中国性病艾滋病预防控制中心:性传播成为主要渠道
2011年12月08日 02:11来源:时代周报 本报记者 韩玮 实习生 徐向科 发自上海
吴尊友中国疾控中心性病艾滋病预防控制中心主任
时代周报:近年来,我国的艾滋病疫情呈现了新的发展趋势?
吴尊友:就全球来看,艾滋病发展的特征是先集中于高危人群,再向社会蔓延,以异性传播为主流方式。比如,泰国于1984年报告首例艾滋病,1988年开始在吸毒人群暴发流行,而1989—1990年间即转变为异性传播。
相较而言,我国疫情变化更慢。1985年报告首例艾滋病后,1989年在中缅边界的云南瑞丽发现了首例吸毒感染者。直到1995年,艾滋病才逐渐传出云南省,从吸毒人群向外扩散,2007年,性途径的感染者数量开始超过吸毒。换言之,经过8年的蔓延后,HIV病毒逐渐从吸毒人群向性途径扩散。
目前,我国性传播的比例逐渐增大。以北京为例,今年1-10月份,新报告的感染者中,异性传播占62%,同性传播占13%。而2011年,据我们推算,全国新发艾滋感染者预计4.8万,其中性传播的比例更高,为82%。
时代周报:HIV病毒如何会进入我国的男同群体?
吴尊友:中国的艾滋病疫情主要有两个源头,1989年,吸毒者携带的病毒从中缅边界,沿着贩毒的通道,向内地蔓延,传染给其他省份的吸毒者、卖血者,再传染给异性。另一条主线则是同性恋群体。
目前,男同是艾滋病感染最严重、感染率上升最快的群体,其中,年轻人的比例在增加,包括大学生。而不少西南地区,每年的新发感染率在15%以上,甚至超过20%,内地一般大城市也达到5%-10%,而全国的平均值为5%左右。
时代周报:除了男男性行为者,从人群分布来看,老年男性也逐渐成为高危人群?
吴尊友:2005年,全国60岁以上的老人,HIV呈阳性者不到483例,2010年,升至3031例,增加了5倍多。而老年艾滋病病人,2005年为237人,2010年增加到2546人,增幅近10倍。
对于这种现象,原因可能在于,随着生活水平的提高,老年人的健康状况逐渐改善,目前,60岁老人的身体状况与30年前相比可能相当于45—50岁,他们有这个需求,同时,退休之后,空余时间较多,而且,他们的经济实力也不错,这三方面的因素会促使其寻求刺激。
时代周报:针对我国的艾滋病疫情,中央和地方政府已采取哪些应对措施?整个防控体系的薄弱之处是什么?
吴尊友:我国在政治上作出了明确表示:控制艾滋病疫情,保证人们的健康。其次,该出台的政策目前都有了,尤其是针对吸毒人群、性传播途径等措施。再次,防艾资金的投入逐年增加,不但可以保障防艾措施落实,也可以满足艾滋病患者治疗的需求。
目前,我们只发现了一部分艾滋病患,还有56%的感染者未被发现,他们可能在没有意识的情况下传播病毒。
时代周报:对于艾滋病在中国蔓延的新趋势,您认为应采取哪些新的防控措施?
吴尊友:特别需要强调的还是宣传,让更多的人了解艾滋病的变化、传播特征,等等,同时,还要强调忠贞的爱情,忠贞的性关系。不要说我老生常谈,如今,大家似乎都不屑提这些,但这确是阻挡艾滋病流行的一道长城。
宣传过程中,我们不仅要讲艾滋病的知识,更要讲一个人的家庭责任感、社会责任感,同时,塑造良好的社会氛围,让人们把尊重婚姻、尊重性爱当成一种道德标准。
除了宣传,还要扩大检测,让检测服务更方便合宜,打消人们的疑虑,保障人们的隐私。这样,我们才可能发现更多的感染者,只有发现他们,才能抑制艾滋病的传播,减少艾滋病患者的死亡。发现感染者是防治工作的第一步,发现了,管理了,对他们进行治疗了,那么,他们作为传染源的作用就会减小了,疾病进展也会延缓,“零战略”才能实现。
此外,面对新问题,我们必须更新知识,调整思维方式,培训整个防治队伍,使之适应变化的形势,更好地推进工作。






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图示∶2011年5月正式出版的《中国特色医疗金鉴》登载的刘君主任及其机构事迹 |
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艾滋病新鸡尾酒疗法 附 HIV感染者,早吃药早受益
Chinese STD and AIDS Prevention and Control Center: to become the main channel of communication
At 02:11 on December 8th 2011 Source: Korea Times Weekly newspaper reporter intern XU Xiang Wei from Shanghai Branch
Wu Zunyou of STD and AIDS Control and Prevention, China CDC director
Die Zeit: In recent years, China's AIDS epidemic presents a new trend?
