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中国艾滋病性传播现状调查:民工已成高危群体
2010/02/26 11:03 来源：新民晚报-新民网
艾滋病性传播调查：农民工已成高危群体
艾滋病性传播调查
文_本刊记者 甄静慧
2008年9月，广州市疾控中心向当地关注艾滋病的NGO组织抛出一个“特殊”项目：由全球基金赞助，在广州进行为期3个月的艾滋病高危人群干预，目标是发廊、出租屋等低价性工作者。
“听到项目内容，大家都吓了一跳，无人敢接茬。”时隔一年多，广州女青年会副主任社工李含如此向记者描述当时的情景，“一则，大家对性工作者群体的特殊性心存顾虑；再者，以往艾滋病行为干预主要是针对吸毒者，对性工作者的干预是个全新的命题，谁也不知道该怎么做。”
然而严峻的形势已不待人犹疑：疾控部门2008年全国监控数字显示，艾滋病异性性传播率已达43%~44%，同性性传播率7%~8%，性传播总比率超过50%，远高于注射传播的39%，首度成为中国艾滋病第一传播途径。
而其中，有数量庞大、流动性极强的农民工高危群体。2009年，湖北省崇阳县发现73例艾滋病感染者，其中72人是农民，59人为外出打工期间感染；在甘肃，2009年1月至10月发现的HIV感染者中，农民、农民工和无业人群占总人数的55.41%；而在东莞，至2009年10月底，累计报告2194例HIV感染病例中，流动人口感染者占总数的91.44%。
农民工群体之危险，因为他们对性知识普遍的无知和频发的高危行为，更因为他们带着致命病毒在全国流动却不知应如何保护自己和他人。
压抑的农民工
“不许录音，给钱就跟你聊天。”发廊妹英子对记者说，这个年仅22岁的姑娘在行内已有4年从业经验。从老家到广州发廊，她的“入行”是一步到位的。农村老家对性知识的普及教育几乎为零，以前，小学学历的英子不仅对艾滋病一无所知，仅有的卫生常识都是由其他发廊姐妹私下“传授”。
在这里，英子的主要客源是退休老人以及在附近打工的农民工。“有工厂的，有建筑工地的，还有做服务的。建筑工比‘工厂仔’来得更频繁。”
有的农民工经常来，熟络了，也跟英子聊天，聊他们的压抑。这种压抑不完全是生理意义的。改革开放30年，珠三角经济腾飞，仰赖的是无数农民工日以继夜付出的廉价劳力，他们称得上是这个社会里工作时间最长、体力上最劳累的人群之一。工厂订单充足的时候，农民工们固然连休息的时间都很少，但与之相比，他们的休闲活动更少。
“下班仅有的娱乐就是看看电视、打打牌。”傍晚，几个外来工兴致勃勃地围在小士多外看重播的粤语片。城中村的士多店多装有小电视机，这是吸引附近工余农民工的最有效办法。
“如碰上工厂订单不足，那就闷得慌了。”在石井仓库打工的威哥有一子一女，几年前，夫妻在广东打工共同进退，虽然艰苦，总算能相互慰藉。孩子出生后，妻子留在河南老家。威哥独自一人在广州，开始感到苦闷，生活既劳累无趣，连基本生理需求也受到压抑。
劳累的工作、贫乏的文化娱乐生活，长期与固定性伴侣分离，种种因素使很多农民工倾向于以原始本能——性的释放来缓解生理和心理上的的双重压抑。
2007年全国“两会”上，全国人大代表黄德明大力倡议农民工所在单位应当提供低价或免费的“夫妻房”；国家也通过相关立法，要求用工单位给农民工休探亲假，或为家属探亲提供廉价的出租房屋，创造夫妻相聚条件。
但这些威哥都不太领情。“即使提供夫妻房，老婆的来回路费难道不花钱。”工资微薄，压力沉重，他宁愿在附近找个临时“女朋友”，不然就找小姐，“主要是便宜，一二十元左右就解决问题。”
显然，农民工群体的两性关系正迅速向多样化和临时性演变。对流动人口的相关调查显示，目前农民工男性对商业性性行为赞成率为32.8%，女性则21.3%；男性对临时性性行为赞成率高达45.5%，女性为33.1%。而在已婚农民工当中，41.84%渴望婚外性生活，其中24.53%已经付诸行动，婚外性行为的对象分别是情人、同事及“小姐”，当中又以情人为多数，占67.05%。
性病阴云
如果说在注射还是艾滋病传播主要途径的时候，防治任务再艰巨，起码有一定范围的人群指向以及行之有效的阻断措施；那么在“风流无罪”的性传播时代，几乎没有彻底的解决办法。
港产片《超级学校霸王》里，来自未来的刘德华对邱淑贞说，“在我们50年后的世界，性生活是犯法的，因为那时艾滋病已经到了失控的程度，政府唯有下令禁欲，直到所有艾滋病人消失为止。”
“禁欲当然是不可能的，唯一的办法只能是提高安全套的使用率。”林鹏表示。然而，性关系正越来越开放和多样化的农民工群体，以及他们最常光顾的低价性工作者，恰恰是安全套使用率极低的群体。
英子长期服用避孕药，然而避孕药避得了怀孕，却避不开千奇百怪的性病。
据了解，广州发廊性工作者中曾患过性病的占66.02%，像英子这样出现症状后继续有商业性行为的占59.92%。
