Achieving Viral Suppression in 90% of People Living With Human Immunodeficiency Virus on Antiretroviral Therapy in Low- and Middle-Income Countries: Progress, Challenges, and Opportunities

被引:40
作者
Nachega, Jean B. [1 ,2 ,3 ,4 ,5 ,6 ,7 ]
Sam-Agudu, Nadia A. [8 ,9 ,10 ]
Mofenson, Lynne M. [11 ]
Schechter, Mauro [12 ]
Mellors, John W. [13 ]
机构
[1] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, 130 DeSoto St,503 Parran Hall, Pittsburgh, PA 15260 USA
[2] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Infect Dis, Pittsburgh, PA USA
[3] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Microbiol, Pittsburgh, PA USA
[4] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
[5] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Baltimore, MD USA
[6] Stellenbosch Univ, Fac Med & Hlth Sci, Dept Med, Cape Town, South Africa
[7] Stellenbosch Univ, Fac Med & Hlth Sci, Ctr Infect Dis, Cape Town, South Africa
[8] Univ Maryland, Sch Med, Inst Human Virol, Baltimore, MD 21201 USA
[9] Inst Human Virol Nigeria, Int Res Ctr Excellence, Abuja, Nigeria
[10] Univ Cape Coast, Sch Med Sci, Dept Paediat, Cape Coast, Ghana
[11] Elizabeth Glaser Pediat AIDS Fdn, Washington, DC USA
[12] Univ Fed Rio de Janeiro, Projeto Praca Onze, Rio De Janeiro, Brazil
[13] Univ Pittsburgh, Sch Med, Div Infect Dis, Pittsburgh, PA USA
基金
美国国家卫生研究院;
关键词
human immunodeficiency virus (HIV); 90-90-90; antiretroviral therapy (ARV); viral suppression; low- and middle-in-come countries (LMICs); ADHERENCE CLUBS; INJECT DRUGS; HIV; INITIATION; CHILDREN; CARE; ADULTS; WOMEN; RISK;
D O I
10.1093/cid/ciy008
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Although significant progress has been made, the latest data from low- and middle-income countries show substantial gaps in reaching the third "90%" (viral suppression) of the UNAIDS 90-90-90 goals, especially among vulnerable and key populations. This article discusses critical gaps and promising, evidence-based solutions. There is no simple and/or single approach to achieve the last 90%. This will require multifaceted, scalable strategies that engage people living with human immunodeficiency virus, motivate long-term treatment adherence, and are community-entrenched and -supported, cost-effective, and tailored to a wide range of global communities.
引用
收藏
页码:1487 / 1491
页数:5
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