Background: Globally, UNAIDS report 2022 shows, there are 84.2 million people affected by HIV/AIDS and 40.1 million deaths from AIDS since the start of epidemic. In sub-Saharan Africa, women and girls accounted for 63...Background: Globally, UNAIDS report 2022 shows, there are 84.2 million people affected by HIV/AIDS and 40.1 million deaths from AIDS since the start of epidemic. In sub-Saharan Africa, women and girls accounted for 63% of all new HIV infections in 2021 with, six in seven new HIV infections among adolescents aged 15 - 19 years being girls. Key populations accounted for 70% of HIV infections globally in 2021, with 51% of these new HIV infections in sub-Saharan Africa. Reflecting on the 4 decades’ journey of HIV epidemic amidst local, national and international efforts, the UN target of ending AIDS as a public health threat by 2030 remains questionable unless new innovative ways are used. This study aimed at analyzing existing HIV/AIDS interventions, discuss UN interventions in line with ending HIV/AIDS by 2030 then, suggest and discuss new innovative ways of ending HIV scourge by 2030. Methods: Systematic literature review methodology was used to extract existing published information on HIV prevention strategies from 1981 to 2023. The articles were previewed by 2 experts for quality and grouped by intervention. Of the 637 articles accessed, on HIV prevention/control only 45 met the inclusion criteria. Data were synthesized using a narrative synthesis approach following standard guidelines on synthesis without meta-analysis. Descriptive analysis was done, strength and limitations were identified. UNAIDS recommendations for ending HIV/AIDS by 2030 identified and analyzed. New Innovations in HIV/AIDS were presented and discussed. The scope of the reviewed literature was limited to HIV preventive strategies practiced between 1981 and 2023. Results: Findings show that, Uganda’s HIV prevalence was at a peak in 1991 of 15% (30% among pregnant women in urban areas). ABC strategy is claimed to have turned sharply downward the prevalence through the mid-1990s and reached 5% (14% for pregnant urban women) by 2001. Analysis of the strategy showed that the achievements of the strategy could not be sustained, subsequently HIV prevalence rose again. This is because none of the ABC components can independently reduce HIV problem. In the real world, 100% abstinence has failed, condom use only reduces infection by 90% (WHO), and lifelong monogamy is impractical. Such limitations weaken ABC strategy. The study established that Post-exposure prophylaxis (PEP) i.e. taking HIV medicines within 72 hours (3 days) after a possible exposure to HIV infection is a safe, effective and a globally practiced HIV preventive intervention in emergency situations of HIV exposure. However, PEP is limited to care sought within 72 hours after exposure and yet timely access especially in rural areas and for key populations remains a big challenge. Oral PrEP was also identified as effective HIV preventive measure that can reduce HIV risk from sex by about 99% and from injection drug users by 74%. However, like PEP, timely access especially in rural areas and for key populations remains a big challenge. The UNAIDS 95-95-95 strategy (i.e. 95% of people know their HIV status, 95% with +HIV status be on sustained ART and 95% on ART get viral load suppression) formed the basis for setting the target of ending HIV/AIDS epidemic by 2030. However, our analysis shows that this target is unrealistic given the above highlighted limitations/ barriers in preventive measures and the unlikely perfect adherence (100%) to ART by all enrolled HIV positive persons. Conclusion: Ending HIV/AIDS by 2030 cannot be achieved by implementing the current preventing strategies and control measures. This study established that most of the existing HIV preventive strategies and control measures have a number of limitations. However, with sustained UN 95-95-95 strategy supplemented with additional innovative ways, there is hope that the UN dream of ending HIV/AIDS though not necessarily by 2030, can in the long run be achieved.展开更多
Objective To evaluate a four-hour life-skills-based HIV/AIDS prevention curriculum among 5th grade students in rural primary schools of Hainan province.Methods The study included two stages.Stage one （September 2006-...Objective To evaluate a four-hour life-skills-based HIV/AIDS prevention curriculum among 5th grade students in rural primary schools of Hainan province.Methods The study included two stages.Stage one （September 2006-May 2007） was a pre-post-quasi experimental design;a total of 2 413 students aged 9 to 14 years from fifth grade classes of nine primary schools completed a baseline survey （1 720 students were in the intervention group,693 in the control group）,and over 98% of them took part in a short survey.The experimental curriculum was provided to the intervention group.At stage two （September 2008）,a cross-sectional questionnaire was administered to 6 923 students in 7th grade classes of eight middle schools in the same study sites.There were 1 437 students in the intervention group when the curriculum was conducted.Results Students tended to score higher in areas of HIV/AIDS related knowledge and attitudes,if they were younger than average,lived in the county seat,had access to the internet,and their parents had completed higher levels of education.Path analysis showed that,after controlling for characteristics such as family and community factors,the total effects of curriculum on knowledge in the short-term model increased remarkably compared with the baseline,and maintained major contributions to knowledge in the mid-term model.The positive effect of knowledge on attitudes was significantly improved in the short-term model as well.Conclusion A life-skills based curriculum can improve HIV/AIDS related knowledge and self-perceived level of life-skills among primary school students in rural areas in a short time,and these positive effects can still be observed at least 2 years post participation in the curriculum.展开更多