四川省皮肤病性病防治研究所专家、国家高危人群干预专家万绍平表示：“感染了性病的人，被艾滋病病毒感染的风险会增加5～10倍。”
“目前，国内已经陆续发现低价格的暗娼出现艾滋病感染。在不同的地区感染率不一样，最高的地方甚至高达10%，很多是5%左右，远远高于全部性工作者0.1%的感染率。”这是一个何等可怕的数字。
在卫生部门的监测结果中，目前国内艾滋病性传播的高危人群，正是农民工、退休老人、暗娼等低价格性交易相关人群，其中又以数量庞大和流动性极强的农民工群体尤为令人担忧。
流动的病毒
在东莞市疾控中心，记者遇到来拿检查报告的地盘工人李平，他拿到的结果是阳性。
“我没找过‘小姐’……曾经有一个女朋友，在洗浴城工作……”这个30岁左右的瘦削青年压低声音，吞吞吐吐地说，并加快脚步向车站走去。走了一段路见到垃圾箱，犹豫一下，把检验报告撕碎并揉成一团扔了进去。
“为什么把报告扔掉，不留着日后咨询和治疗用？”记者问。李平涨红着脸答：“不能留，回去被人看到就坏事了，要被开除。施工队里有我的老乡，搞不好老家都会知道的。”他告诉记者，在疾控中心做检查时，留的也不是真实姓名。
当问及这样是否会影响卫生部门随访以及他日后的定期检查时，李平紧张得连连摆手：“不能随访。我问过医生，他说这个病有潜伏期，现在不发病，可以不治疗。”他不愿与记者多说，匆匆上了回工地的班车。
与那些因卖血、吸毒感染上艾滋病的病人相比，由性传播染上HIV的感染者更为敏感。通过多个NGO组织和医院的努力，没有一个感染者和病人愿意坦然分享自己的故事。从乡村社会走出来的农民工尤甚，尽管他们行为开放，但在深层观念里，仍然觉得在外面乱搞男女关系而得的“病”是见不得人的丑事。再加上对社会歧视的担心，若不到发病的一刻，绝大多数感染者都选择在检测时隐匿自己的真实姓名和联系方式。卫生部门难以对他们进行追踪和随访。
“尤其是工地的建筑工人，他们的嫖娼率比工厂工人更高，流动性也更大，很多人都是做完一期工程就走。”林鹏表示。
没有办法随访，就难以提醒他们定期检查。广州市第八人民医院副主任医师何浩岚表示：“国家规定，当艾滋病感染者的CD4指标低至200以下，可以享受免费治疗，那个时候大多数人尚未发病，能够较好地控制病情。但现实却是很多感染者由于没有接受定期检查，直至发病才开始治疗，那时CD4已低到100甚至50以下，进入了艾滋病晚期，治疗难度非常之大。”
而另一方面，感染者在没有接受随访和行为干预的情况下带着病毒全国流动，既不懂得保护自己，更不知道保护别人，或轻易成为了艾滋病从城镇向农村传播的桥梁，或使病毒从高危人群向一般人群扩散。这样的结果是灾难性的。
“小姐”的尴尬
为了遏制性传播的蔓延，这几年，万绍平带领着他的高危人群干预人员马不停蹄地全国到处跑，在夜总会召集“小姐”大谈安全套的使用，甚至教她们如何与客人在安全措施上“讨价还价”。
但对于风险最大的底层性工作者，卫生部门依旧一筹莫展。她们的高流动性、隐蔽性、分散性，使政府专家的介入几乎成为不可能的任务。“在这种情况下，义工干预的效果会显着得多。”在女青年会，李含和义工们感到责任重大。
义工的身份的确也帮了义工苏小欢很大忙。
第一次踏进小发廊的时候，她知道自己不受欢迎，才把艾滋病防治的传单拿出来，“小姐”们忙不迭塞回去给她，说，“我们不是干那个的，不需要。”后来去的次数多了，“小姐”们知道她不是来扫黄的，态度才友善起来。
苏小欢每次去发廊和出租屋都会带上一些小礼物，口红、丝袜等，她把安全套偷偷夹在传单和其他礼物里一起送出。“开始很担心她们会抗拒。”但意外的是，“小姐”们大方地将安全套拣出来，兴高采烈说，“这份礼物最好。”
有一次外展，苏小欢带了100个安全套，不到3分钟就被抢光了。“这是个好现象，证明她们接受了相关知识后，更愿意使用安全套了。”苏小欢高兴地说。
英子对此表示赞同：“我们也爱惜自己的身体啊！”去年她也碰到来做外展的义工，一开始看到艾滋病单张，她感觉受到羞辱，气愤地把当着义工的面扔了出去。但义工走了后，又忍不住捡回来看。“现在我懂得很多了，随时都带着安全套。”她打开包包的搭扣给记者看，“问题是很多时候客人不愿用，如果他们坚持，我也只能答应。”英子无奈地说。
2008年9~12月，女青年会的义工团队共持续干预了发廊和街头性工作者300多人次，超出了疾控中心预期的10倍；2009年9月，她们又开展了第二期干预，干预人次接近300人。这样的成效让李含和义工们非常雀跃。
不过，万绍平却不太乐观。“越低端的性交易里，‘小姐’越处于脆弱、被动的位置，她们对男性的要求无法抗拒。我们曾经做过调查，干预低档的暗娼，安全套使用率只能在原来30%的基础上再提高15%，达到45%左右，之后再难提高。但经验表明安全套使用率必须达到80%以上才能对艾滋病起到较好的阻断的效果。”
故此，提高底层性工作者的性保护意识固然具有重要社会意义，但仅从艾滋病防治来说，这样还远远不够。
策略转变
