艾滋病疫情:正向一般人群扩散

艾滋病疫情:正向一般人群扩散

 
 
 
 
 

艾滋病疫情:正向一般人群扩散
2009年02月20日14:52
来源:北京科技报   2008年7月,联合国艾滋病规划署报告称,艾滋病流行首次呈现缓和态势,新增艾滋病毒感染者数量及因艾滋病死亡人数都出现下降。但各国情况并不均衡:中国、印尼、俄罗斯、乌克兰、德国、英国等国的新增艾滋病毒感染者数量出现上升。
 
 
 
2008年第17届国际艾滋病大会上,以美国为代表的一些国家,主张艾滋病防控要回归到强化发现传染源,控制和管理传染源的传统公共卫生道路。

  科学家一直推测,HIV急性感染期为艾滋病传播源头,急性期虽短但传染性极强,是艾滋病防控的关键时期。数学模型已提示,约56%-92%的HIV感染是由急性感染者传播的,急性期感染者传播病毒的可能性要比长期无症状感染者大100-1000倍。

  理论上讲,急性期感染者的识别和咨询(甚至治疗),有可能阻止HIV爆发,以及控制或减少HIV传播。而急性期病人的性伴被认为有传播病毒及被病毒感染的真正风险。但由于HIV急性期感染者缺乏特异性症状,因此经常延迟诊断,从而错过了最佳干预时间。急性排毒期约在HIV感染后10周之内,这至关重要,对急性期感染者进行公共卫生干预迫在眉睫。

  目前,我市艾滋病疫情和全国类似,总体呈现低流行态势,疫情仍处于上升阶段,艾滋病疫情正在从高危人群向一般人群扩散。2006年9月,北京市科委启动了“艾滋病防治策略及综合防治研究”重大项目,由北京佑安医院牵头,重点是从男男性行为者入手,研究高危人群筛查综合干预模式,开展以高危人群监测为切入点,以控制传染源为目标的艾滋病防控新策略。

  项目发现,高危人群干预效果欠佳是造成艾滋病感染率持续上升的重要原因。尽管全市公共场所安全套发放覆盖率为100%,但安全套使用依从性问题没有很好解决。尤其是男男性接触人群安全套使用率只有20%左右。目前,艾滋病高危人群干预工作的深度和广度还不够,必须通过挑选、发展、培训同性恋人群中的活跃分子(同伴教育者),将信息有效地传递到目标人群,同时实施社会学、性行为学、心理学等多学科相结合的综合干预策略。而安全套是预防艾滋病最为简便、经济的首要手段,必须进一步全面推广使用。此外,有必要考虑逐渐将HIV检测纳入医疗服务的常规项目,建立规范的艾滋病检测网络,提供灵活多变、符合高危人群需求的诊疗服务。通过研发简便易行的检测方法,提高检测可及性,真正做到HIV的早期诊断及早期干预,以获得控制HIV蔓延的最佳时机。

  北京流动人口多,人员结构复杂,具有城市重大传染病防控的各类突出问题和显著特征,处于艾滋病防治的关键时期。采取更积极有效的干预措施控制艾滋病的传播和蔓延,是北京目前艾滋病防控工作的首要任务。

AIDS epidemic: the spread of the general population are
At 14:52 on February 20, 2009
Source: Beijing Science and Technology reported in July 2008, UNAIDS reported that the AIDS epidemic first emerged to ease the situation, add the number of people living with HIV and AIDS deaths have declined. However, the situation is not balanced countries: China, Indonesia, Russia, Ukraine, Germany, Britain and other countries of the new people living with HIV increased quantity.
 
 
 
2008 17th International AIDS Conference to the United States, represented by some countries, AIDS prevention and control advocates to strengthen the return to the source of infection was found, sources of infection control and management of the traditional path of public health.

Scientists have long speculated, HIV acute infection period of the spread of AIDS at the source, the acute phase is short but highly infectious, are a crucial period for AIDS prevention and control. Math model has been suggested that about 56% -92% of HIV infections are from the spread of acute infection, acute phase of infection are likely to transmit the virus than long-term asymptomatic infection times major 100-1000.

Theoretically, the acute phase of the identification of infected persons and advice (and even treatment), it is possible to prevent the outbreak of HIV, as well as to control or reduce the spread of HIV. The acute phase of the sexual partners of patients who are considered to have the spread of viruses and virus infection was the real risk. However, acute phase of HIV infection because of the lack of specific symptoms, so often delayed diagnosis and thus missed the best time to intervene. Acute detoxification period of HIV infection in about 10 weeks, which is essential for the acute stage of infection for an imminent public health interventions.

At present, the city and the National AIDS epidemic similar to the overall trend showed a low prevalence, the epidemic is still in an increase phase, the AIDS epidemic is moving from high-risk groups to the general population proliferation. September 2006, the Beijing Municipal Science and Technology launched the "AIDS prevention and control strategies and integrated control of" significant project, led by Beijing佑安hospital, with a focus on male actors from the man to start to study the high-risk population screening of comprehensive intervention model, to carry out monitoring high-risk groups as the breakthrough point, to控制传染源targeting AIDS prevention and control of the new strategy.

Project found that high-risk population intervention is ineffective AIDS infection are caused by the rise of important reasons. Despite the issuing of condoms in public places throughout the city for 100 percent coverage, but condom use compliance solution to the problem is not very good. Especially the MSM crowd condom use is only about 20%. At present, AIDS intervention in high-risk groups the depth and breadth of job were not enough, must pass the selection, development, training of homosexual activists in the crowd (peer education) will effectively pass on information to the target population, while the implementation of sociology, sexuality study , psychology and other multi-disciplinary combination of integrated intervention strategies. AIDS prevention and condoms are the most simple, the primary means of economy, we must further promote the use of. In addition, it is necessary to consider gradually Detect HIV medical services into conventional projects, the establishment of a standardized AIDS Detect network, providing flexible, high-risk groups in line with the needs of treatment services. Through the development of simple detection methods, can improve detection and sex, truly HIV Early diagnosis and early intervention to control the spread of HIV the best time.

Floating population in Beijing and more complex personnel structure, with a major infectious disease prevention and control of the city to highlight the types of questions and significant features, at a crucial period for AIDS prevention and control. Take a more active and effective intervention measures to control the spread of AIDS and the spread of AIDS prevention and control are the current job Beijing's top priority.

个人简介
协和专家门诊部艾滋病治疗中心主任、教授、专家,中医药疑难病专治网站长等。论文《艾滋病中医论治探析》登载《中国性病艾滋病》2003版杂志,发明的艾滋病治疗新药康生丹自2002年临床应用至今疗效显著,现有中国唯一艾滋病新药3代…
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