Wu Zunyou: a global context, characterized by the development of AIDS to focus on high-risk groups, further community spread, with heterosexual transmission as a mainstream way. For example, Thailand's first case of AIDS reported in 1984, 1988 outbreak among drug users, and 1989-1990 that into heterosexual transmission.
In comparison, China's epidemic situation changes more slowly. Report the first case of AIDS in 1985, the China-Burma border in 1989, discovered the first case of Ruili, Yunnan drug users infected. Until 1995, gradually spread AIDS in Yunnan Province, spread out from the drug users in 2007, the number of channels of infection begins to exceed the drug. In other words, after eight years after the spread of, HIV virus, and gradually spread from drug users in sexual ways.
At present, the proportion of sexual transmission increases. Beijing, for example, 1-10 months of this year, a new report of infection, heterosexual transmission accounted for 62%, homosexual transmission 13%. In 2011, according to our projections, new HIV infections nationwide is expected to 48,000, of which a higher proportion of sexual transmission, 82%.
Die Zeit: HIV virus to enter China's men will be the same group?
Wu Zunyou: China's AIDS epidemic has two main sources, in 1989, drug carrying virus from the China-Burma border, drug trafficking along the channel, spread to the mainland, the drug spread to other provinces, paid donors, and then transmitted to the opposite sex. Another theme is the gay community.
Currently, men with HIV infection is the most serious, the fastest growing group of infection, which increased the proportion of young people, including college students. And many Southwest, annual new infection rate of 15% or more, even more than 20%, the Mainland cities are generally 5% -10%, while the national average of about 5%.
Die Zeit: In addition to MSM, distribution from the crowd, older men has become a high-risk groups?
Wu Zunyou: 2005, 60 years of age or older, HIV-positive were less than 483 cases in 2010, rose to 3031 cases, an increase of 5 times. The elderly AIDS patients, 237 in 2005, 2010 to 2546, an increase of nearly 10 times.
For this phenomenon, the reasons may be that, as living standards improve, the elderly's health gradually improved, the current 60-year-old's physical condition may be compared with the equivalent of 30 years ago, 45-50 years old, they have this requirement at the same time, after retirement, more free time, and that their economic strength is good, these three factors will lead to its thrills.
Die Zeit: for China's AIDS epidemic, the central and local governments have taken counter measures? The prevention and control system weaknesses that?
Wu Zunyou: China has made it clear that political: control the AIDS epidemic, to ensure people's health. Secondly, the introduction of the policy is there, especially for drug users, sexual transmission and other measures. Again, AIDS prevention funding and increases every year, not only to protect AIDS prevention measures in place, but also to meet the needs of AIDS patients.
Currently, we only found a part of the AIDS patients, and 56% of those infected undetected, they may be the case in the absence of awareness spread of the virus.
Die Zeit: the spread of HIV in China for a new trend, what do you think should be taken to the new control measures?
Wu Zunyou: What must be emphasized, or publicity, to let more people know about AIDS and changes in propagation characteristics, etc., while also stressed the loyalty of love, loyal relationship. Do not say that I talked about, now, everybody seems to have bothered to mention this, but it is really a great wall blocking the AIDS epidemic.
Sensitization process, we not only talk about AIDS knowledge, but talk about a person's sense of family responsibility, social responsibility, at the same time, create a good social atmosphere for people to respect marriage, respect for sex as a moral standard.
In addition to publicity, but also to expand the testing, so testing services more convenient and suitable, to dispel people's doubts, to protect people's privacy. In this way, we may find more of those infected, only to find them, in order to curb the spread of AIDS, reducing AIDS deaths. Infection prevention and control of discovery is the first step, find, manage, and treat them, then they, as the role of source of infection is reduced, the disease will slow down progress, "zero strategy" can be achieved.
In addition, the face of new problems, we need to update their knowledge, adjust the way of thinking, the prevention and control team training to adapt to changing circumstances, to better promote the work.
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