PDF(Pubmed)
Abstract：
To reach its goal of ending AIDS by 2030, Thailand has adopted antiretroviral treatment as prevention and HIV pre-exposure prophylaxis for men who have sex with men (MSM) and transgender women (TGW) as its core HIV control strategy. However, in the absence of reliable epidemiologic indicators, the impact of these policies on the course of the HIV epidemic in these groups remains unknown. To help answer this question, we formulated an HIV epidemic consensus initiative for Bangkok, Thailand, to analyze epidemiologic and program data and reach agreement between experts and stakeholders on the evolving state of the HIV epidemic among MSM and TGW. A customized Delphi process was used to consult and consolidate viewpoints of experts and stakeholders. Experts presented and discussed HIV prevalence and incidence data from recent and ongoing studies among MSM and TGW in Bangkok (2014 to 2018) during a meeting with stakeholders representing government, donors, and civil society. Agreement about the course of the HIV epidemic among MSM and TGW was attained by voting consensus. Based on presented data, meeting participants agreed that HIV prevalence and incidence had decreased among Bangkok MSM from 2014 to 2018. Despite these declines, HIV prevalence and incidence were found to remain high. This was particularly the case among younger MSM. Participants agreed that there was no evidence for a decrease in HIV prevalence and incidence among Bangkok TGW. Introduction of antiretroviral treatment as prevention and HIV pre-exposure prophylaxis may have contributed to these declines. However, HIV prevalence and incidence remained high, and no signs of a decrease were reported among Bangkok TGW. At the current rate of new HIV infections in MSM and TGW, Thailand will not reach its goal of ending AIDS by 2030. This HIV consensus initiative may serve as a model for building agreement and advocacy on epidemiologic and program data and their implications for a large metropolitan city.
摘要：
为了实现到2030年结束艾滋病的目标，泰国已将抗逆转录病毒治疗作为预防手段，并将男男性行为者（MSM）和变性女性（TGW）的艾滋病毒暴露前预防作为其核心艾滋病毒控制策略。然而,在缺乏可靠的流行病学指标的情况下，这些政策对这些人群中艾滋病毒流行过程的影响仍然未知。为了帮助回答这个问题，我们为曼谷制定了艾滋病毒流行病共识倡议，泰国,分析流行病学和计划数据，并在专家和利益相关者之间就MSM和TGW中HIV流行的演变状态达成协议。使用定制的Delphi流程来咨询和巩固专家和利益相关者的观点。专家们在与代表政府的利益相关者举行的会议上，介绍并讨论了曼谷MSM和TGW最近和正在进行的研究（2014年至2018年）的艾滋病毒流行率和发病率数据。捐助者,和民间社会。MSM和TGW之间就艾滋病毒流行的过程达成了共识。根据提供的数据，会议参与者一致认为,2014年至2018年曼谷MSM人群的HIV患病率和发病率有所下降.尽管这些下降,发现艾滋病毒的患病率和发病率仍然很高。在年轻的MSM中尤其如此。与会者一致认为，没有证据表明曼谷TGW的艾滋病毒流行率和发病率有所下降。引入抗逆转录病毒治疗作为预防和艾滋病毒暴露前预防可能导致了这些下降。然而,艾滋病毒的流行和发病率仍然很高，曼谷TGW没有下降的迹象。以目前MSM和TGW的新艾滋病毒感染率，泰国将无法实现到2030年终结艾滋病的目标。这项HIV共识倡议可以作为建立流行病学和计划数据及其对大城市影响的协议和宣传的模型。
