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首页> 外文期刊>JAIDS: Journal of acquired immune deficiency syndromes >Measuring the impact of the global response to the AIDS epidemic: challenges and future directions.
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Measuring the impact of the global response to the AIDS epidemic: challenges and future directions.

机译：衡量全球应对艾滋病流行的影响：挑战和未来方向。

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OBJECTIVES: In the Declaration of Commitment of the 2001 United Nations General Assembly Special Session on AIDS, all Member States agreed to a series of actions to address HIV. This article examines the availability of data to measure progress toward reducing HIV incidence and AIDS mortality and discusses the extent to which changes can be attributed to programs. METHODS: Lacking a method to directly measure HIV incidence, trends in HIV prevalence among 15-year to 24-year olds and groups with high-risk behaviors are used as a proxy measure for incidence trends among adults in generalized and concentrated/low-level epidemics, respectively. Although there is limited empirical data on trends in new infections among children, progress in the treatment area is tracked through indicators for the percentage of people who remain on antiretroviral treatment 12 months after initiation and the coverage of antiretroviral treatment. Successive iterations of epidemiological models using surveillance data from pregnant women and groups with high-risk behavior and data from national household surveys, demographic data and epidemiological assumptions have produced increasingly robust estimates of HIV prevalence, incidence and mortality. RESULTS: Globally, incidence has decreased among adults (accompanied by evidence of changes in behavior in several countries) and children over the past decade. The decline in AIDS mortality is more recent. On the basis of the underlying logical framework and mathematical models, it is concluded that programs have contributed to a reduction in HIV incidence and AIDS mortality. CONCLUSIONS: More data are needed to reliably inform trends in HIV incidence and AIDS mortality in many countries to allow an assessment of progress against national and global targets. In addition, impact evaluation studies are needed to assess the relationship between changes in incidence and mortality and the HIV response and to determine the extent to which these changes can be attributed to specific programmatic interventions.
机译：目标：在2001年联合国大会关于艾滋病的特别会议的《承诺宣言》中，所有会员国都同意采取一系列行动应对艾滋病。本文研究了数据的可利用性，以衡量在降低艾滋病毒感染率和艾滋病死亡率方面的进展，并讨论了可将变更归因于项目的程度。方法：缺乏直接测量HIV发病率的方法，因此将15岁至24岁年龄段和高风险行为人群的HIV流行趋势用作全面和集中/低水平成年人发病率趋势的指标。流行病。尽管关于儿童中新发感染趋势的经验数据有限，但可通过启动后12个月仍接受抗逆转录病毒治疗的人数百分比以及抗逆转录病毒治疗的覆盖范围来跟踪治疗领域的进展。流行病学模型的连续迭代使用孕妇和高危行为群体的监测数据以及全国家庭调查，人口统计数据和流行病学假设得出的数据，对艾滋病毒的患病率，发病率和死亡率有了越来越强的估计。结果：在过去的十年中，在全球范围内，成年人（儿童的行为发生变化的证据）和儿童的发病率有所下降。艾滋病死亡率的下降是最近的。根据基本的逻辑框架和数学模型，可以得出结论，方案有助于减少艾滋病毒的发病率和艾滋病的死亡率。结论：需要更多的数据来可靠地告知许多国家的艾滋病毒感染率和艾滋病死亡率趋势，以便根据国家和全球目标评估进展情况。此外，还需要进行影响评估研究，以评估发病率和死亡率变化与艾滋病毒应对之间的关​​系，并确定这些变化可归因于特定的计划干预措施的程度。

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