中国80%艾滋感染者在农村
2009-12-09 16:44:40 来源：中国青年报 编辑：蒲明军
有记者来到湖北崇阳，通过这个中部小城的艾滋伤痛，折射出整个中国，尤其是中国农村地区艾滋病防治、检测和治疗等方面的薄弱环节。
在这个47万人口的县里，有近6万人在外打工，其中，40岁以下的中青年占90%。艾滋病在民工群体中，通过廉价诊所的注射或血液采集、性交易等方式传播。由于他们的弱势地位和低廉收入，在巨大的生存压力下，这些方式往往是他们迫不得已的选择。截至2009年9月底，崇阳县共发现73名感染者，其中72人是农民，59人是外出打工期间感染。
而民工的受教育程度低、流动性大，给艾滋病防治工作增加了难度，而农村的经济状况、医疗条件和基层医务工作者素质，更是让防治工作显得薄弱。
从记者调查可以发现，国家早已规定的艾滋病感染者“秘密告知”制度，在农村地区成了一纸空文，基层防疫人员开着3辆汽车呼啸而来，在村干部的陪同下直奔感染者家，当着满屋看热闹的同乡宣布对方感染。在治疗方面，要享受国家的“四免一关怀”，领取免费药物，按照规定，必须回到户籍所在地，这又造成很多人因此不治疗。
早在2005年，卫生部就公布统计数据，称目前中国80%的艾滋病感染者在农村。而据卫生部与联合国艾滋病规划署、世界卫生组织对中国2009年艾滋病疫情的联合评估结果显示，截至2009年底，估计中国目前存活艾滋病感染者和病人约74万人，也就是说，其中近60万在农村地区。所以，加强农村地区的艾滋病防治工作已是迫在眉睫。20多年前，我们宣传艾滋病是资产阶级生活方式导致的，而现在80%的艾滋病感染者在农村，不能不说是当年公共政策取向失误造成的悲剧。
除了上述经济和技术上的制约外，目前农村地区的艾滋病防治工作最大的困难，就是无所不在的歧视。由于在长期的防艾宣传中，把艾滋病与性乱、吸毒等负面行为联系在一起，感染者普遍遭受歧视。用记者报道的说法，连空气中都有恐惧和歧视的味道。
中国人民大学教授潘绥铭曾说：“不管是艾滋病还是流感，都只是一种疾病。需要理解的是他们患病的现状，而不是他们得病的原因。”而著名民间防艾人士高耀洁医生长期致力于农村地区防艾知识分普及工作，一直呼吁“艾滋病也是病，艾滋病人也是人”、“知识是预防艾滋病的最好疫苗”，目前看来，要消除歧视，还是任重道远。
然而，却有相反的例子。四川省资中县公民镇就被西方媒体誉为“人类同艾滋病斗争的灯塔”、“艾滋病患者的天堂”，形成消除歧视与扶持感染者创业并举的“资中模式”。他们的经验值得各地借鉴。
由于赴外省地下血站非法卖血等原因，公民镇曾是继上蔡县文楼村外，艾滋病感染者最为集中的地区之一。与其他地区一样，感染者在家乡备受歧视，成为人人避之唯恐不及的另类。甚至荒唐到群众害怕感染者生产的蜂窝煤都会传染艾滋病毒的地步。
但随着2002年联合国艾滋病规划署与英国国际发展部主导的中英性病艾滋病防治合作项目启动，资中成为首批试点地区之一，仅用短短4年，公民镇上对艾滋病患者的歧视现象已荡然无存。资中模式“消除歧视与扶持感染者创业并举”的经验主要是两点：
第一，将消除歧视作为试点的重点，大力开展针对艾滋病防治知识的普及培训，而且培训重点是包括县长在内的县政府各部门官员，并且将这项列为年终考核目标。随后接受培训的有镇、村、社基层干部，卫生技术人员、中小学教师、公安干警、感染者及其家属等各种人群。
第二，解决艾滋病感染者的生计问题，组织感染者生产自救。县税务局对感染者的创业免征税收;县畜牧、农业局对感染者实施技术培训并赠送家禽、家畜、种子;县教育局免去感染者子女的就学经费等等。
在这两项政策推动下，感染者逐渐融入主流社会，普通人也不再觉得感染者有什么可怕，把他们视为普通的慢性病人。在公民镇上，如果记者刻意和艾滋病感染者握手，反而会被视为歧视。公民镇上甚至出现了艾滋病感染者经商有一定的经济实力后，资助健康公民的公益善举。
资中模式表明，消除农村艾滋病歧视尽管艰巨，但并不困难。关键是基层政府不能把防艾光停留在文件中、嘴巴上，说一些没用但永远正确的废话，而是要真正重视和投入——建立了以政府为主导，全民动员的模式，投入资金解决感染者的生产生活，同时带动和发展一批NGO组织的建立，为上至各级领导下至普通公众以及媒体、病患普及艾滋病知识，才能为中国防治艾滋病塑造良好的社会环境。（中国网，中国青年报）
China 80% of HIV-infected people in rural areas
2009-12-09 16:44:40 Source: China Youth Daily editor: PU MING-Jun
A reporter came to Hubei Chongyang, the central town of HIV through this pain, which reflects the whole of China, particularly in rural China AIDS prevention, detection and treatment of the weak links in such areas.
