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中国民主促进会中央委员会关于加强我国民族地区艾滋病防治工作的提案
2011年03月04日16:28 来源：人民网
自2003年我国实施“四免一关怀”艾滋病防治政策以来，防治艾滋病各项措施得到较好地落实，更多的感染者被诊断，更多的病人得到治疗，防治工作取得很大进展，并得到国际社会广泛赞誉和国内人民群众的充分肯定。然而，我国艾滋病防治工作仍然任重道远，面临严峻形势，特别是少数民族地区形势更加严峻。
在全国31个省、自治区、直辖市中，报告艾滋病感染者和病人数排名前五位的云南、广西、河南、四川、新疆占全国报告总数的 69.7%。除河南省由于上世纪90年代中期采浆污染事故造成艾滋病大范围流行外，其余四省、自治区都是由吸毒引发艾滋病疫情，通过性途径蔓延扩散，而且，主要受害人群集中在少数民族地区、集中在少数民族人群。在新疆，维族艾滋病感染者和病人数占全疆总报告数的80%；在四川，彝族艾滋病感染者和病人数占全省报告总数约60%，而凉山州布拖县，彝族一般人群的艾滋病感染率超过6%，成为非洲以外在一般人群中发现感染率最高的地区。
由于种种原因，在民族地区、民族人群中开展艾滋病防治工作，难度很大，疫情仍在继续蔓延扩散。如新疆和田地区维吾尔族占96.3％，报告艾滋病感染人数在过去几年持续上升，从2005年前每年新报告感染者不足20人，上升到2008-2009年每年新170-175例。如果不尽快采取强有力措施遏制民族地区艾滋病疫情蔓延，过去几十年民族团结和发展的成果，可能会因为艾滋病的流行而被吞噬。
艾滋病高比例地影响着少数民族同胞，有几方面原因。一是毒品危害。受艾滋病影响最重的几个少数民族地区，不仅是艾滋病的重灾区，也是毒品危害的重灾区。这些地区的艾滋病流行主要是由吸毒人群引入，然后再由吸毒人群向其他人群传播，在当地造成更大范围扩散。如云南省德宏州，总人口约110万，1989年仅仅报告了146例吸毒者感染艾滋病，20年后，德宏州约有2万多人感染艾滋病，涉及到工人、农民、干部、战士、教师、医生、警察等各行各业。早期疫情出现后，控制不力，也是造成疫情蔓延的重要要原因。
二是少数民族地区的社会风俗和民族文化，在某种程度上不利于控制艾滋病疫情。一方面，受“共享文化”的影响，少数民族吸毒者在一起吸毒时更倾向于共用注射器吸毒，这加速了艾滋病在吸毒人群中的传播。另一方面，崇尚“自然”的思维方式，使一些少数民族在婚姻和性行为方面没有足够的约束，在一定程度上促进了艾滋病的传播。如在云南、广西、新疆等地，性传播已经占到当地新报告艾滋病感染者的60%以上。
三是少数民族地区相对经济落后、防疫人才缺乏，难以应对突如其来的艾滋病疫情，即使是经济、有效的防治措施，可能因为经费问题，难以落到实处。例如，针对吸毒人群艾滋病流行，国家在全国范围内实施了吸毒成瘾者美沙酮维持治疗工作，这不仅有效地控制了吸毒人群的艾滋病传播流行，而且还减少了吸毒现象、减少了吸毒引发的相关犯罪，同时还改进了社会治安，促进了家庭和社会和谐。吸毒成瘾者每天参加美沙酮维持治疗收取5-10元不等的治疗费用，虽然比吸毒每天花费几百元甚至上千元要便宜得很多，但对新疆、广西、四川等边疆少数地区的吸毒者来说，特别是对于那些没有收入来源的吸毒者来说，也是一笔不小的开支，很多人因为交不起治疗费而脱失。初步统计，全国约有1万多名吸毒的艾滋病感染者因交不起美沙酮治疗费，而从美沙酮治疗门诊脱失。这些人流入社会后，失去管制，不仅继续吸毒，危害社会，而且还将把艾滋病向当地更广大的人群传播扩散。
为此，提出如下建议：
一、中央政府要把民族地区的艾滋病防治作为全国艾滋病防治重点工作给予特殊支持；地方各级政府，特别是多民族的省、自治区，要把民族地区少数民族的艾滋病防治工作作为民族地区发展的重要组成给予高度重视，要下决心，狠抓少数民族的艾滋病防治工作。艾滋病防治工作要同扶贫、禁毒和社会经济综合发展结合起来。
二、要加大民族卫生干部培养，采用短期集训方式，在短时间内培养一批少数民族艾滋病专业技术人员，从事艾滋病防治工作；从长远出发，把培养少数民族艾滋病防治专业技术人员作为艾滋病防治长期战略措施；
三、对一些特殊群体的有效防治措施落实，可采取国家和省（区）财政支持的方式，最大限度地管理传染源，控制疫情扩散。如，为所有感染艾滋病的吸毒者提供免费的美沙酮维持治疗。把这些人控制在美沙酮门诊，就能够很好地防止他们在社会上进一步传播艾滋病疫情。还可在少数民族地区加大推行避孕套力度，经验证明，此举可使艾滋病大大下降。
四、组织、动员民族群众，积极参与到艾滋病防治斗争中来。在社区和学校开展大众健康教育，以本土化的“同伴教育”模式，提高少数民族群众对艾滋病的认知水平。发挥社会组织在艾滋病防治和关怀中的作用，有效遏止艾滋病在民族地区的扩散趋势。
艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复
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| 图示∶2010年12月即将出版的《中国特色医疗金鉴》登载的刘君主任及其机构 |
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Association for Promoting Democracy Central Committee on strengthening our national AIDS prevention and treatment of the proposal area
At 16:28 on March 4, 2011 Source: People's Network
Since 2003, China implemented the "Four Frees and One Care" AIDS policy, AIDS prevention and control measures to be implemented better, more infections were diagnosed more patients to receive treatment, prevention and control has made great progress and widely praised by the international community and domestic full recognition of the people. However, China's AIDS prevention work is still long way to go, facing a serious situation, especially the ethnic minority areas even more severe.
