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首页> 外文期刊>AIDS care. >Prioritising prevention strategies for patients in antiretroviral treatment programmes in resource-limited settings.
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Prioritising prevention strategies for patients in antiretroviral treatment programmes in resource-limited settings.

机译：在资源有限的情况下，在抗逆转录病毒治疗计划中优先考虑患者的预防策略。

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Expanded access to antiretroviral therapy (ART) offers opportunities to strengthen HIV prevention in resource-limited settings. We invited 27 ART programmes from urban settings in Africa, Asia and South America to participate in a survey, with the aim to examine what preventive services had been integrated in ART programmes. Twenty-two programmes participated; eight (36%) from South Africa, two from Brazil, two from Zambia and one each from Argentina, India, Thailand, Botswana, Ivory Coast, Malawi, Morocco, Uganda and Zimbabwe and one occupational programme of a brewery company included five countries (Nigeria, Republic of Congo, Democratic Republic of Congo, Rwanda and Burundi). Twenty-one sites (96%) provided health education and social support, and 18 (82%) provided HIV testing and counselling. All sites encouraged disclosure of HIV infection to spouses and partners, but only 11 (50%) had a protocol for partner notification. Twenty-one sites (96%) supplied male condoms, seven (32%) female condoms and 20 (91%) provided prophylactic ART for the prevention of mother-to child transmission. Seven sites (33%) regularly screened for sexually transmitted infections (STI). Twelve sites (55%) were involved in activities aimed at women or adolescents, and 10 sites (46%) in activities aimed at serodiscordant couples. Stigma and discrimination, gender roles and funding constraints were perceived as the main obstacles to effective prevention in ART programmes. We conclude that preventive services in ART programmes in lower income countries focus on health education and the provision of social support and male condoms. Strategies that might be equally or more important in this setting, including partner notification, prompt diagnosis and treatment of STI and reduction of stigma in the community, have not been implemented widely.
机译：扩大获得抗逆转录病毒疗法（ART）的机会提供了在资源有限的环境中加强艾滋病毒预防的机会。我们邀请了来自非洲，亚洲和南美的城市地区的27个抗逆转录病毒方案参加一项调查，目的是研究哪些预防服务已纳入抗逆转录病毒方案。参加了22个方案;来自南非的八家（36％），来自巴西的两个，来自赞比亚的两个，以及来自阿根廷，印度，泰国，博茨瓦纳，科特迪瓦，马拉维，摩洛哥，乌干达和津巴布韦的一个，啤酒公司的一项职业计划包括五个国家（尼日利亚，刚果共和国，刚果民主共和国，卢旺达和布隆迪）。有21个站点（96％）提供了健康教育和社会支持，有18个站点（82％）提供了HIV检测和咨询。所有站点都鼓励向配偶和伴侣披露HIV感染情况，但是只有11个（50％）有告知伴侣的协议。有21个场所（占96％）提供了男用避孕套，有七个场所（占32％）提供了女用避孕套，有20个场所（占91％）提供了预防母婴传播的预防性ART。定期对七个站点（33％）进行性传播感染（STI）筛查。有十二个地点（55％）参与了针对妇女或青少年的活动，有十个地点（46％）参与了针对血脂异常夫妇的活动。污名和歧视，性别角色和资金限制被认为是抗病毒治疗规划中有效预防的主要障碍。我们得出的结论是，低收入国家抗病毒治疗计划中的预防服务侧重于健康教育以及社会支持和男性避孕套的提供。在这种情况下可能同等或更重要的策略，包括伙伴通知，对性传播感染的及时诊断和治疗以及减少社区的污名化，尚未得到广泛实施。

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