KLJUČNE POLITIKE I MERE ZA PREVENCIJU I SUZBIJANJE HIV/AIDS EPIDEMIJE NA GLOBALNOM NIVOU

  • Slađana Baroš Institut za javno zdravlje Srbije "Dr Milan Jovanović Batut"
  • Prof. dr Sandra Šipetić Grujičić Institut za epidemiologiju Medicinskog fakulteta Univerziteta u Beogradu
Ključne reči: HIV, AIDS, Epidemija, cirkumcizija, profilaksa, prevencija, suzbijanje

Sažetak


Tokom poslednjih 40 godina, sa razvojem medicinskog znanja u vezi HIV infekcije i AIDS-a, razvijao se i koordinisan međunarodni odgovor na širenje HIV epidemije, u smislu razvoja politika i mera za preveniju i suzbijanje HIV/AIDS-a zasnovanih na dokazima iz javnozdravstvenih i kliničkih studija. Odgovor na HIV epidemiju može se podeliti na tri perioda: period uspostavljanja odgovora (1981-1996. godine); period multisektorskog odgovora (1996-2007. godine) i period jačanja biomedicinskih mera prevencije HIV epidemije (2007. godine i dalje). Međunarodne politike i preporučene mere prevencije HIV epidemije su prošli niz transformacija, od uspostavljanja prvih organizovanih koordinisani nacionalnih programa, do dizajna i implementacije inovativnih biomedincinskih mera prevencije, poput preporučene dobrovoljne medicinske cirkumcizije, pre-ekspozicione profilakse i primene mere „testiraj i leči“ – uvođenje antiretrovirusne terapije odmah po dijagnostikovaju HIV infekcije radi postizanja nedetektibilne viremije. Nova saznanja vezana za uspešnost korišćenja antiretrovirusne terapije u preventivne svrhe dovela su do formulisavanja ciljeva za 2020. godinu: da 90% osoba inficiranih HIV-om sazna svoj HIV status, da od njih 90% počne sa lečenjem, a da od njih 90% postigne nedetektabilnu viremiju, kao i da broj osoba novoinficiranih HIV infekcijom, odnosno umrlih od bolesti i stanja povezanih sa AIDS-om bude manji od 500.000. I pored velikih pomaka u odgovoru na HIV infekciju u smislu razvoja i implementacije multisektorskih nacionalnih politika vezanih za prevenciju i suzbijanje HIV/AIDS epidemije, postavljeni ciljevi za 2020. godinu nisu realizovani. Za postizavnje osnovnog cilja – okončanje epidemije AIDS-a kao javnozdravstvene pretnje do 2030. godine potrebno je intezivno sprovoditi sve preporučene kako biomedicinske, tako i bihejvioralne i strukturne intervencije.

Biografija autora

Prof. dr Sandra Šipetić Grujičić, Institut za epidemiologiju Medicinskog fakulteta Univerziteta u Beogradu

Redovni profesor na Medicinskom fakultetu

Reference


1.         Visseaux B, Damond F, Matheron S, Descamps D, Charpentier C. Hiv-2 molecular epidemiology. Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases. 2016;46:233-40.


2.         Simić D. Epidemiološke odlike infekcije virusom humane imunodeficijencije i sindroma stečene imunodeicijencije. U: Jevtović Đ, urednik. HIV infekcija: Priručnik za lekare. Beograd: Institut za javno zdravlje Srbije "Dr Milan Jovanović Batut"; 2007. p. 6-20.


3.         Jevtović Đ. HIV infekcija: Početni pristup i dalji tretman pacijenata sa infekcijom virusom humane imunodeficijencije. U: Jevtović Đ, urednik. HIV infekcija: priručnik za lekare. Beograd: Institut za javno zdravlje Srbije "Dr Milan Jovanović Batut"; 2007. p. 31-46.


4.         Centers for Disease Prevention and Control. Ways HIV can be transmitted Atlanta, USA: CDC; 2022 [ažurirano 4. mart 2022, pristupljeno 11. avgust 2022]. Dostupno na: https://www.cdc.gov/hiv/basics/hiv-transmission/ways-people-get-hiv.html.


5.         Joint United Nations Programme on HIV/AIDS. Fact sheet 2022: Latest global and regional statistics on the status of the AIDS epidemic Geneva: UNAIDS; 2022 [ažurirano 27. jul2022, pristupljeno 20. septembar 2022]. Dostupno na: https://www.unaids.org/en/resources/documents/2022/UNAIDS_FactSheet.


6.         Centers for Disease Prevention and Control. Pneumocystis pneumonia - Los Angeles. Morbidity and mortality weekly report. 1981;30(21):250-2.


7.         Centers for Disease Prevention and Control. Kaposi's Sarcoma and Pneumocystis Pneumonia Among Homosexual Man - New York City and California. Morbidity and mortality weekly report. 1981;30(25):305-8.


