Course 4
Political
Getting the Facts
Empowering Women
Delivering Health Services
Delivering Health Services
 性傳播疾病的預防:行為的改變
 
STD Prevention: Behavior Change
 安全性行為-推行安全性行為所面臨的問題
政治上的問題-履行衛生保健問題
在許多貧窮國家,事實上現在已經有較便宜的AIDS治療藥物可供使用,但是,便宜的藥物本身並沒有解決這些國家的難題。在某些貧窮國家,衛生保健系統已經崩潰,因而要將藥物發放到所有那些需要的人的手裏是困難的。經常的情形是,外國強制實行的財政緊縮措施已經引起削減衛生保健方面的預算。在世界的一些地區,去援助的醫生和護士只是無奈地離去,在其他的地區,卻從來沒有足夠的衛生保健人員去開展服務。
在許多發展中國家,有超過90%的感染者並不知道自己的HIV感染狀態,由此而不知道自己對他人具有傳染性。只有少數人獲得了HIV抗體檢測和得到諮詢服務。即使他們知道了自己的感染狀態,他們也不會必定有足夠的安全套可用,因為發生供應短缺太常見了。在這些情形下,衛生保健服務不健全的國家必須優選改善和擴充這個服務體系。
考慮到上述所有的因素,全球預防HIV工作小組(由美國兩個基金會資助的公共衛生專家小組)最近已經制定了對抗AIDS的很有前途的策略。小組成員所提出的報告推薦了一個預防與治療相結合的方案。實際上,這個方案就是:促進廣泛使用安全套、志願的HIV諮詢和檢測和允許使用藥物以防止HIV從孕婦傳染給胎兒。報告推薦的策略中對那些高危行為者實行額外服務運動:促進節欲和/或專一性關係、為靜脈毒品注射者提供消毒針頭,等等……。換句話說,預防與治療策略能夠也應該整合在一起發揮作用:檢測、諮詢和治療的三位一體服務能夠帶動千百萬人參與到衛生保健服務體系中去,然後能夠通過這個服務體系強化宣傳預防AIDS的知識。
AIDS全球流行所造成的威脅是巨大的和迫切的。鑒於此,從1988年起,在聯合國的支持下,
世界衛生組織(WHO)已經推出了每年12月1日都會舉行的“世界愛滋病日”。這個日子提醒全世界的人們,承擔起自己的義務,在所有的戰線為戰勝愛滋病而戰鬥;它也提醒人們,擔當起自己的義務,去關愛和照護所有的愛滋病感染者。

 Safer Sex - Problems of Safer Sex Promotion

Political Problems - Delivering Health Services
The fact that cheaper AIDS drugs have now become available in many poor countries does not, in itself, solve their problems. In some of these countries, the health care systems have broken down, and it is therefore difficult to deliver the drugs to all those who need them. Often, foreign-imposed austerity measures have led to cutbacks in the health sector. In some areas, doctors and nurses have simply left, and other areas never had enough health personnel to begin with.
In many developing countries up to 90% of the infected do not know their HIV status and thus do not know that they are infectious to others. Only a few have access to testing and counseling. Even if they knew their status, they would not necessarily have sufficient access to condoms which all too often remain scarce. Under these circumstances, countries with inadequate health care services must give priority to improving and expanding them.
In view of all this, a promising strategy against AIDS has recently been proposed by The Global HIV Prevention Working Group, a panel of public health experts convened by two American foundations. Their report recommends a combination of prevention and treatment programs. This means, in practice, the widespread promotion of condom use, voluntary HIV counseling and testing, and the administration of drugs to prevent HIV transmission from mother to child. Additional campaigns for behavior change could make an additional difference with certain people at risk: Promoting abstinence and/or exclusive sexual relationships, providing clean needles to intravenous drug users, etc. In other words, prevention and treatment stategies can and should work hand in hand: Testing, counseling and treatment can bring millions of people into health care settings where caregivers then can reinforce their prevention messages.
The dangers posed by the AIDS pandemic are great and keep growing. Therefore, since 1988, the
World Health Organization (WHO), with the support of the United Nations, has been promoting a “World AIDS Day” which is being observed on December 1 of each year. It reminds the world of its obligation to fight the disease on all fronts, and to care for all of its victims.
 

[Course 4] [Description] [How to use it] [Introduction] [Curable STDs] [Incurable STDs] [STD Prevention] [Abstinence] [Safer Sex] [Additional Reading] [Examination]