“后来我们转变策略，尝试从嫖娼的主体——男性着手进行干预。”万绍平说。近来，他尝试在各种各样的场所接触这些男性，在建筑工地、技校等地方做健康讲座，介绍艾滋病性传播的危险性，教导他们预防。
“从干预效果来看，男性接受干预后，安全套使用的提升率要快得多，因为他们是性关系里使用安全套的主动方，在自主行为上没有客观阻碍。”这个理念推广开来后，今年广东爱之关怀组织也开始着手对农民工进行干预。他们在中山、东莞等农民工集中的城市开展行动。但阻力同样很大。
“一开始，想进入厂区把工人集中起来进行宣传干预，但根本没有一家企业老板答应。”爱之关怀负责人告诉记者。后来，社工只好在道路两旁设置桌椅摆放宣传资料，沿路拦着三三两两的农民工进行干预。这样做效率不高，有时大半天下来也干预不了多少人。
在对男性的干预中，万绍平还发现另一个问题：“干预的短期效果很好，但如果不持续干预，比如干预半年后停下来，安全套使用率又会下降。这证明行为干预是一项长期、专业的工作，并不仅是知识普及宣传这么简单。”
在临床经验里，何浩岚发现，经过这些年的艾滋病知识普及，发生高危性行为的人也不一定对其一无所知，相反部分人对艾滋病很了解，有主动到医院检查求诊的行为。
有一名中年男人，每年都来找何浩岚开几次检查单。“来的时候害怕得不行，但几个月后，又发生高危行为，又来检查。”何浩岚责问他，明知道艾滋病可怕，何不停止高危行为？男人只是赔笑，“一到了那个情景，就忍不住了。”何浩岚将此归结为一种普遍存在的侥幸心理。
对艾滋病性传播机率的统计显示，HIV阳性感染者通过性行为传播艾滋病的机率是2‰。“这个结果容易令人掉以轻心，所以我经常纠正他们的观念：对于每个个体来说，每次高危行为的可能性只有两个，感染，或不感染。这是50%的机率。还有一个更大的误区是，很多人总在下意识认为得了艾滋病的人肯定都病殃殃的样子。”
总有性传播感染者悔不当初地说，“他长得白白胖胖、精神奕奕，如何想得到身上带有致命病毒？”调查显示，在商业性行为中，不使用安全套的原因，除因“客人不愿意”外，“客人外表无异常”的考虑也占了相当比例。但事实上，在艾滋病5~8年的潜伏期中，没发病的感染者看上去就是一个正常人。尽管人们不愿意接受，危机往往的确就掩藏在美好的情爱背后。
近来，何浩岚最忧心的是，临床的女性患者比例正不断升高。2000年前，第八人民医院的12间艾滋病房里，女病房只有1~2间，而今女病房已增加到4间。
女性感染人数的上升绝对是一个更危险的信号。“从全球看来，一旦艾滋病受感染的男女比例达到1∶1，就到达性传播的晚期，意味着艾滋病已蔓延至普通家庭，那时即便使用干预手段也再难控制。”万绍平说，“目前中国的比例是4∶1，我们的路还有很长。”
无疑，面对世纪绝症，我们正面临一场长期而艰辛的战斗。
Investigation of sexual transmission of AIDS in China: migrant workers has become a high-risk groups
2010/02/26 11:03 Source: Xinmin Evening News - Xinmin Net
AIDS and sexually transmitted Survey: migrant workers has become a high-risk groups
AIDS and sexually transmitted Survey
Wen _ reporter Jing Zhen Hui
In September 2008, the Guangzhou CDC to the local NGO concerned about AIDS organization throws a "special" project: sponsored by the Global Fund, in Guangzhou 3-month high-risk groups for AIDS intervention goal is to salons, rental, etc. Low sex workers.
"On hearing the contents of the project, everyone was shocked that no one dared Jiecha." More than a year later, Guangzhou, deputy director of the YWCA including social workers, Li told reporters the case described the scene at that time, "one, everyone on the sex work have misgivings about the particularity of groups of persons; Moreover, in the past AIDS behavioral intervention mainly aimed at drug users, sex workers intervention is a new proposition, no one knows how to do. "
