艾滋病的流行形势和防治研究进展

结合第１３届世界艾滋病大会的内容及世界控制艾滋病的经验和教训。根据国情分析了我国艾滋病流行的形势，探讨了有关艾滋病的研究、防治和控制工作的策略。     

Policy responses to HIV/AIDS in Central Asia

The countries of Central Asia (Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan) are confronted with one of the fastest growing HIV/AIDS epidemics worldwide, largely driven through injecting drug use. This article, based on a review of academic and grey literature, explores how they have responded. We find major similarities and differences across the region. At one extreme is Turkmenistan, which denies that there is any problem, does not offer harm reduction services or HIV/AIDS treatment and does not report any meaningful data to the international community. Uzbekistan is also pretty closed to outside influences, has discontinued its opioid substitution project and shares with Turkmenistan the legal prohibition of male-to-male sex. Kyrgyzstan originally led many progressive approaches in the region and, like neighbouring Tajikistan, has received substantial assistance by international agencies, in particular the Global Fund. Kazakhstan, with a much higher gross domestic product per capita, has taken on the financing of harm reduction activities through its national budget and has liberalised its drug policies. Yet, across the region punitive approaches to injecting drug use and people living with HIV/AIDS persist as do stigma and discrimination, while coverage with harm reduction programmes and treatment services is still low although with substantial variation across countries.     

HIV/AIDS Prevention in New York City: Identifying Sociocultural Needs of the Community

This article is a call for those who design social work courses to recognize the complexity and richness of aged care social work in health care and to social workers to shake off ageist attitudes and consider working with older people as a positive option in this rapidly expanding area of social work practice. A mixture of practice experience together with findings from the literature, this article explores social work practice with older people in hospital settings. Social work with older people has both therapeutic and practical components. The importance of integrating a therapeutic approach into all aspects of social work practice with this population cannot be overestimated.     

联合国儿童基金会/云南省HIV/AIDS预防控制与关怀项目在开远的进展

市政府分管副市长亲自抓项目工作，部门间相互配合，媒体及社会积极参与，相关知识的宣传和普及面广。重点介绍对长途卡车司机、娱乐服务业、戒吸毒人员三类高危人群进行健康促进和行为干预及其成效，项目还对驻军官兵、学生、妇女干部等其他人群开展了艾滋病预防知识培训，对新的HIVA感染者进行调查建档工作，对广大市民开展咨询服务。     

From treatment to prevention: The interplay between HIV/AIDS treatment availability and HIV/AIDS prevention programming in Khayelitsha,South Africa

There is a paucity of research that illustrates the interplay between HIV/AIDS treatment and prevention programs. We describe the central role that public access to antiretroviral (ARV) medication has played in the development and efficacy of HIV/AIDS prevention programming in Khayelitsha, a resource-poor township in the Western Cape of South Africa. We document the range of preventive interventions and services available in Khayelitsha since the early 1990s and explore the impact of ARV availability on prevention efforts and disease stigma on the basis of extensive indepth interviews, supplemented by data collection. The information gathered suggests that the introduction of the mother-to-child-transmission (MTCT) prevention programs in 1999 and the three HIV treatment clinics run by Doctors Without Borders/ Médecins Sans Frontières (MSF) in 2000 were turning points in the region’s response to the HIV/AIDS epidemic. These programs have provided incentives for HIV testing, galvanized HIV/AIDS educators to reach populations most at risk, and decreased the HIV incidence rates in Khayeltisha compared to other areas in the Western Cape. Lessons learned in Khayelitsha about the value of treatment availability in facilitating prevention efforts can inform the development of comprehensive approaches to HIV/ AIDS in other resource-poor areas.     

女性高危人群预防HIV/AIDS知识的认知调查

目的通过对女性高危人群预防HIV/AIDS知识的认知调查,以保护妇女健康,防止HIV和性传播疾病在社会上的流行和蔓延。方法以云南省某女子劳教所劳教人员为对象,运用社会学的个案研究、问卷调查,以及开展预防HIV/AIDS知识的培训。结果女性高危人群大多数受教育程度低,初中文化程度以下的人群占89.66%,无职业者占82.7%,她们对艾滋病的病因、症状和预防方法等问题不是很清楚,只有25%的人对HIV的传播途径有所认识。结论通过对女性高危人群进行预防HIV/AIDS感染健康教育的培训后,女性高危人群对艾滋病的病因、传播途径、初期症状、HIV所需的检测时间,以及感染艾滋病高危行为等知识的认知度明显提高,93.10%的人表示赞成预防HIV首先从自己做起。     

