HIV in Africa: Challenges and Directions for the Next Decade

被引：0
作者：
Bruce L. Gilliam
Devang Patel
Rohit Talwani
Zelalem Temesgen
机构：
[1] University of Maryland School of Medicine,Institute of Human Virology
[2] Mayo Clinic College of Medicine,undefined
来源：
Current Infectious Disease Reports | 2012年 / 14卷
关键词：
HIV; Africa; Antiretroviral treatment; Monitoring; Resource-limited setting; Treatment failure; Viral load; When to start treatment; Resistance; Therapeutic sequencing; Adherence; Nurse-managed vs. doctor-managed care; Scaling-up; Task-shifting; Preexposure prophylaxis; Male circumcision; Microbicides; Vaccine; Efficacy; Operational research; Early diagnosis; Tuberculosis; Cryptococcus; Residency; Work force;
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学科分类号：
摘要：
Africa carries a disproportionate burden of the global HIV endemic, accounting for two thirds of the global 33.3 million people living with HIV. While tremendous advances have been made in addressing the HIV epidemic in Africa, considerable challenges remain. Testing for HIV increased by 86% from 2007 to 2009 but more than 75% of people 15–49 years remain unaware of their HIV status. CD4 count at diagnosis tends to be low and linkage to care and treatment is suboptimal. The scale-up of antiretroviral therapy is ongoing but is hampered by the lack of diagnostic capability to monitor response to therapy and a substantial healthcare workforce shortage. Prevention strategies such as male circumcision, pre-exposure prophylaxis, and antiretroviral therapy for prevention have generated great excitement but cost and healthcare infrastructure deficiencies may limit their widespread applicability. Operational research to validate and inform treatment decisions, health care policies, and prevention strategies is sorely needed.
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页码：91 / 101
页数：10
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