However grim the situation has not on our hesitation: Disease Control Department in 2008 nationwide surveillance figures show that the rate of heterosexual transmission of AIDS has reached 43% ~ 44%, same-sex sexual transmission rate of 7% to 8%, the overall rate of sexually transmitted more than 50%, much higher than the injection of the spread of 39%, for the first time become China's first AIDS transmission.
Of these, there are large number of highly mobile high-risk groups of migrant workers. In 2009, Chongyang County, Hubei Province, found that 73 cases of HIV infection, of whom 72 were farmers, 59 people work outside the home during the infection; in Gansu Province, in January 2009 to October found that HIV-infected persons, farmers, migrant workers and the total number of unemployed people accounted for 55.41%; in Dongguan, to the end of October 2009, the cumulative report of 2194 cases of HIV infection cases, the floating population infected persons accounted for 91.44% of the total.
Peasant-workers of the danger, because they are generally ignorant of sexual knowledge, and frequent high-risk behavior, but also because they flow with the deadly virus across the country do not know how to protect themselves and others.
Repression of migrant workers
"Do not recording and sending money to told you chat." Salon girl Eiko, told reporters that the only line within the 22-year-old girl has been four years of experience. From home to Guangzhou salon, her "entry" is a one-stop. Rural home on sexual knowledge, education is almost zero, before the child with primary education, Britain is not only ignorant of AIDS, the only health knowledge are sisters from other salons in private, "pass."
Here, the British child's major source, as well as the retired elderly people in a nearby migrant workers. "There factory, there are construction sites, as well as to do service. Construction workers than the 'factory earners' to more frequently."
