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中国艾滋病防治工作出现重大转变

发布者: chrislau2001 | 发布时间: 2008-11-20 18:33| 查看数: 2071| 评论数: 1|

A Big Shift For China's AIDS Fight

AIDS, which has long thrived quietly on the fringes of Chinese society among drug addicts and recipients of tainted blood donations, is on the verge of going mainstream here.

One major cause is prostitution, a booming industry in China that has helped make sex the most common form of AIDS transmission in China.

China's hopes of stopping the disease from turning into the country's next health crisis may rest with the efforts of people like Guan Baoying, a 56-year-old activist who has defied standard government attitudes about high-risk groups such as prostitutes.

As a Beijing health bureaucrat until last year, Ms. Guan managed to convince the government to support regulations that require hotels to supply condoms to their guests -- with the result that even in five-star hotels, condoms are a standard part of the minibar. Today, she leads the charge as the head of a nongovernment organization that helps fund outreach work with backing from the Bill & Melinda Gates Foundation.

China has a condom problem. A recent survey of six major Chinese cities by the Joint United Nations Program on HIV/AIDS, known as UNAIDS, found that just 54% of Chinese would use a condom if they had sex with a new partner.

UNAIDS estimates that about 700,000 people in China carry the HIV virus, though accurate figures are difficult to come by. 'The epidemic is starting to generalize,' says Li Dongliang, a district director of the AIDS program of the Center for Disease Control and Prevention in Beijing.

To fight the tide, Ms. Guan embraces an approach already proven to work in other countries: give condoms to the very people at high risk of spreading the disease. Tens of thousands of massage parlors and karaoke bars double as brothels, where businessmen and migrant workers can contract the disease and carry it to their hometowns and families.

'These sex workers are disadvantaged people in society,' says Ms. Guan. 'No one cares about them.'

Ms. Guan has become a regular at brothels such as one near Beijing's Wangfujing shopping district. She is friendly with Sun Jie, a 37-year-old procurer who employs the other male prostitutes here. Above the bed in his tiny, cigarette-strewn hotel room hangs a framed photo of him and the matronly AIDS worker.

'We have learned a lot from Ms. Guan,' he says. He holds up a box of Partner brand condoms and a yellow bottle of lubricant, which helps prevent breaks in the skin that allow infection.

Ms. Guan's first experience with AIDS came in the mid-1980s. As a member of Beijing's Center for Disease Control, she visited a patient dying from the disease -- one of China's first such cases. Fearing infection, she returned home from the hospital, stripped naked and sent her clothes to be cleaned.

As the years went by, Ms. Guan grew bolder in her approach to tackling the disease's spread. She visited detention centers in Beijing where arrested sex workers were held, and instructed women on how to protect themselves against AIDS. In July 2004, she rallied support from 12 government departments for a regulation that would expand the availability of condoms in Beijing. All of the bureaus signed a commitment, she remembers -- except for the Public Security Bureau, China's police.

'For the Public Security Bureau, their mission is to crack down hard on selling sex in society,' she says. 'This was a total conflict.'

The bureau refused to offer formal support for Ms. Guan's plan, she says, but it didn't block it either. An official at the Public Security Bureau in Beijing who gave his name only as Mr. Zi declined to comment on the incident except to say the police have 'nothing to do with condoms.'

In March 2006, a regulation issued by China's State Council began requiring government-designated public places, including hotels, to install condom vending machines or otherwise provide access to condoms. This May, the city of Beijing went a step further, requiring that condoms be placed in all public places, including restrooms, karaoke parlors and big construction sites.

'It is by no means easy for Beijing to take this step, and I am very happy to see it happen finally,' says Ms. Guan.

Her gains represent a significant shift in a country where, for decades, prostitutes were sent to re-education camps en masse.

Much of the country has yet to adopt Mr. Guan's focus on harm reduction, but her efforts received a big boost in 2007, when Bill Gates met with her while visiting a health center in Beijing. Impressed by the official's work, the Gates Foundation decided to adopt her model of prevention and outreach and replicate it in major cities across 12 provinces.

Ms. Guan retired last year as the head of disease control at the Beijing Municipal Health Bureau and today leads the Beijing office of the AIDS program of the Global Fund, an international public-private health charity that's partly funded by the Gates Foundation. She steers the process of awarding grants to grass-roots organizations in Beijing working to prevent the disease through education and other activities.

'We have done our best to make people aware of the importance of wearing condoms,' says Ms. Guan, 'but it's hard to judge how many of them will actually do it.'