以学校为基础进行预防艾滋病健康教育的实践

目的：探索开展中学生艾滋病预防教育方式。方法：采用参与式方法培训学校领导、教师和学生骨干，并培训效果进行评估。结果：项目学校学生艾滋病知识水平高于非项目学校。结论：在中学生中开展艾滋病知识教育是可行和有效的。     

Evolution of HIV/AIDS response in Brazil: Policy innovations and challenges in the fourth decade of the epidemic

Brazil was the first low‐ and middle‐income country to provide universal treatment access to people living with the acquired immunodeficiency syndrome (AIDS), becoming a widely acclaimed model for best practice to managing this epidemic. However, we know little about important challenges to the key pillars of Brazil's response. This article discusses how the evolution of the country's health system institutions and international advancements in AIDS treatment and prevention affected the national response. Decentralization of health system resources and policy making brought fresh challenges to the centralized governance of the national AIDS program and to civil society, weakening their coordination and advocacy capacity. Regardless, AIDS treatment and prevention strategies in Brazil remain aligned with the current international protocols, but unfortunately have been restricted in some geographic areas and/or populations.     

人本主义对艾滋病防控策略的影响

艾滋病是全球面临的一个重大公共卫生问题和社会问题。对艾滋病感染者和艾滋病病人的歧视,必然导致这部分人不敢公开到正规机构接受咨询检测和治疗,从而成为潜在的传染源,造成艾滋病的扩散蔓延。在艾滋病的防控策略中引入人本主义精神,能够营造全社会关注、支持与参与艾滋病防控的良好氛围,最终实现控制艾滋病的目标。     

AIDS policy modeling for the 21st century: an overview of key issues

Decisions about HIV prevention and treatment programs are based on factors such as program costs and health benefits, social and ethical issues, and political considerations. AIDS policy models – that is, models that evaluate the monetary and non-monetary consequences of decisions about HIV/AIDS interventions – can play a role in helping policy makers make better decisions. This paper provides an overview of the key issues related to developing useful AIDS policy models. We highlight issues of importance for researchers in the field of AIDS policy modeling as well as for policy makers. These include geographic area, setting, target groups, interventions, affordability and effectiveness of interventions, type and time horizon of policy model, and type of economic analysis. This paper is not intended to be an exhaustive review of the AIDS policy modeling literature, although many papers from the literature are discussed as examples; rather, we aim to convey the composition, achievements, and challenges of AIDS policy modeling.     

艾滋病患儿高效抗逆转录病毒治疗相关肝毒性

抗逆转录病毒药物引起肝毒性比较常见,而且每类药物肝毒性机制不同.儿童患者HAART相关肝毒性的发生机制与成人患者相似,但发生率要低一些.HAART开始后的早期阶段要加强对肝毒性的监测,及时发现肝功能异常,如果肝酶升高超过10倍正常上限或出现肝炎症状要及时停药,如果肝毒性是由奈韦拉平或阿巴卡韦引起的,停药后不要再次应用,以防致命反应的发生.     

路边店艾滋病/性病预防知识宣教和行为干预

[目的]提高路边店女性服务人员性病艾滋病知识知晓率和安全套的使用率,促进行为改变,增加其预防艾滋病性病的能力,遏制艾滋病/性病在该类人群中的传播蔓延。[方法]采用对领导层倡导,建立多部门合作的艾滋病防治管理体系。在对目标人群需求评估的基础上,采取形式多样的方法进行宣传和干预。[结果]目标人群艾滋病防治知识知晓率和安全套使用率有所提高,自我保护意识增强;项目工作人员能力提高,基本形成多部门合作的防治体系。[结论]项目工作的成功为探索在路边店性服务人员中开展性病艾滋病防治干预活动积累经验。     

在HIV/AIDS中筛查结核病的现状及问题分析

目的：了解在HIV/AIDS转诊到结核病防治机构进行结核病筛查的工作现状、问题并探讨问题产生的原因,为相关政策制定与修订提供依据。方法：通过定性研究,对艾滋病高流行地区3县区的领导和技术人员进行个人深入访谈。结果：在HIV/AIDS病人中进行结核病筛查主要问题有,第一,HIV/AIDS病人中筛查结核病筛查率难以保证;第二,HIV/AIDS病人中筛查结核病时在诊断上存在一定的困难;第三,在HIV/AIDS病人中筛查结核病时可能存在交叉感染,大部分防治机构未采取有效的措施预防交叉感染。结论：通过随访责任人加强HIV/AIDS随访率,提高HIV/AIDS中结核病诊断水平,加强结核病感染控制等加强HIV/AIDS中结核病的识别和诊断。     

