Key policies and measures of HIV/AIDS prevention and control at global level

Slađana Baroš, S. Šipetić-Grujičić
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Abstract

During the last 40 years, the development of medical HIV and AIDS related knowledge has been followed by a coordinated international HIV response, in terms of developing policies and measures for the HIV/AIDS prevention and control based on evidence from public health and clinical studies. The HIV response can be divided into three periods: the period of HIV response establishment (1981-1996); the period of multi-sectoral response (1996-2007) and the period of strengthening biomedical measures for HIV prevention (2007 and beyond). International policies and recommended HIV prevention measures have undergone a series of transformations, from the establishment of the first organized and coordinated national programs, to the design and implementation of innovative biomedical prevention measures, such as voluntary medical circumcision, pre-exposure prophylaxis and the implementation of the "test and treat" measure - the introduction of antiretroviral therapy immediately after diagnosing HIV infection to achieve undetectable viral load. New findings on successful use of antiretroviral therapy as prevention led to the formulation of goals for 2020: 90% of all people living with HIV to know their HIV status, 90% of them to receive antiretroviral therapy, and 90% of them to have viral suppression; to have less than 500 000 of both newly HIV infected persons, and AIDS related deaths. Despite of the HIV response major improvements, such as development and implementation of multisectoral national HIV/AIDS policies on prevention and control, the 2020 goals have not been meet. For achieving the main goal - ending AIDS as public health threat by 2030 - implementation of all recommended biomedical, behavioral and structural interventions should be intensified.
全球预防和控制艾滋病毒/艾滋病的主要政策和措施
在过去40年里,随着艾滋病毒和艾滋病相关医学知识的发展,国际上采取了协调一致的艾滋病毒应对措施,根据公共卫生和临床研究的证据制定了预防和控制艾滋病毒/艾滋病的政策和措施。艾滋病防治工作可分为三个阶段:艾滋病防治工作建立阶段(1981-1996年);多部门应对时期(1996-2007年)和加强预防艾滋病毒的生物医学措施时期(2007年及以后)。国际政策和建议的艾滋病毒预防措施经历了一系列转变,从制定第一个有组织和协调的国家方案,到设计和实施创新的生物医学预防措施,如自愿包皮环切术,暴露前预防和实施“检测和治疗”措施——在诊断出艾滋病毒感染后立即采用抗逆转录病毒治疗,以达到无法检测到的病毒载量。关于成功使用抗逆转录病毒治疗作为预防的新发现促使制定了2020年的目标:90%的艾滋病毒感染者了解自己的艾滋病毒状况,90%的艾滋病毒感染者接受抗逆转录病毒治疗,90%的艾滋病毒感染者接受病毒抑制;将新感染艾滋病毒的人和与艾滋病有关的死亡人数控制在50万以下。尽管在应对艾滋病毒方面取得了重大进展,例如制定和实施了多部门的国家艾滋病毒/艾滋病预防和控制政策,但2020年的目标尚未实现。为实现到2030年消除艾滋病这一公共卫生威胁的主要目标,应加强实施所有建议的生物医学、行为和结构干预措施。
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