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概述-歷史記載
Introduction
- Historical Notes |
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波動的性傳播疾病發病率 |
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1950年代，在美國抗生素的使用，加之大規模公共教育運動，導致性傳播疾病發病戲劇般的下降。但是，這種成功激起了反常的反應：許多醫學權威人士和政客擔心，一旦“罪惡的報應”被排除，男男女女們可能轉向亂交、放蕩和墮落。結果就是婚姻、家庭和作為整體的社會將面臨崩潰和衰落。從這個意義上看，“治癒疾病將比疾病更糟”。 無論如何，美國政府在1950年代也或多或少受到疾病治療表面看起來簡單的誤導，開始逐漸加大力度削減性傳播疾病的預防專案。與此同時，社會和政治氛圍使公開討論性問題變得越來越困難了。
不幸而又可預見的是，性傳播疾病感染率再次上升。因而，美國失去了控制性傳播疾病發病率的唯一歷史機遇。一系列疾病防治失控的局面再度出現，沒有了足夠可資利用的有效治療措施。疾病預防項目也必須對應人們的性行為做出調整，而且這些項目必須不間斷地堅持下去。
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美國：1950年代，性傳播疾病病例的戲劇性下降及其隨後的急劇上升
USA: A dramatic drop in STD cases in the 1950s, followed by a steep rise
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一期和二期梅毒（單位：千）
Primary and secondary syphilis (in thousands)
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淋病（單位：千）
Gonorrhea (in thousands)
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Source: Allan M. Brandt, No Magic Bullet - A Social History of Venereal Diseases in the United States since 1880,
Oxford University Press, 1987
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Falling and rising STD rates |
In the 1950s, the use of antibiotics together with a massive public education campaign, led to a dramatic decline of STDs in the United States. However, this success provoked a paradoxical reaction: Many medical and political authorities feared that, once “the wages of sin” had been eliminated, men and women would turn to promiscuity, debauchery, and vice. As a result, marriage, the family, and society as a whole would face ruin and decline. In that sense, “the cure would be worse than the disease”.
In any case, in the early 1950s, the U.S. government, in part also misled by the apparent simplicity of a cure, began ever more drastic cuts in its STD prevention programs. At the same time, the social and political climate made the open discussion of sexual issues more and more difficult. Unfortunately, and predictably, the infection rate rose again. Thus, a unique historical opportunity was lost to get American STD rates under control. The episode also proved once again that it is not enough to have effective treatments available. Prevention programs must also address the issue of human sexual behavior, and they must do this continuously. |
