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首页> 外文期刊>AIDS care. >Advances in HIV treatment and prevention: should treatment optimism lead to prevention pessimism?
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Advances in HIV treatment and prevention: should treatment optimism lead to prevention pessimism?

机译：HIV治疗和预防的进展：乐观的治疗是否会导致预防悲观？

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Advances in HIV treatment have changed the natural history of HIV disease and improved the life of infected people. But, paradoxically, the transformation of a lethal disease into a chronic condition has lead many people to pessimism regarding the future of HIV prevention. Post-exposure prophylaxis and prophylaxis of vertical transmission have added new tools, although they do not change the main features of HIV prevention which still relies on safer drug use and safer sex. The role assigned to HIV testing started to change in some countries where it had not been encouraged; however the impact of these changes appears still very limited, except for prevention of vertical transmission. Recent developments should be placed in the whole historical perspective of HIV infection: after the early period of dramatic favourable changes (around 1990), positive changes in attitudes and behaviour have slowed down or even stabilized. Proofs of 'relapse' are, however, still tenuous. The impact of therapeutic changes is combined with the normalization process of HIV infection issues. In the general population, HIV infection seems a more remote personal and social concern and the perception of risk has decreased. The changes in the social context of prevention are more diverse. On one hand, some social norms renewed during the HIV era may have long-lasting effects. The acknowledgement of social and human rights of homosexuals and drug users, stimulated by the AIDS movement, has entered a long-term process and may continue to support preventive behaviours. On the other hand, the exceptionalist alliance which supported and stimulated the HIV policies is weakening. This process might be accelerated by improved therapeutic perspectives. The main challenge is the success of the integration of HIV prevention in broader public health policies (including prevention of STI transmission, family planning, health promotion, etc.) without losing advances in prevention strategies gained in the HIV/AIDS era.
机译：HIV治疗的进步改变了HIV疾病的自然史并改善了感染者的生活。但是，自相矛盾的是，致死性疾病转变为慢性疾病已导致许多人对艾滋病毒的预防前景感到悲观。暴露后的预防和垂直传播的预防增加了新的手段，尽管它们并没有改变艾滋病毒预防的主要特征，而艾滋病的主要特征仍然依赖于更安全的吸毒和更安全的性行为。在一些未受到鼓励的国家中，分配给艾滋病毒检测的作用开始发生变化;但是，这些变化的影响似乎非常有限，除了防止垂直传播。应当从艾滋病感染的整个历史角度看待最近的事态发展：在经历了令人鼓舞的有利变化的早期阶段（大约1990年）之后，态度和行为的积极变化已经放缓甚至稳定下来。但是，“复发”的证据仍然微不足道。治疗性改变的影响与HIV感染问题的正常化过程结合在一起。在一般人群中，艾滋病毒感染似乎对个人和社会的影响更加遥远，对风险的认识有所降低。预防的社会环境的变化更加多样化。一方面，在艾滋病时代更新的一些社会规范可能会产生长期影响。在艾滋病运动的推动下，对同性恋者和吸毒者的社会和人权的承认已进入一个长期过程，并可能继续支持预防行为。另一方面，支持和刺激艾滋病毒政策的例外主义联盟正在减弱。改良的治疗方法可能会加速这一过程。主要挑战是如何将艾滋病毒预防成功纳入更广泛的公共卫生政策（包括预防性传播感染，计划生育，促进健康等）中，而又不会失去在艾滋病毒/艾滋病时代获得的预防策略的进步。

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