観察研究とランダム化比較試験のレビュー.
- * 男性用コンドーム,男性割礼,STI治療,抗レトロウイルス薬を含む介入の評価.
- * 製品への忠誠心や性的な無抑制といった課題を議論する.
主要な成果:
- * 男性用コンドームは,正しく一貫して使用すると,HIV感染を予防するのに非常に効果的です.
- *男性割礼は,男性におけるHIV感染リスクを大幅に減らす.
- *性感染症の治療は,文脈によって異なる結果が出ています.
- * 経口および局所用抗レトロウイルス薬は,HIV感染の減少のために調査中です.
結論:
- * 生物医学的な介入は,HIV予防の可能性を秘めているが,実施の課題に直面している.
- * 介入の遵守と性的な抑制の解消の可能性は,重要な懸念事項です.
- *効果的なHIV予防には,生物医学,行動,構造戦略の統合されたパッケージが必要です.
- * 多成分介入の評価には,対照群とアデレンス効果を慎重に検討する必要がある.
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