Some migrant workers often come addict to get acquaintance, and also with the English sub-chat, chat about their depression. Such repression is not entirely physical sense. 30 years of reform and opening up, the Pearl River Delta economic take-off, depend on the countless migrant workers around the clock to pay for cheap labor that they be regarded as the longest working hours in this society, physical strength, one of the most tired of the crowd. Factory orders for sufficient time, migrant workers are of course even the rest of the time small, but compared to their less leisure activities.
"Work only entertainment is to see TV or playing cards." Evening, several migrant workers happily Wai, in a small store outside to see the replay of the Cantonese films. Villages stores are equipped with small television shop more than it is to attract migrant workers near the industrial Yunong the most effective way.
"If the factory orders hit enough of it dull." Ishii warehouse workers in the Wei Ge has a son and a daughter, a few years ago, the husband and wife working in Guangdong, act in unison, though hard, finally able to comfort each other. The child was born, his wife to stay in my hometown in Henan. Wei Ge alone in Guangzhou, began to feel depressed, tired of living not only uninteresting, and even the basic physiological needs have also been suppressed.
Tired of work, cultural and recreational life of poor, long-term partner with the permanence of the separation factors for many migrant workers tend to primitive instincts - to ease the release of physical and psychological double depression.
2007 National "two sessions", the NPC and De-Ming Huang vigorously advocated on behalf of migrant workers where the unit should provide low-cost or free of the "couples room"; countries have adopted the relevant legislation requiring labor units for migrant workers off home leave, to visit relatives or family members to provide low-cost rental housing, and create conditions for husband and wife together.
But these are not very appreciative Wei Ge. "Even if the offer couples room, his wife's round-trip travel expenses Is not money." Wages were low and under immense pressure, he would prefer to find a nearby temporary "girlfriend", or else to find Miss, "mainly cheap, ten to twenty yuan to solve problems. "
Clearly, migrant workers groups, gender relations are rapidly evolving to the diversification and temporary. Related to the floating population survey shows that male migrant workers in favor of the commercial sex ratio was 32.8%, females 21.3%; male sexual behavior in favor of the temporary rate of 45.5%, females 33.1%. While migrant workers were married, 41.84% desire extramarital sexual life, of which 24.53% have been put into action, extramarital sex objects are lovers, colleagues and "Miss", which Youyi lover for most, accounting for 67.05% .
STD cloud
If the injection is still the main way of HIV transmission when the mandate for a further prevention and treatment difficult, at least point to a range of groups, as well as effective blocking measures; then "The Merry guilty" of sexually transmitted era, almost no complete solution approach.
Hong Kong films "Super School Overlord", the right from the next Andy Lau Shu-Jen Chiou said, "In our 50 years later, the world, sex life is an offense, because when AIDS has reached the extent of out of control, the Government has only ordered abstinence, until all people with AIDS until they disappear. "
"Abstinence is of course impossible, the only way to be increases in condom usage." Lin Peng said. However, sexual relations are becoming more open and diverse group of migrant workers and their low-priced most often patronize sex workers, precisely the very low condom usage groups.
English sub-long-term use of contraceptives, however, to avoid birth control pills got pregnant, but inescapable strange, sexually transmitted diseases.
It is understood that sex workers in Guangzhou, hair salons, they have had sexually transmitted diseases accounted for 66.02%, like the United Kingdom will continue after the child developed symptoms such commercial sex accounted for 59.92%.
Sichuan Provincial Institute of Dermatology sexually transmitted disease experts, national experts, 10000 chopim intervention in high-risk groups, said: "those who are infected with sexually transmitted diseases, was the risk of HIV infection will increase 5 to 10 times more."
"At present, China has gradually found that low prices of AIDS infection in clandestine prostitution. In various different areas of infection, the highest places, even as high as 10%, a lot is about 5%, far higher than 0.1% of all sex workers infected with rate. "This is what a terrible figure.
The monitoring results in the health sector, the current domestic high risk of sexual transmission of AIDS, it is migrant workers, retired elderly people, commercial sex workers and other low-price transaction crowd Among them, the number of large and highly mobile groups of migrant workers is especially so grave concern.