The HIV pandemic seems to be fading to some degree—but there are regional exceptions. The current liberal prevention strategy with programs aimed at risk reduction interventions in particular for sexual behavior and ...The HIV pandemic seems to be fading to some degree—but there are regional exceptions. The current liberal prevention strategy with programs aimed at risk reduction interventions in particular for sexual behavior and injecting drug use has been expanded by antiretroviral treatment approaches. It was expected to keep the prevalence of infectious individuals below a certain threshold to curb self-sustaining chains of HIV infections. The introduction of biomedical approaches by ART/HAART with regard to practicing risk reduction behavior has been received as an exemption of responsibility by certain populations who are defined as “at-risk” population. Certain parts of the hard-to-reach, high-risk population have returned to unsafe sex practices leading to careless behavior which in turn has promoted the spread of HIV. This is supported by modern trends in risk societies where with regard to HIV basic principles of ethics and tenets of the Human Rights like “don’t harm other people” have lost any normative power. In addition, with the support of NGOs, legal norms such as protecting the “bodily integrity of individuals” have been ignored, allowing the “passing of HIV to partners” to become socially acceptable behavior. As a whole, in defiance of the endeavors of prevention applied so far, certain societies are exposed to an ongoing spread of HIV.展开更多
Background: The global incidence of STIs is rising. It is estimated that 499 million new cases of curable STIs occur every year. The existence of more than one million reported cases of STIs annually in Iran shows tha...Background: The global incidence of STIs is rising. It is estimated that 499 million new cases of curable STIs occur every year. The existence of more than one million reported cases of STIs annually in Iran shows that addressing this issue must be a priority for Iranian health authorities. While recognition of the importance of gender issues to reproductive health (RH) programs has grown significantly in the past several years, major challenges remain in implementing gender-sensitive programs. Gender mainstreaming in Iranian reproductive health program is a relatively new issue, so this study aims to explore gender sensitive STIs/HIV/AIDS prevention policies. Method: This study employed a qualitative research design. Participants were health managers, health policy makers and reproductive health providers. They were selected purposefully and then continued by snowball sampling method. 43 semi-structured in-depth interviews with 37 key informants were done. All the interviews were recorded and transcribed. The data were analyzed by content analysis method. Trustworthiness of the data was achieved by using credibility, trans-ferability and conformability. Results: Key informants clearly explained the gender sensitive STIs/ HIV/AIDS prevention policies in three main categories: 1) advocacy, 2) collaboration between different sectors and 3) community empowerment to gender sensitive STIs/HIV/AIDS prevention programs. Conclusion: Changing gender neural STIs/HIV/AIDS prevention policy to more complete gender sensitive policy needs advocacy, collaboration of sectors and community empowerment.展开更多
The purpose of the PO2 project is to improve the special health education on reproductive health and HIV/ AIDS prevention knowledge in classroom education in the rural junior high schools of China. Commissioned by the...The purpose of the PO2 project is to improve the special health education on reproductive health and HIV/ AIDS prevention knowledge in classroom education in the rural junior high schools of China. Commissioned by the Ministry of Education(MOE)of China,the Center for Population and Development Studies of Renmin University of China carried out a baseline KAP survey on the展开更多
Objective:This study aims to provide a theoretical foundation for the development and practical application of human immunodeficiency virus(HIV)/acquired immunodeficiency syndrome(AIDS)prevention and control policy sy...Objective:This study aims to provide a theoretical foundation for the development and practical application of human immunodeficiency virus(HIV)/acquired immunodeficiency syndrome(AIDS)prevention and control policy systems in China by scrutinizing,analyzing,and synthesizing the evolution of Chinese policies in this domain.Methods:Utilizing grounded theory,we employed NVivo12 software to perform text content analysis,mining,and coding classification,along with visualization techniques,on policy texts sourced from Chinese government platforms,including the official website of China’s State Council.We considered four analytical dimensions—time,subject,type,and object.Results:The National Health Commission and the State Council emerged as the primary entities engaged in policymaking for HIV/AIDS in China.We identified four distinct stages in the evolution of these policies,culminating in a novel‘sun-shaped’HIV/AIDS prevention and control policy network model with an emphasis on‘knowledge,attitude,and practice’at its nucleus,which aligns with national conditions and societal progress.Furthermore,the focal groups of these policies have been dynamically refined and updated over time.Conclusions:Our findings introduce a‘sunshaped’HIV/AIDS prevention and control policy network model specific to China.We observed a conceptual policy shift towards prioritizing overall human health rather than confining the focus to disease treatment.Additionally,in light of China’s growing elderly population,the imperative to address HIV/AIDS prevention and control among older adults is an issue that warrants increased attention.展开更多