8.         Centers for Disease Prevention and Control. A Cluster of Kaposi's Sarcoma and Pneumocystit carinii Pneumonia among Homosexual Male Resident of Los Angeles and Orange Counties, California. MMWR Morbidity and mortality weekly report. 1982;31(23):305-7.


9.         New York Times. New Homosexual Disorder Worries Health Officials. New York Times. 1982, 11. maj 1982.


10.       Centers for Disease Prevention and Control. Update on Aquired Immune Deficiency Syndrome (AIDS) - United States. MMWR Morbidity and mortality weekly report. 1982;31(37):507-14.


11.       Centers for Disease Prevention and Control. Update: Acyuired Immunodeiciency Syndrome (AIDS) - United States. MMWR Morbidity and mortality weekly report. 1983;32(35).


12.       Centers for Disease Prevention and Control. Aquired Immunodeficiency Syndrome (AIDS) Update - United States. MMWR Morbidity and mortality weekly report. 1983;32(24):309-11.


13.       World Health Organization. Acquired immunodeficiency syndrome--an assessment of the present situation in the world: memorandum from a WHO meeting. Bull World Health Organ. 1984;62(3):419-32.


14.       Centers for Disease Prevention and Control. Recommendations for Assisting in the Prevention of Perinatal Transmission of Human T-Lymphotropic Virus Type III/Lymphadenopathy-Associated Virus and Acyuired Immunodeficiency Syndrome. MMWR Morbidity and mortality weekly report. 1985;34(48):721-31.


15.       Barré-Sinoussi F, Chermann JC, Rey F, Nugeyre MT, Chamaret S, Gruest J, et al. Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS). Science. 1983;220(4599):868-71.


16.       Montagnier L, Dauguet C, Axler C, Chamaret S, Gruest J, Nugeyre MT, et al. A new type of retrovirus isolated from patients presenting with lymphadenopathy and acquired immune deficiency syndrome: Structural and antigenic relatedness with equine infectious anaemia virus. Annales de l'Institut Pasteur / Virologie. 1984;135(1):119-34.


17.       Broder S, Gallo RC. A pathogenic retrovirus (HTLV-III) linked to AIDS. The New England journal of medicine. 1984;311(20):1292-7.


18.       Marx J. Strong new candidate for AIDS agent. Science. 1984;224(4648):475-7.


19.       Case K. Nomenclature: human immunodeficiency virus. Ann Intern Med. 1986;105(1):133.


20.       Clavel F, Guétard D, Brun-Vézinet F, Chamaret S, Rey MA, Santos-Ferreira MO, et al. Isolation of a new human retrovirus from West African patients with AIDS. Science. 1986;233(4761):343-6.


21.       Sharp PM, Hahn BH. Origins of HIV and the AIDS pandemic. Cold Spring Harb Perspect Med. 2011;1(1):a006841-a.


22.       Faria NR, Rambaut A, Suchard MA, Baele G, Bedford T, Ward MJ, et al. HIV epidemiology. The early spread and epidemic ignition of HIV-1 in human populations. Science. 2014;346(6205):56-61.


23.       Broder S. The development of antiretroviral therapy and its impact on the HIV-1/AIDS pandemic. Antiviral Res. 2010;85(1):1-18.


24.       Dujić A. Od prvog slučaja HIV/AIDS-a u Srbiji do formiranja Nacionalne komisije. U: Šulović V, Cucić V, Ilic D, urednici. Naučni skup: Dvadeset godina HIV/AIDS-a u Srbiji; Beograd: Srpska akademija nauke i umetnosti - Međuodeljenski odbor za SIDU, Asocijacija za borbu protiv SIDE - JAZAS; 2006. p. 13-24.


25.       Kim YS. World Health Organization and Early Global Response to HIV/AIDS: Emergence and Development of International Norms. Journal of International and Area Studies. 2015;22(1):19-40.


26.       Knight L. UNAIDS: The First 10 Years 1996-2007. Geneva, Swityerland: UNAIDS; 2008.


27.       Mann JM, Kay K. Confronting the pandemic: the World Health Organization's Global Programme on AIDS, 1986-1989. AIDS (London, England). 1991;5 Suppl 2:S221-9.


28.       Mann JM. The World Health Organization's global strategy for the prevention and control of AIDS. West J Med. 1987;147(6):732-4.


29.       HIV.gov. A Timeline of HIV and AIDS: HIV.gov; n.d. [updated n.d.; cited 2020 17 jun]. Available from: https://www.hiv.gov/hiv-basics/overview/history/hiv-and-aids-timeline.


30.       Centers for Disease Prevention and Control. Current Trends Prevention of Acquired Immune Deficiency Syndrome (AIDS): Report of Inter-Agency Recommendations. MMWR Morbidity and mortality weekly report. 1983;32(8):101-3.


31.       Centers for Disease Prevention and Control. Provisional Public Health Services Inter-Agency Recommendations for Sreening Donated Blood and Plasma for Antibody to the Virus Causing Acquired Immunodeficiency Syndrome. MMWR Morbidity and mortality weekly report. 1985;34(1):1-5.