The 47 million people in the county, there are nearly 6 million people working abroad, of which 40 years of age accounted for 90% of the young. AIDS among migrant groups, through low-cost vaccination clinics or blood collection, the sex trade, communication, etc.. Because of their disadvantaged status and low income, living in the great pressure, these methods are often their Hobson's choice. As of the end of September 2009, Chongyang County, 73 were found infected, of whom 72 were farmers, 59 people are infected during work outside the home.
The migrant workers with low educational level, mobility, to AIDS prevention and control work more difficult, while the rural economic situation, medical conditions and quality of grassroots medical workers, but also appear weak is to make prevention work.
Can be found from the investigation by the reporter, the state has long been prescribed AIDS "secret tell" system, in rural areas are empty, grass-roots medical personnel drove three cars roaring, accompanied by the village cadres went straight to infection home Full House to watch the fellow in front of the other declared infected. As regards treatment, to enjoy the country's "Four Frees and One Care" and can receive drugs free of charge, in accordance with regulations, must return to domicile, which in turn caused a lot of people not treated.
As early as 2005, the Ministry of Health has published statistics, said that China's current 80% of HIV-infected persons in rural areas. According to Ministry of Health and UNAIDS, the World Health Organization, the AIDS epidemic in China in 2009 a joint assessment results show that as at the end of 2009, it is estimated China's current HIV infection and the patient survived about 74 million people, that is, of which nearly 60 million in rural areas. Therefore, to strengthen HIV prevention work in rural areas is urgent. More than 20 years ago, our propaganda that AIDS is caused by the bourgeois way of life, and now 80% of HIV infected people in rural areas can not be said then the tragedy of public policy-oriented errors.
In addition to these economic and technical constraints, the current AIDS prevention and control work in rural areas, the greatest difficulty is that ubiquitous discrimination. As the long-term anti-aids publicity to AIDS and sexual promiscuity, drug abuse and other negative behaviors associated with the infection generally subjected to discrimination. With news reports say, even the air has the smell of fear and discrimination.
Renmin University of China, Professor Pan Sui-ming, said: "Whether AIDS or influenza, is just a disease. Need to understand is that the status of their illness, rather than their cause illness." Famous people who Dr. Gao Yaojie long-term commitment to AIDS Prevention points in rural areas, the work of popularizing the knowledge of anti-aids, has been called "AIDS is also a disease, AIDS is also a" and "Knowledge is the best prevention of AIDS vaccine", it now appears to eliminate discrimination, or a long way to go.
However, there are contrary examples. County, citizens of the town-owned Sichuan Province was the Western media as the "beacon of human beings with the fight against AIDS," "AIDS paradise," the elimination of discrimination and support the formation of entrepreneurial simultaneously infected with the "capital in the model." Their experience is worth learning all over.
Go to other provinces because of the illegal blood-selling underground Blood and other reasons, citizens of the town was following the Shangcai Wenlou Village, the highest concentration of people living with HIV in the world. Like other regions of infected persons subject to discrimination at home, and became a shunned alternative. And even absurd to the people afraid of infection briquette production will be the point of transmission of HIV.
But with the 2002 UNAIDS and the United Kingdom Department for International Development-led British STD & AIDS Prevention and Care Project started, funded the first pilot to become one of the areas, and in just a short four years, the citizens of the town of discrimination against AIDS patients no longer intact. Capital in the model "the elimination of discrimination and support entrepreneurial simultaneously infected," the experience is mainly two things:
First, focus on the elimination of discrimination as a pilot, great efforts for the popularization of knowledge of AIDS prevention and control training, and training priorities include county departments, including county government officials, and will target this as a year-end appraisal. Then trained with the town, village, community grass-roots cadres, health technicians, primary and secondary school teachers, policemen, infected persons and their families and other groups.
Second, addressing the livelihood of people living with HIV, infected with self-help production organization. County Tax Bureau of the infected person's business shall be exempted from taxation; County Livestock, Agriculture Bureau of infection and to implement technical training and gifts of poultry, livestock, seeds; County Board of Education to remove schooling of the children infected with funding and so on.
In these two policies under the impetus of a gradual integration into mainstream society infected person, ordinary people no longer feel that infected persons have nothing to fear, to them as ordinary chronic disease. In the civil town, if the journalists and people living with HIV deliberately shaking hands, but will be considered discriminatory. Citizens in town and even appeared in people living with HIV to do business with a certain economic strength, we subsidize the health of citizens of the public charity.
Capital in the model shows that the elimination of discrimination of AIDS in rural areas despite the formidable, but not difficult. The key is the grass-roots government can not stay in the light of anti-aids in the document, mouth, say something useless but they will never correct nonsense, but to truly focus on and commitment - established a government-led, full mobilization mode, invested infected persons to solve production and living at the same time promote and develop a number of NGO organizations established, ranging from leadership at all levels down to the general public and the media, the patient spread of AIDS knowledge, in order to fight against AIDS in China to create a favorable social environment. (China Network, the China Youth Daily)