男性と性交するアメリカ人における HIV 流行の持続と進化

Kenneth H Mayer¹, LaRon Nelson², Lisa Hightow-Weidman³

¹Beth Israel Deaconess Medical Center, Harvard Medical School, Fenway Health, Boston, MA, USA.

Lancet (London, England)

|February 22, 2021

まとめ

米国で進行中のHIV流行は生物学,個人,社会的要因によって引き起こされています. 多様なMSMサブグループがHIV感染を制御するために文化的に適したプログラムが不可欠です

科学分野:

公衆衛生
流行病学
社会科学

背景:

米国では男性とセックスする男性 (MSM) がエイズと診断された最初の集団であり,HIV感染のリスクが高いままです.
社会生態学的観点では,この集団におけるHIVの流行に寄与する多面的な要因が強調されています.

研究の目的:

アメリカ人のMSMの間で進行中のHIVの流行を促す要因を体系的に特定する.
多様なMSMのサブグループに対する微妙で文化的に適したHIV予防とケア戦略の開発を促す.

主な方法:

社会生態学的枠組みを用いた体系的な文献検索
MSMにおけるHIV感染と感染伝播の共通およびサブグループ特有の危険因子の分析

主要な成果:

重要な要因には,役割の汎用性,生物学的,個人的,社会的,構造的な要素が含まれます.
マイノリティのMSMは,様々な混合,有害な生活経験,医療の回避により,集中したリスクに直面しています.
若いMSMは衝動制御とリスク議論の熟知に関連したリスクがあります.高齢のMSMは併発性に焦点を当てたケアを必要とします.トランスジェンダーのMSMはあまり研究されていませんが,リスクが高いです.

結論:

効果的なHIV対策には共通の脆弱性に対処するプログラムを拡大し特定の社会・文化・構造・行動問題に対応する介入策を策定する必要があります
医療従事者の文化的な能力の訓練は,HIVのケアと予防の最適化,暴露前予防 (PrEP) と"検出不能は感染不能" (U=U) キャンペーンを活用するために不可欠です.

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