Galli Massimo, Borderi Marco, Viale Pierluigi
Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy; III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy.
Unit of Infectious Diseases, Department of Medical and Surgical Sciences, S. Orsola Hospital, "Alma Mater Studiorum" University of Bologna, Italy.
Infez Med. 2020 Mar 1;28(1):17-28.
The HIV epidemic has not yet ended, and there are ever more challenges: the recent Italian National Plan of Interventions against HIV and AIDS (Piano Nazionale di Interventi Contro HIV e AIDS (PNAIDS) 2017-2019) was hailed for its comprehensiveness. Its likelihood of success across the HIV care continuum was therefore assessed. Awareness interventions are sporadic and continue to miss high risk populations; if effectively implemented, the prescriptive detail in PNAIDS may help address this. Combined prevention needs greater focus and investment. However, there has been recent progress: free anonymous testing is available at multiple settings although improvements to provide access to key vulnerable populations are needed. Clinical management is available to a high standard across the country, with some areas for improvement in ensuring equality of access. Long-term management of people living with HIV is often effective, but discrepancies exist across regions and settings of care. It is recommended to enable implementation of PNAIDS as a matter of urgency, develop integrated awareness and testing interventions for STIs and HIV, make condoms free for high-risk populations, and develop a network of multidisciplinary services for long-term holistic care of people living with HIV.
艾滋病毒疫情尚未结束,且挑战日益增多:意大利近期的《2017 - 2019年国家防治艾滋病毒和艾滋病干预计划》(Piano Nazionale di Interventi Contro HIV e AIDS (PNAIDS))因其全面性而受到赞誉。因此,对其在整个艾滋病毒护理连续过程中的成功可能性进行了评估。提高认识的干预措施零散,仍未覆盖高危人群;如果有效实施,《国家防治艾滋病毒和艾滋病干预计划》中的详细规定或许有助于解决这一问题。联合预防需要更多关注和投入。不过,近期已取得进展:多个场所提供免费匿名检测,尽管仍需改进以覆盖主要脆弱人群。全国各地的临床管理水平较高,但在确保平等获得服务方面仍有一些需要改进之处。艾滋病毒感染者的长期管理通常有效,但不同地区和护理场所存在差异。建议紧急推动《国家防治艾滋病毒和艾滋病干预计划》的实施,针对性传播感染和艾滋病毒制定综合提高认识和检测干预措施,为高危人群提供免费避孕套,并建立多学科服务网络,为艾滋病毒感染者提供长期全面护理。