In the 31 provinces, autonomous regions and municipalities, the report the number of AIDS patients and the top five in Yunnan, Guangxi, Henan, Sichuan, Xinjiang accounts for 69.7% of the total reported. In addition to Henan Province, the mid-90s as the last century, mining slurry pollution incident caused by AIDS pandemic, the other four provinces, autonomous regions and are caused by the drug epidemic, spreading through sexual transmission, and the main victims of cluster in ethnic minority areas, concentrated in minority populations. In Xinjiang, Uighur patients with AIDS and Xinjiang accounted for 80% of the total number of reports; in Sichuan, Yi AIDS and report the total number of patients account for about 60% of the province, while Butuo County of Liangshan Prefecture, Yi general population more than 6% AIDS infection rate, as in the general population outside of Africa region with the highest infection rate found.
For various reasons, in the minority areas, ethnic groups to carry out AIDS prevention work is very difficult, the spread of the epidemic continues to spread. Hotan, Xinjiang Uygur, such as 96.3%, the number of reported HIV infections continue to rise over the past few years, a new report from the year 2005 less than 20 people infected, up to 170-175 cases each year 2008-2009. As soon as possible if you do not take strong measures to curb the spread of AIDS epidemic in minority areas, over the past few decades the results of national unity and development, because of the AIDS epidemic may be swallowed.
AIDS affects a high proportion of ethnic minority compatriots, there are several reasons. First, drug hazards. Most affected by AIDS in several of the ethnic minority areas, not only the hardest hit by AIDS, but also hardest hit by the harm of drugs. AIDS epidemic in these areas mainly by the introduction of drug users, and then the rest of the population by the spread of drug users, resulting in a greater range of local spread. Such as Dehong Prefecture in Yunnan Province, with a total population of about 110 million, in 1989 only 146 cases reported in drug addicts infected with HIV, 20 years later, about 20,000 people in Dehong HIV infection, involving workers, peasants, cadres, soldiers , teachers, doctors, police and other industries. The emergence of the early epidemic, inadequate control, also contributed to an important reason for the spread of the epidemic.
Second, the social customs of ethnic minority areas and national culture in a way not conducive to controlling the AIDS epidemic. On the one hand, by the "shared culture", minorities are more likely when drug addicts with drug users sharing syringes, which accelerated in HIV transmission among drug users. On the other hand, advocating "natural" way of thinking, so that some ethnic minorities in marriage and sexual behavior do not have enough constraints, to a certain extent, promoted the spread of AIDS. Such as Yunnan, Guangxi, Xinjiang and other places, sexual transmission has accounted for the local new reports of AIDS more than 60%.
Third, relatively economically backward minority areas, vaccination shortage of talent is difficult to cope with the sudden outbreak of AIDS, even though the economic and effective control measures, probably because of financial problems, difficult to implement. For example, for the AIDS epidemic among drug users, the state implemented a nationwide drug addicts, methadone maintenance treatment, which not only effectively controlled the epidemic spread of AIDS among drug users, but also reduce drug use, drug-induced reduction of the related crime, while also improving the social order, promoting the family and social harmony. Drug addicts, methadone maintenance treatment every 5-10 per month to receive the cost of treatment, although the ratio of drug to spend several hundred dollars a day or even a thousand dollars cheaper a lot, but in Xinjiang, Guangxi, Sichuan and other border a few areas The drug addicts, especially those drug addicts, no source of income, but also cost a small fortune, many people can not afford the treatment costs and loss. Preliminary statistics, about 10,000 more than the national AIDS drugs because they can not afford the methadone treatment, outpatient methadone treatment from the loss. These people into society, the loss of control, not only continued drug use, harm to society, but also to AIDS to the local spread of the wider spread of people.
To this end, the following recommendations:
The central government put AIDS prevention and minority areas as a national AIDS prevention and control priorities to give special support; local levels of government, especially the multi-ethnic provinces, autonomous regions, ethnic minority areas should work for AIDS prevention as a national regional development Important to give high priority to be determined, pay close attention to minority AIDS. With AIDS to poverty, drug and integrated social and economic development together.
Second, to increase the national health cadre training, the use of short-term training means training in a short time a group of professional and technical personnel Minority AIDS, engage in AIDS prevention and control; from the long-term perspective, to train minority AIDS prevention and treatment professionals, as AIDS Long-term strategic measures;
Third, for some special groups to implement effective control measures can be taken to the national and provincial (regional) financial support the way possible to manage the source of infection, control of spread of the epidemic. If, for all HIV-infected drug users with free methadone maintenance treatment. These people control the methadone clinic, we can very well prevent their further spread of the AIDS epidemic in society. Increase in ethnic minority areas also introduced intensity condoms, experience shows that this can significantly decrease HIV.
Fourth, organization, mobilization of national people to actively participate in the fight against AIDS in the past. In communities and schools to carry out public health education to localization of the "peer education"model minority people to improve the level of AIDS awareness. Society organizations to play in AIDS prevention and care in the role and effectively curb the spread of AIDS trends in minority areas.
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