Course 4
Cultural
National
Ethnic
Religious
Subcultural
National Problems
 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
文化方面的問題-國家方面的問題
意欲控制AIDS的流行,首要的職責通常在於各個國家的政府。下面兩個案例可能具有指導意義:不久前,HIV/AIDS的感染率在烏干達和泰國是世界上最高的。可是,採取了適當的國家宣傳運動卻能夠使感染率降了下去。

烏干達 以簡單的“ABC”口號一直致力於預防AIDS的國家項目:

節欲(Abstinence)
忠誠
(Being faithful)
或如果前兩者都未採用,則使用安全套(Condom use)。

因為HIV感染率有了顯著的下降,這個項目已經取得了重大的成就。人們一直在觀察這種趨勢是否能夠持續下來,這三個要素中每一個對這個成就貢獻有多大。在烏干達,只要足夠多的人群堅持A(節欲)B(忠誠),而有高危行為者堅持採取C(使用安全套),這個項目可能確實要堅持推行下去。

與之大不相同的是,泰國已經成功地開闢了另一路。在認識到大多數HIV感染能夠追溯到商業性性接觸後,這個國家啟動了大眾宣傳運動,在大的性產業經營場所強行推廣安全套:

“100%使用安全套專案”

該專案的目標是在商業的性工作者中間推廣使用安全套。如果顧客拒絕合作,他就得不到服務。那些沒有強制遵守這一規則的妓院被關閉了。另外,政府分發大量的免費安全套。其結果是,在性工作者中的性傳播疾病感染率戲劇般地下降,現在有更多的男性使用了安全套,而HIV/AIDS已經令人注目地下降了。
上述兩個不同的預防路徑並不必定會在其他國家獲得成功,但是卻教給了我們相同的經驗:
任何地方實施行為改變專案之前,研究研究當地的文化以及籌畫出適合那裏的戰略是必要的。這個項目然後在那個特定的地點要簡單地運用“萬事皆有果”定律做出檢驗 ,因為最終只能拿結果來衡量所付出的艱辛和所投入的費用。

 Safer Sex - Problems of Safer Sex Promotion

Cultural Problems - National Problems
The first responsibility for controlling epidemics usually lies with the respective national governments. The two following examples may be instructive: Not long ago, the HIV/AIDS infection rates in Uganda and Thailand were among the highest in the world. However, appropriate national campaigns were able to bring them down.

Uganda has been using a prevention program under the simple slogan “ABC”:

Abstinence, Being faithful, or, if the first two are not practiced, Condom use.

This program has had measurable success as the incidence of HIV infections has clearly decreased. It remains to be seen if the trend continues and how much each of the three elements contributes to the success. As long as a sufficiently large majority sticks to A and B while those at high risk adopt C, the program may indeed keep working in Uganda.

In contrast, Thailand has successfully taken another route. Realizing that most of its HIV infections could be traced to commercial sex contacts, the country started a massive campaign enforcing the use of condoms in its large sex industry:

"The 100% Condom Program"

The goal was to make condom use universal among commercial sex workers. If a client refused to cooperate, he was not to be serviced. Brothels that did not enforce this rule were closed. In addition, the government distributed large quantities of free condoms. As a result, the STD infection rate among sex worlers decreased dramatically, more men than ever now use condoms, and the spread of HIV/AIDS has significantly slowed down.
These two different approaches are not necessarily successful in other countries, but they teach the same lesson:
Before any program of behavior change is launched anywhere, it is necessary to study the local culture and to devise a strategy appropriate to it. The program will then simply use “anything that gets results” in that particular locality because, in the end, only the results justify the effort and expense.
 

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