Mobile virus
In Dongguan City, CDC, the reporter met the inspection report of the construction workers to come and collect Li Ping, he received the results were positive.
"I did not find a 'lady' ... ... There was a girlfriend in the bath city work ... ..." This 30-year-old youth down the thin voice, hesitant to say, and accelerate the pace went to the station. Go some way to see the litter bins, hesitated for a moment if inspection reports and crumpled pieces thrown into it.
"Why throw away the report, non-therapeutic counseling and Retention in the future?" A reporter asked. Li Ping, blushing, replied: "can not stay, go back to being seen on the bad things, and we should be dismissed. The construction team have my fellow is probably a native would know." He told reporters at the CDC for check-ups, the remaining is not their real names.
When asked if this will affect his future health sector, as well as periodic follow-up inspection, Li repeatedly waved nervously: "Can not follow-up. I asked a doctor, he said that it have an incubation period, is it not the disease, may not treatment." He would not say much with journalists rushing back to the site on the shuttle.
And those who are selling blood, drugs to patients infected with HIV compared to HIV-infected by sexually transmitted infection is more sensitive. NGO organizations and hospitals through multiple efforts, no one infected person and patients are willing to openly share their stories. From a rural society to come out especially for migrant workers, even though they conduct open, but in deep thinking, still feel outside 乱搞男女关系 drawn from the "disease" is a shady scandal. Coupled with fear of social discrimination, if not to the onset of the moment, the vast majority of those infected have chosen to hide their own when it detects real name and contact information. The health sector is difficult for them to track and follow-up.
"In particular, site construction workers, and their prostitutes higher rate than factory workers, mobility is also larger, many of them are finished a project and left." Lin Peng said.
There is no way to follow-up, would be difficult to remind them of regular inspections. Guangzhou 8th People's Hospital Hehao Lan, deputy chief physician, said: "The state provides that when HIV-infected CD4 targets as low as 200 persons in the following, you can enjoy free treatment, then the majority of people have not the disease, being able to better control the disease. But the reality is that many infected people have not received due to periodic inspection, until the disease began treatment, when CD4 has been as low as 100 or even 50 below, entered the last stages of AIDS, treatment is very great difficulty. "
On the other hand, infected people did not accept the follow-up and behavior intervention with the national movement of the virus, neither know how to protect themselves, and do not know to protect others, or easily become AIDS transmission from urban to rural bridges, or to the virus from the proliferation of high-risk groups to the general population. This result is disastrous.
"Miss" in embarrassment
To contain the spread of sexually transmitted these years, 10000 chopim led intervention in persons at high risk of his non-stop running around the country, in the nightclub called "Miss" to talk about condom use, and even teach them how to network with their customers on security measures that "bargain."
But the biggest underlying risk sex workers, the health sector remains frustrated. Their high mobility, concealment, dispersion, so that the involvement of governmental experts almost impossible task. "In this case, the volunteers of intervention would be much more effective." In the YWCA, Li-containing and other volunteers felt a great responsibility.
Indeed, the identity of volunteers also helped volunteers very busy SU Xiao-huan.
The first stepped into the small salon, she knew that they were unwanted, and only then AIDS prevention leaflets out, "Miss" had hastened to plug back to her and said, "We do not do that, and do not need to." He then went to the number of times more, "Miss" They know that she did not come to an anti-vice, and the attitude was friendly and up.
SU Xiao-huan Every time I go hair salon and rented rooms will bring some small gifts, lipstick, stockings and so on, she caught condoms secretly together in leaflets and other gifts sent. "Start very worried that they will resist." But unexpectedly, the "Miss" had the decency to pick the condom out, happily said, "This gift is best."
Once outreach, SU Xiao-huan brought 100 condoms, less than 3 minutes robbed bare. "This is a good sign that they have received the relevant knowledge, the more willing to use a condom." SU Xiao-huan said happily.
Eiko expressed his agreement: "We also care for their body ah!" Last year, she has met the volunteers to do outreach, one began to see AIDS pamphlets, and she felt humiliated and angry face to the front of the volunteers throwing out. However, after the volunteers left, they could not help but saved his view. "Now I know a lot, always with a condom." She opened the bag of the hasp to reporters, "The problem is that many times customers do not want to use, if they insist, I can only promise." Eiko says with resignation .
