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