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首页> 外文期刊>AIDS care. >A public health dilemma: a testing question.
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A public health dilemma: a testing question.

机译：公共卫生困境：一个测试问题。

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摘要

The current moves to provide access to antiretroviral therapy (ART) to all in need has led to a push to HIV test. In particular, there have been policy moves endorsed by the World Heath Organization and UNAIDS to introduce routine 'opt out' HIV testing in countries with high prevalence. A number of claims have been made with regard to the benefits of increasing the numbers of people on antiretroviral therapy. Two of these claims are disputed here. Treatment roll-out and the associated push for routine testing raise questions of concern to public health and human rights. While it is claimed that treatment roll-out will reduce stigma and discrimination, there is little evidence to support the claim. It is also claimed that treatment uptake will reduce the likelihood of HIV transmission and that thus treatments themselves have a preventive effect. This direct effect of treatment uptake on prevention is augmented, it is claimed, if use is made of the voluntary counselling and testing (VCT) encounter and people counselled to act safely. Again there is little evidence to support the claims made. In addressing the evidence for these two claims, the paper cautions against the large scale adoption of routine 'opt out' or, as it is sometimes called, 'provider-initiated' testing.
机译：当前为所有需要的人提供抗逆转录病毒疗法（ART）的举措导致了对HIV检测的推动。特别是，世界卫生组织和联合国艾滋病规划署（UNAIDS）批准了一些政策措施，以在流行率很高的国家进行例行的“选择退出”艾滋病毒检测。关于增加接受抗逆转录病毒疗法的人数的益处，已经提出了许多要求。这些主张中有两个在这里有争议。推出治疗方案以及随之而来的常规检测要求引起了人们对公共卫生和人权关注的问题。虽然声称治疗的推出将减少污名和歧视，但几乎没有证据支持这一说法。还声称治疗的吸收将减少艾滋病毒传播的可能性，因此治疗本身具有预防作用。据称，如果利用自愿咨询和检测（VCT）遇到的情况以及被劝告采取安全行动的人，则可以增强治疗对预防的直接效果。同样，几乎没有证据支持所提出的主张。在处理这两个主张的证据时，本文告诫不要大规模采用常规的“选择退出”或有时被称为“提供商启动”的测试。

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