最新评论

chrislau2001 发表于 2008-11-20 18:33:26


期以来在吸毒人群及被污染血液感染人员中间悄悄传播的艾滋病现在大有进入社会主流的势头。

性产业的日益泛滥是艾滋病在中国蔓延的一个重要原因,这已经成为了中国艾滋病传播最常见的渠道。



                               
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关宝英



如果中国希望阻止艾滋病演变成为下一个健康危机,它或许需要来自关宝英这类人士的努力。这位56岁的防治艾滋病活动家向中国政府对性工作者等艾滋病高危人群的态度发起了挑战。

关宝英去年之前一直在北京市卫生部门任职,她努力说服政府支持有关规定,要求在酒店向住客提供安全套──现在,即使是在五星级酒店,安全套也已成为房间迷你酒吧里的标准配置品之一。如今,关宝英领导着一家非政府组织,在比尔及梅林达·盖茨基金会(Bill & Melinda Gates Foundation)的赞助下从事预防艾滋病的宣传教育工作。

在中国,安全套的使用并不普及。据联合国艾滋病规划署(UNAIDS)近期对中国6个大城市的调查表明,中国人在与非固定性伙伴发生性行为时,只有54%的人会用安全套。

UNAIDS估计,中国艾滋病毒携带者大约有70万人,不过精确数字很难获得。北京市朝阳疾病预防控制中心艾滋病项目负责人李东亮说,这一传染性疾病现在开始逐渐蔓延起来。

为抵御艾滋病的蔓延,关宝英主张采取一种在其他国家已被证明行之有效的方法:向艾滋病高危人群发放安全套。中国数以万计的发廊、按摩房、歌厅实际也是性活动场所,在此接受服务的生意人和外来务工人员可能会感染艾滋病并传染给家人或老家所在地区。

关宝英说,这些性工作者是社会弱势群体,没有人关注她们。

关宝英经常到这类场所开展工作,比如位于北京王府井商业区附近的一处。她跟37岁的中间人孙杰(音)关系很好,孙杰还雇佣了一些男性性工作者。在他那间小小的、到处扔着烟头的酒店房间里,床头上方挂着他自己和这位耐心的艾滋病工作者的照片。

孙杰说,我们从关女士这里学到了很多。他拿起一盒“伙伴”牌安全套和一瓶用于防止皮肤划伤感染的黄色润滑剂。

关宝英最早接触到艾滋病还是在八十年代中期。当时,在北京疾控中心工作的她看望了一位病入膏肓的艾滋病患者。这位病人是中国第一批艾滋病感染者。因为害怕传染,她从医院回家后将全身上下的衣服全部脱下清洗。

随着时间的推移,关宝英在艾滋病防治工作中采取的方式也越来越大胆。她到北京关押性工作者的收容教育所里,教给那些女性如何保护自己、预防艾滋病。2004年7月,她得到了政府的支持:12个部门联合制定条例,在北京增加安全套供应渠道。她记得所有部门都签署了承诺,除了公安局。

她说,公安局的任务是严厉打击社会的卖淫嫖娼活动。这方面完全冲突。

关宝英称,公安局不愿提供正式支持,但也不阻止她开展工作。北京市公安局一位自称姓资(音)的人士拒绝对此事发表看法,只是说警方与安全套问题没有任何关系。

2006年3月,中国国务院颁布条例,要求在政府指定的公共场所(包括酒店)安装安全套自动售卖机或设立其他提供安全套的途径。今年5月,北京市采取进一步措施,要求在所有公共场所配备安全套,包括卫生间、卡拉OK厅和大型建筑工地。

关宝英说,北京能做到这一步太不容易了。我很高兴能看到这一步最终实现。

她取得的成果意味着中国显著改变了过去的态度;数十年来,性工作者会被送去劳动改造。

虽然中国大部分地区还没有采纳关宝英提倡的预防工作,但她的努力在2007年获得了大力支持:比尔·盖茨(Bill Gates)在参观北京一家医疗中心时与关宝英见了面。盖茨基金会被关宝英的工作所打动,决定采用她的预防和宣传教育模式,并在中国12个省的主要城市推广。

关宝英去年在北京市卫生局疾控处处长任上退休。现在担任Global Fund艾滋病项目北京代表处负责人。Global Fund是一家国际公共-民间医疗慈善基金,部分资金来自盖茨基金会。她负责将援助基金发放给北京基层艾滋病预防组织从事教育和其他相关活动。

关宝英说,我们尽最大努力让人们认识到使用安全套的重要性,但现在还很难判断到底有多少人确实使用了。
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