32.       Witteveen E, Schippers G. Needle and syringe exchange programs in Amsterdam. Substance use & misuse. 2006;41(6-7):835-6.


33.       Gay Men’s Health Crisis (GMHC). Syringe exchange programs around the world: The global context. New York: Gay Men’s Health Crisis; 2009.


34.       Palmisano L, Vella S. A brief history of antiretroviral therapy of HIV infection: success and challenges. Annali dell'Istituto superiore di sanita. 2011;47(1):44-8.


35.       Delaney M. History of HAART – the true story of how effective multi-drug therapy was developed for treatment of HIV disease. Retrovirology. 2006;3(Suppl 1):S6-S.


36.       United Nations. The Millenium Development Goals Report 2015. New York: 2015.


37.       Joint United Nations Programme on HIV/AIDS/World Health Organization. Guidelines for Second Generation HIV Surveillance. Geneva: UNADIS/WHO Working Group on Global HIV/AIDS and STI Surveillance 2000.


38.       World Health Organization. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations: WHO; 2016.


39.       Joint United Nations Programme on HIV/AIDS. The 'Three Ones' key principles. Geneva: UNAIDS; n.d. p. 2.


40.       United Nations. Declaration of Commitment on HIV/AIDS; Adopted by General Assembly resolution S-26/2 of 27 June 2001: United Nationas Human Rights Office o the High Commissioner; 2001 [pristupljeno 10. jul 2022]. Dostupno na: https://www.ohchr.org/EN/ProfessionalInterest/Pages/CommitmentOnHIVAIDS.aspx.


41.       World Health Organization. WHO and UNAIDS announce recommendations from expert consultation on male circumcision for HIV prevention [Internet]. World Healht Organization site: World Health Organization; 2007 [ažurirano 28. mart 2007; pristupljeno 1. oktobar 2022]. Dostupno na: https://www.who.int/hiv/mediacentre/news68/en/.


42.       Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A. Randomized, Controlled Intervention Trial of Male Circumcision for Reduction of HIV Infection Risk: The ANRS 1265 Trial. PLOS Medicine. 2005;2(11):e298.


43.       Baker J, OʼHara KM. Oral preexposure prophylaxis to prevent HIV infection: clinical and public health implications. JAAPA : official journal of the American Academy of Physician Assistants. 2014;27(12):10-7.


44.       Weber J, Tatoud R, Fidler S. Postexposure prophylaxis, preexposure prophylaxis or universal test and treat: the strategic use of antiretroviral drugs to prevent HIV acquisition and transmission. AIDS (London, England). 2010;24 Suppl 4:S27-39.


45.       Mayer K, Gazzard B, Zuniga JM, Amico KR, Anderson J, Azad Y, et al. Controlling the HIV epidemic with antiretrovirals: IAPAC consensus statement on treatment as prevention and preexposure prophylaxis. Journal of the International Association of Providers of AIDS Care. 2013;12(3):208-16.


46.       Celum C, Baeten JM. Tenofovir-based pre-exposure prophylaxis for HIV prevention: evolving evidence. Current opinion in infectious diseases. 2012;25(1):51-7.


47.       Jourdain H, de Gage SB, Desplas D, Dray-Spira R. Real-world effectiveness of pre-exposure prophylaxis in men at high risk of HIV infection in France: a nested case-control study. The Lancet Public Health. 2022;7(6):e529-e36.


48.       Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Antiretroviral Therapy for the Prevention of HIV-1 Transmission. New England Journal of Medicine. 2016;375(9):830-9.


49.       Joint United Nations Programme on HIV/AIDS. Undetectable = Untransmittable: Public Health and HIV Viral Supression Geneva: UNAIDS; 2018 [updated 20. juli 2018. Available from: https://www.unaids.org/en/resources/presscentre/featurestories/2018/july/undetectable-untransmittable.


50.       World Health Organization. Consolidated Guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: Recommendations for public health approach. Gneva: World Health Organization; 2013.


51.       World Health Organization. Consolidated Guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: Recommendations for public health approach - Second Edition. Geneva: World Health Organization; 2016.


52.       Joint United Nations Programme on HIV/AIDS. 90-90-90: An ambitious treatment target to help end AIDS epidemic. Geneva: Joint United Nations Program on HIV/AIDS (UNAIDS); 2014.


53.       United Nations. Susteinable Development Goals: 3 - Ensure healthy lives and promote well-being for all at all ages: United Nations; 2015 [pristupljeno 29. septembar 2022]. Dostupno na: https://sdgs.un.org/goals/goal3.


54.       Joint United Nations Programme on HIV/AIDS. 2016-2021 Strategy: On the Fast-Track to end AIDS. Geneva: UNAIDS; 2016.

Objavljeno
2023/02/06
Rubrika
Mini pregledni članak