HIV・エイズ予防計画の展開－米国、1981～2006年

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ホーム IMICライブラリ MMWR抄訳 2006年（Vol.55)HIV・エイズ予防計画の展開－米国、1981～20･･･

MMWR抄訳

2006/06/02Vol. 55 / No. 21

MMWR55(21): 597－603
Evolution of HIV/AIDS Prevention Programs － United States, 1981-2006

HIV・エイズ予防計画の展開－米国、1981～2006年

後天性免疫不全症候群（AIDS）として知られるようになった最初の症例が1981年に報告された時、流行の規模と死亡数は想像できなかった。その後25年間、個人、社会、政府全体の空前の動員が、流行撲滅のために実施された。CDCは米国でヒト免疫不全ウイルス（HIV）予防活動を幅広く支持しており、1）行動やHIV・エイズ症例監視データを収集し、流行やリスク行動傾向を文書化、2）州、准州の保健衛生局、地方の保健所、社会を基盤とした組織、国の組織、教育機関による計画実施、3）HIV予防計画を改善するための能力開発、4）予防サービスの提供と成果を監視するための計画評価、5）HIV・エイズ感染を予防するために新戦略に導く研究などを行っている。1994年以来、地方の保健所と州保健衛生局は、スタッフ、予防提供者、ウイルス感染した社会の人々を含む地域社会計画過程を通じて、具体的計画や集団へ情報を提供した。3つのアプローチ、1）HIV感染に高リスクを有する人のために行われる予防活動、2）HIVカウンセリング、検査、照会サービス、3）HIV感染者の健康改善と感染予防のために行われる予防活動が展開された。米国におけるHIV感染予防については、ある程度成し遂げられ、HIV検査やドナー供血停止は、国による血液供給の安全性を明らかに拡大した。周産期HIV感染は大きく削減され、注射針の共有をなくすことも注射薬使用に関連するHIV感染の大きな減少をもたらした。さまざまな予防成果により、1980年半ばに毎年150,000症例以上から1990年後半以来毎年およそ40,000症例までHIV感染発生率を減少させた。しかし、その成功にもかかわらず、予防戦略はまだ継続している。

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