通过例行选择退出HIV查,减少美国南部的艾滋病毒发病率
Deven T Hamilton1, Karen W Hoover2, Kevin P Delaney2
1Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington, USA.
AIDS (London, England)
|May 15, 2025
概括
常规选择退出测试 (ROOT) 和暴露前预防 (PrEP) 显著减少了南方新的艾滋病毒感染. 这种低成本的干预措施为结束艾滋病毒流行病的目标提供了实质性的进展.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 美国结束艾滋病毒流行病 (EHE) 倡议旨在减少艾滋病毒发病率.
- 常规选择退出测试 (ROOT) 和暴露前预防 (PrEP) 是预防艾滋病毒的关键策略.
- 美国南部承受着艾滋病毒感染的重大负担.
研究的目的:
- 评估ROOT和PrEP对在美国南部实现EHE发病率减少目标的综合影响.
- 评估在社区卫生中心 (CHC) 和急诊室 (ED) 实施ROOT的有效性.
- 模拟PrEP扩展对艾滋病毒预防结果的影响.
主要方法:
- 基于代理的流行病预测模型模拟遵守CDC的ROOT指南.
- 基于文献评论,国家家庭增长调查和ARTnet数据的模拟.
- 模拟干预:CHC/ED中的ROOT (单独和组合) 和PrEP扩展.
主要成果:
- 在CHC和ED中使用ROOT可以避免13.9%的感染,并将艾滋病毒状况的认识从84.8%提高到94.4%.
- 结合PrEP扩展,确诊个体增加到95.1%,避免了23.3%的感染.
- 与基线情景相比,年发病率减少了42.4%.
结论:
- 根结合PrEP扩展,在2022-2030年期间,将近四分之一的新艾滋病毒感染被避免.
- 这项干预表明,在实现EHE目标方面取得了实质性的进展,尽管未达到90%的目标.
- 根有效地识别未被诊断的个人,包括那些没有照顾或不愿寻求查的人.
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