中国艾滋病防治策略

Discussion of HIV control and prevention strategies

中国艾滋病防治与全球一样，取得了显著进展，但一些防治策略的成效未能尽如预期。国际社会提出了2030年终结艾滋病流行的目标，同时提出2020年实现“3个90%”及扩大HIV检测和艾滋病治疗范围为核心的综合防治策略。目前中国艾滋病流行以性传播为主，流行因素更加复杂，要充分分析流行形势和防治形势，结合过去30年防治成效和存在的问题，以及国际社会提出的目标，确定全国及各地艾滋病防治的目标、指标及指标值。防治策略上，一方面要全面推进有效的防治策略措施；另一方面，要创新策略，突破瓶颈。首先，针对社会因素，加强源头治理，标本兼治；其次，以社区为单位、问题为中心开展艾滋病防治工作；第三，深入分析流行规律，加强循证，有效遏制性接触传播；第四，进一步完善防治工作长效机制；第五，创新社会管理，加强非政府组织有效参与。此外，要提高技术和管理能力，夯实防治工作的基础。

Expansion of HIV testing and ART treatment are core strategies for achieving the ambitious global goal of ending the HIV epidemic by the end of 2030, and achieving the＂90-90-90＂target by 2020. In China, great progress in HIV control and prevention has been made;however, there is room to enhance the effectiveness of HIV-related strategies. In addition, some implemented strategies have not achieved their expected output. To confront the challenge of sexual transmission of HIV, which is the main route of transmission in China, more targeted HIV prevention strategies that lead to their expected outcomes are essential. It is important to strengthen existing strategies that have been proved effective. However, it is also critical to create innovative strategies, and there are five approaches to achieve this. First, a holistic perspective should be adopted, to better understand the current situation and problems. This means intervention strategies should give serious consideration of how to meet the sociocultural needs of target populations rather than merely carry out behavioral interventions. Second, community-based HIV prevention settings should have more important roles in providing HIV-related health care services. Moreover, to improve the effectiveness of these strategies, a problem-led working style should be integrated into HIV prevention measures overall. Third, thoroughly analyzing characteristics of the current HIV epidemic using more evidence-based considerations must be undertaken, to better control HIV sexual transmission. Fourth, continued improvement of AIDS prevention and control mechanisms is needed, to ensure their sustainable development. Last, it is necessary to involve more NGOs in HIV prevention work by strengthening their management and working capacities to provide HIV-related services. Also needed is further improvement in both technical and management capacities, so as to build a stable basis for effective response.