2008 9 ~ 12 months, a total of YWCA's volunteer team continued to interfere with hair salon and street sex workers, more than 300 passengers, the CDC is expected to exceed 10 times; in September 2009, they have launched a second phase of intervention to interfere with views close to 300. Such results for Li-containing and volunteers are very excited.
However, the 10000 chopim, but not very optimistic. "The more low-end sex trade, the 'miss' the more vulnerable, passive position, their demands for men can not resist. We have conducted a survey to interfere with low-end sex workers, condom use can only be based on the original 30% further increased by 15% to about 45%, followed by hard to improve. But experience shows that condom use must meet more than 80% of AIDS can play a better blocking effect. "
Therefore, to improve the underlying protection of sex workers sense of course, has important social significance, but only from AIDS prevention and control run, it is not enough.
Policy changes
"Later we changed strategy, try the main body of prostitution - men begin to intervene." 10000 chopim said. Recently, he tried a variety of places in contact with these men, in the construction sites, technical schools and other places to do health talks, introducing the risk of sexual transmission of AIDS, teach them to prevent.
"From the intervention effect, men accept the intervention, enhancement of the rate of condom use should be much faster, because they are sexual relationships where condom use active side, in the autonomous behavior is no objective obstacles." The idea of promoting open, after the arrival AIDS Care in Guangdong this year, organizations have also begun to right of migrant workers to intervene. They in Zhongshan, Dongguan and other cities focused on migrant workers to take action. But the resistance just as great.
"In the beginning, want to enter the factory the workers together in carrying out advocacy interventions, but not a business owner agreed." AIDS Care China told the reporter. Later, social workers had set up tables and chairs placed along the roads and promotional materials, along Lan Zhao of migrant workers to intervene in 3322. This efficiency is not high, and sometimes down most of the day how many people are not interfere.
In men's interventions, 10000 chopim also found another problem: "a good short-term effects of intervention, but without sustained intervention, such intervention to stop after six months, condom use will decrease. This shows that behavioral intervention is a key long-term, professional work and outreach is not only a simple knowledge. "
In clinical experience, the He Haolan found that, after all these years of AIDS knowledge and popularity of high-risk sexual behavior took place not necessarily of their ignorant, on the contrary some people are understanding of AIDS has taken the initiative to hospital for treatment behavior.
One middle-aged man to open several times each year to come He Haolan checklist. "To a time when fear was not, but a few months later, there was another high-risk behavior, check again." He Haolan questioned him, knows the terrible AIDS, why not stop high-risk behavior? Men just smile apologetically, "one to that scenario, they could not bear." He Haolan this boils down to a prevailing left to chance.
Risk of sexual transmission of HIV statistics, HIV-positive AIDS and sexually transmitted infection probability is 2 ‰. "This result is easy to be taken lightly, so I often have to correct their ways of thinking: For each individual run, each time the possibility of only two high-risk behavior, infection, or not infected. This is a 50% chance. There is a a greater misunderstanding is that many people are always subconsciously think that people who suffer from AIDS Galium aparine certainly look sick. "
Total sexual transmitted infections regretted having done that, "he looks glowing, lively as ever, how to want him with the deadly virus?" The survey shows that in the commercial sex, do not use condoms because, unless they are "guests are not willing ", the" guest appearance without exception "consideration also accounted for a considerable proportion. But in fact, in the AIDS incubation period of 5 to 8 years, the incidence of infection did not looked like a normal person. While it is unwilling to accept, the crisis often do, on a beautiful love hidden in the back.
Recently, He Haolan most worried about is that clinical is constantly increasing the proportion of female patients. 2000 years ago, the Eighth People's Hospital, 12 AIDS room, female wards only 1 ~ 2, and now, female wards has been increased to four.
Increase in the number of infected women is definitely a more dangerous signal. "From a global view, if the proportion of HIV infected men and women to achieve a 1:1, they reach the sexual transmission of the late, meaning that AIDS has spread to ordinary families, when even the use of interventions is also hard to control." Wan said chopim , "China's current ratio is 4:1, we still have a long way."
Undoubtedly, the face of century, a fatal disease, we are facing a long and difficult battle.
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