Objective: To explore the impact of achievement of the "90-90-90" goals on reductions in HIV incidence in Shandong province. Methods: An algebraic method was developed to link new HIV infections and the "90-90-90" goals in Shandong province. The risk estimation equation was used to analyze the effect of achievement of the "90-90-90" goals on reductions of HIV incidence, and explore the impact of application of antiviral therapy based prevention and control strategy on reduction of new HIV infections. Results: If "90-90-90" goals were achieved in 2020 in Shandong compared with annual new HIV infections in 2010, the percentage of reduction would be 17.27%, 35.99% and 67.55% respectively when transmission rate decreased by 26.00%, 53.00% and 96.00% respectively. Compared with 2017, when the transmission rate decreased by 53.00%, the annual new HIV infections would has a decrease of 10.10% if the rates of diagnosis and ART reached 90.00%; the annual new HIV infections would has a decrease of 20.80% if the rates of diagnosis and viral suppression reached 90.00%; the annual new HIV infections would has a decrease of 12.29% if the rates of ART and viral suppression reached 90.00%. Conclusions: HIV incidence would decrease with the achievement of "90-90-90" goals in Shandong. Compared with the improvement of ART, the improvement in diagnosis of HIV infection and viral suppression would result in more rapid decrease of new HIV infections. Besides expanding ART coverage, more attention should be paid to the strengthening of the diagnosis of HIV infection and viral suppression in Shandong.
目的: 探讨"三个90%"目标实现对降低山东省HIV新发感染的影响。 方法: 构建"三个90%"目标与HIV新发感染的风险估计方程,分析实现"三个90%"目标时山东省HIV新发感染降低情况,探讨以抗病毒治疗为核心的诊疗综合防控措施的实施对降低HIV新发感染的影响。 结果: 2020年山东省实现"三个90%"目标,抗病毒治疗使HIV/AIDS传染性分别降低26.00%、53.00%和96.00%时,HIV年新发感染较2010年下降比例分别为17.27%、35.99%和67.55%。当抗病毒治疗使HIV/AIDS传染性降低53.00%,基于2017年实际情况,发现率和抗病毒治疗率实现90.00%,HIV年新发感染降低10.10%;发现率和病毒抑制率实现90.00%,HIV年新发感染降低20.80%;治疗率和病毒抑制率实现90.00%,HIV年新发感染降低12.29%。 结论: 实现"三个90%"目标,可降低山东省HIV新发感染。提高发现率和病毒抑制率可使HIV新发感染下降更快;扩大抗病毒治疗覆盖面的同时,重点提高HIV/AIDS的诊断发现及抗病毒治疗效果。.
Keywords: AIDS; Antiviral therapy; New infections; Risk estimation equation.