文摘Background: Globally, UNAIDS report 2022 shows, there are 84.2 million people affected by HIV/AIDS and 40.1 million deaths from AIDS since the start of epidemic. In sub-Saharan Africa, women and girls accounted for 63% of all new HIV infections in 2021 with, six in seven new HIV infections among adolescents aged 15 - 19 years being girls. Key populations accounted for 70% of HIV infections globally in 2021, with 51% of these new HIV infections in sub-Saharan Africa. Reflecting on the 4 decades’ journey of HIV epidemic amidst local, national and international efforts, the UN target of ending AIDS as a public health threat by 2030 remains questionable unless new innovative ways are used. This study aimed at analyzing existing HIV/AIDS interventions, discuss UN interventions in line with ending HIV/AIDS by 2030 then, suggest and discuss new innovative ways of ending HIV scourge by 2030. Methods: Systematic literature review methodology was used to extract existing published information on HIV prevention strategies from 1981 to 2023. The articles were previewed by 2 experts for quality and grouped by intervention. Of the 637 articles accessed, on HIV prevention/control only 45 met the inclusion criteria. Data were synthesized using a narrative synthesis approach following standard guidelines on synthesis without meta-analysis. Descriptive analysis was done, strength and limitations were identified. UNAIDS recommendations for ending HIV/AIDS by 2030 identified and analyzed. New Innovations in HIV/AIDS were presented and discussed. The scope of the reviewed literature was limited to HIV preventive strategies practiced between 1981 and 2023. Results: Findings show that, Uganda’s HIV prevalence was at a peak in 1991 of 15% (30% among pregnant women in urban areas). ABC strategy is claimed to have turned sharply downward the prevalence through the mid-1990s and reached 5% (14% for pregnant urban women) by 2001. Analysis of the strategy showed that the achievements of the strategy could not be sustained, subsequently HIV prevalence rose again. This is because none of the ABC components can independently reduce HIV problem. In the real world, 100% abstinence has failed, condom use only reduces infection by 90% (WHO), and lifelong monogamy is impractical. Such limitations weaken ABC strategy. The study established that Post-exposure prophylaxis (PEP) i.e. taking HIV medicines within 72 hours (3 days) after a possible exposure to HIV infection is a safe, effective and a globally practiced HIV preventive intervention in emergency situations of HIV exposure. However, PEP is limited to care sought within 72 hours after exposure and yet timely access especially in rural areas and for key populations remains a big challenge. Oral PrEP was also identified as effective HIV preventive measure that can reduce HIV risk from sex by about 99% and from injection drug users by 74%. However, like PEP, timely access especially in rural areas and for key populations remains a big challenge. The UNAIDS 95-95-95 strategy (i.e. 95% of people know their HIV status, 95% with +HIV status be on sustained ART and 95% on ART get viral load suppression) formed the basis for setting the target of ending HIV/AIDS epidemic by 2030. However, our analysis shows that this target is unrealistic given the above highlighted limitations/ barriers in preventive measures and the unlikely perfect adherence (100%) to ART by all enrolled HIV positive persons. Conclusion: Ending HIV/AIDS by 2030 cannot be achieved by implementing the current preventing strategies and control measures. This study established that most of the existing HIV preventive strategies and control measures have a number of limitations. However, with sustained UN 95-95-95 strategy supplemented with additional innovative ways, there is hope that the UN dream of ending HIV/AIDS though not necessarily by 2030, can in the long run be achieved.
基金supported by Ministry of Health of China "AIDS prevention and cure application project,WA2005-11"
文摘Objective To evaluate a four-hour life-skills-based HIV/AIDS prevention curriculum among 5th grade students in rural primary schools of Hainan province.Methods The study included two stages.Stage one （September 2006-May 2007） was a pre-post-quasi experimental design;a total of 2 413 students aged 9 to 14 years from fifth grade classes of nine primary schools completed a baseline survey （1 720 students were in the intervention group,693 in the control group）,and over 98% of them took part in a short survey.The experimental curriculum was provided to the intervention group.At stage two （September 2008）,a cross-sectional questionnaire was administered to 6 923 students in 7th grade classes of eight middle schools in the same study sites.There were 1 437 students in the intervention group when the curriculum was conducted.Results Students tended to score higher in areas of HIV/AIDS related knowledge and attitudes,if they were younger than average,lived in the county seat,had access to the internet,and their parents had completed higher levels of education.Path analysis showed that,after controlling for characteristics such as family and community factors,the total effects of curriculum on knowledge in the short-term model increased remarkably compared with the baseline,and maintained major contributions to knowledge in the mid-term model.The positive effect of knowledge on attitudes was significantly improved in the short-term model as well.Conclusion A life-skills based curriculum can improve HIV/AIDS related knowledge and self-perceived level of life-skills among primary school students in rural areas in a short time,and these positive effects can still be observed at least 2 years post participation in the curriculum.
