从怀孕到之后:在南非,重新强调全面预防艾滋病毒
Chibuzor M Babalola1, Remco P H Peters2,3, Christina A Muzny4
1Keck School of Medicine Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA.
AIDS (London, England)
|February 26, 2025
概括
南非在孕妇中面临高艾滋病毒患病率,在Philani试验中,这一比例达到28.6%. 针对年龄的预防和改善的病毒抑制对于结束疫情至关重要.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 传染性疾病 传染性疾病
背景情况:
- 南非艾滋病毒发病率很高,特别是在孕妇中,这表明持续的预防挑战.
- 尽管全国下降,但局部高率仍然存在,如东开普省所见.
研究的目的:
- 分析南非孕妇的艾滋病毒患病率和趋势.
- 评估当前艾滋病毒预防和治疗策略的有效性.
- 确定影响怀孕人口艾滋病毒风险和结果的关键因素.
主要方法:
- 来自国家调查 (第六届南非艾滋病毒流行调查,2022年产前艾滋病毒哨兵调查) 和"Philani Ndiphile"试验的数据的三角化.
- 在试验队列中按年龄组分析艾滋病毒流行率.
- 对抗逆转录病毒疗法 (ART) 启动和病毒抑制率的评估.
主要成果:
- 菲拉尼试验在孕妇中记录了28.6%的艾滋病毒流行率,随着年龄的增长,这一比例显著增加 (18岁的6%到43岁的63%).
- 虽然在艾滋病毒状况知识和ART启动方面取得了国家进展,但病毒抑制仍然是一个挑战 (20%的新/重新启动ART).
- 在年轻女性,怀孕期间和分娩后,艾滋病毒发病率仍然很高.
结论:
- 对于处于生育年龄的年轻女性,迫切需要针对年龄的HIV干预措施.
- 加强艾滋病毒预防工作,包括扩大孕妇和产后妇女接触暴露前预防 (PrEP) 的机会,至关重要.
- 针对社会经济因素,亲密伴侣暴力,性传播感染和男性伴侣参与的综合性干预措施对于疫情控制至关重要.
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