HIV/AIDS discourses in Kyrgyzstan’s policy arena

This article explores the major discourses on HIV/AIDS in the policy arena in Kyrgyzstan, a former Soviet country in Central Asia that has experienced a rapid rise in HIV infections since the early 2000s. Based on an analysis of policy documents and 54 semi-structured in-depth interviews with key stakeholders in the area of HIV/AIDS policies in Kyrgyzstan, we distinguish a number of key discourses, competing for legitimacy and authority. While some of these discourses have been used in other countries (such as those presenting HIV/AIDS as a biomedical, social or moral issue), others are more specific to Kyrgyzstan (such as a discourse presenting the country as a regional pioneer in HIV/AIDS prevention efforts). Our analysis shows how HIV/AIDS discourses in the policy arena overlap and complement each other and how stakeholders employ a number of tools and strategies to promote and secure their agendas and positions of power. Our findings help to better understand HIV/AIDS discourses in Kyrgyzstan and elsewhere. They highlight the importance of understanding which discourses are prevailing, who drives them and why, how they change over time, and how they can be framed to achieve policy objectives.     

九江市艾滋病流行现状与预防对策探讨

目的分析九江市HIV/AIDS流行现状、特征和趋势,为制定防治策略提供依据。方法对全市历年来流行病学调查和随访资料、监测哨点资料、特殊人群筛查和相关研究资料进行分析。结果自1998年发现首例艾滋病病毒感染者以来,到2006年10月已累计报告47例,其中艾滋病病人14人,死亡7人。以性传播为主要传播途径,并已出现母婴传播病例,HIV/1B亚型是主要流行株。结论近年来,AIDS流行速度明显加快,在外出打工农民工中存在流行危险,应采取有效健康教育和行为干预措施预防HIV在该人群的流行。     

性病艾滋病防治战略规划分析

目的 探讨省级艾滋病防治战略规划对本省艾滋病防治工作所发挥的作用,为进一步利用和修订规划提出建议。方法 对吉林、重庆等省、市和自治区的艾滋病防治战略规划的制定过程、内容和使用及各参与部门在战略规划修订过程中的参与情况进行了问卷调查,对调查结果和存在的问题进行分析。结果 战略规划的制定和实施等过程中确实在政策动员与多部门合作等方面发挥了重要的作用,各省、市和自治区都能将战略规划作为实际工作中的参考文件,但是并没有充分发挥战略规划的指导作用,也没有针对战略规划的实施情况开展相应的评估活动。随着时间推移和防治工作内容的调整,对已经制定的战略规划进行了认真的修订。结论 应该加强艾滋病防治战略规划在各省艾滋病防治工作中的指导作用,要根据形势变化,及时对战略规划进行修订。     

艾滋病防治经费筹资来源分析

为了深入了解我国各级地方政府艾滋病防治工作的筹资状况,对艾滋病流行状况较为严重的某省的艾滋病防治经费进行了分析,结果显示政府投入是艾滋病防治工作最稳定的经费来源,目前政府的投入主要来自中央和省两级财政,有1/3的市级财政没有艾滋病经费投入,85.00%以上的县级财政没有艾滋病经费投入。需要加强地方政府艾滋病防治的筹资责任,增强地方政府领导对艾滋病防治意识。     

2006-2010年蒲江县HIV/AIDS流行趋势分析

目的分析蒲江县2006-2010年H IV/AIDS流行趋势。方法对2006-2010年H IV/AIDS疫情资料、监测资料进行描述性分析。结果 2006-2010年共监测8464人份,发现H IV感染者32例,阳性检出率为0.38%,其中艾滋病患者17例,死亡5例。32例感染者中通过性传播占93.75%,通过配偶或性伴传播占21.88%,50岁以上人群占34.38%,农民占81.25%,出现1例学生,全县12个乡镇中有8个发现感染者。结论目前蒲江县H IV/AIDS处于低流行,主要以性传播为主,存在从高危人群转向一般人群趋势。目前应加强H IV/AIDS监测,提高自愿咨询检测比例以及早发现感染者,在对感染者加强管理的同时应加强50岁以上人群及农民和学生的艾滋病防治知识宣传,防止疫情进一步蔓延扩散。     

博茨瓦纳的艾滋病防治经验

一个人口170万,孕产妇HIV感染率高达37.4%的非洲国家,艾滋病使全国人均期望寿命由67岁下降到现在的近40岁,全国有30万人感染了HIV,有11万人需要艾滋病抗病毒治疗,有4万名艾滋病孤儿。政府将控制艾滋病视为社会生存和发展问题,通过多部门合作、综合干预及有效的国际合作,使艾滋病得到了初步有效的控制。