文摘The HIV pandemic seems to be fading to some degree—but there are regional exceptions. The current liberal prevention strategy with programs aimed at risk reduction interventions in particular for sexual behavior and injecting drug use has been expanded by antiretroviral treatment approaches. It was expected to keep the prevalence of infectious individuals below a certain threshold to curb self-sustaining chains of HIV infections. The introduction of biomedical approaches by ART/HAART with regard to practicing risk reduction behavior has been received as an exemption of responsibility by certain populations who are defined as “at-risk” population. Certain parts of the hard-to-reach, high-risk population have returned to unsafe sex practices leading to careless behavior which in turn has promoted the spread of HIV. This is supported by modern trends in risk societies where with regard to HIV basic principles of ethics and tenets of the Human Rights like “don’t harm other people” have lost any normative power. In addition, with the support of NGOs, legal norms such as protecting the “bodily integrity of individuals” have been ignored, allowing the “passing of HIV to partners” to become socially acceptable behavior. As a whole, in defiance of the endeavors of prevention applied so far, certain societies are exposed to an ongoing spread of HIV.
文摘Background: The global incidence of STIs is rising. It is estimated that 499 million new cases of curable STIs occur every year. The existence of more than one million reported cases of STIs annually in Iran shows that addressing this issue must be a priority for Iranian health authorities. While recognition of the importance of gender issues to reproductive health (RH) programs has grown significantly in the past several years, major challenges remain in implementing gender-sensitive programs. Gender mainstreaming in Iranian reproductive health program is a relatively new issue, so this study aims to explore gender sensitive STIs/HIV/AIDS prevention policies. Method: This study employed a qualitative research design. Participants were health managers, health policy makers and reproductive health providers. They were selected purposefully and then continued by snowball sampling method. 43 semi-structured in-depth interviews with 37 key informants were done. All the interviews were recorded and transcribed. The data were analyzed by content analysis method. Trustworthiness of the data was achieved by using credibility, trans-ferability and conformability. Results: Key informants clearly explained the gender sensitive STIs/ HIV/AIDS prevention policies in three main categories: 1) advocacy, 2) collaboration between different sectors and 3) community empowerment to gender sensitive STIs/HIV/AIDS prevention programs. Conclusion: Changing gender neural STIs/HIV/AIDS prevention policy to more complete gender sensitive policy needs advocacy, collaboration of sectors and community empowerment.
文摘The purpose of the PO2 project is to improve the special health education on reproductive health and HIV/ AIDS prevention knowledge in classroom education in the rural junior high schools of China. Commissioned by the Ministry of Education(MOE)of China,the Center for Population and Development Studies of Renmin University of China carried out a baseline KAP survey on the
基金This work was supported by the National Natural Science Foundation of China(Grant No.72274091)National Key Research and Development Program of China(Grant No.2020YFC2006400)General Program of the Guangdong Philosophy and Social Science Planning(Number:GD23CGL06).
文摘Objective:This study aims to provide a theoretical foundation for the development and practical application of human immunodeficiency virus(HIV)/acquired immunodeficiency syndrome(AIDS)prevention and control policy systems in China by scrutinizing,analyzing,and synthesizing the evolution of Chinese policies in this domain.Methods:Utilizing grounded theory,we employed NVivo12 software to perform text content analysis,mining,and coding classification,along with visualization techniques,on policy texts sourced from Chinese government platforms,including the official website of China’s State Council.We considered four analytical dimensions—time,subject,type,and object.Results:The National Health Commission and the State Council emerged as the primary entities engaged in policymaking for HIV/AIDS in China.We identified four distinct stages in the evolution of these policies,culminating in a novel‘sun-shaped’HIV/AIDS prevention and control policy network model with an emphasis on‘knowledge,attitude,and practice’at its nucleus,which aligns with national conditions and societal progress.Furthermore,the focal groups of these policies have been dynamically refined and updated over time.Conclusions:Our findings introduce a‘sunshaped’HIV/AIDS prevention and control policy network model specific to China.We observed a conceptual policy shift towards prioritizing overall human health rather than confining the focus to disease treatment.Additionally,in light of China’s growing elderly population,the imperative to address HIV/AIDS prevention and control among older adults is an issue that warrants increased attention.
