National Problems

 性传播疾病的预防:行为的改变   STD Prevention: Behavior Change

 安全性行为-推行安全性行为所面临的问题

文化方面的问题-国家方面的问题
意欲控制AIDS的流行,首要的职责通常在于各个国家的政府。下面两个案例可能具有指导意义:不久前,HIV/AIDS的感染率在乌干达和泰国是世界上最高的。可是,采取了适当的国家宣传运动却能够使感染率降了下去。

乌干达 以简单的“ABC”口号一直致力于预防AIDS的国家项目:

节欲(Abstinence)
忠诚
(Being faithful)
或如果前两者都未采用,则使用安全套(Condom use)。

因为HIV感染率有了显著的下降,这个项目已经取得了重大的成就。人们一直在观察这种趋势是否能够持续下来,这三个要素中每一个对这个成就贡献有多大。在乌干达,只要足够多的人群坚持A(节欲)B(忠诚),而有高危行为者坚持采取C(使用安全套),这个项目可能确实要坚持推行下去。

与之大不相同的是,泰国已经成功地开辟了另一路。在认识到大多数HIV感染能够追溯到商业性性接触后,这个国家启动了大众宣传运动,在大的性产业经营场所强行推广安全套:

“100%使用安全套项目”

该项目的目标是在商业的性工作者中间推广使用安全套。如果顾客拒绝合作,他就得不到服务。那些没有强制遵守这一规则的妓院被关闭了。另外,政府分发大量的免费安全套。其结果是,在性工作者中的性传播疾病感染率戏剧般地下降,现在有更多的男性使用了安全套,而HIV/AIDS已经令人注目地下降了。
上述两个不同的预防路径并不必定会在其他国家获得成功,但是却教给了我们相同的经验:
任何地方实施行为改变项目之前,研究研究当地的文化以及筹划出适合那里的战略是必要的。这个项目然后在那个特定的地点要简单地运用“万事皆有果”定律做出检验 ,因为最终只能拿结果来衡量所付出的艰辛和所投入的费用。

 Safer Sex - Problems of Safer Sex Promotion

Cultural Problems - National Problems
The first responsibility for controlling epidemics usually lies with the respective national governments. The two following examples may be instructive: Not long ago, the HIV/AIDS infection rates in Uganda and Thailand were among the highest in the world. However, appropriate national campaigns were able to bring them down.

Uganda has been using a prevention program under the simple slogan “ABC”:

Abstinence, Being faithful, or, if the first two are not practiced, Condom use.

This program has had measurable success as the incidence of HIV infections has clearly decreased. It remains to be seen if the trend continues and how much each of the three elements contributes to the success. As long as a sufficiently large majority sticks to A and B while those at high risk adopt C, the program may indeed keep working in Uganda.

In contrast, Thailand has successfully taken another route. Realizing that most of its HIV infections could be traced to commercial sex contacts, the country started a massive campaign enforcing the use of condoms in its large sex industry:

"The 100% Condom Program"

The goal was to make condom use universal among commercial sex workers. If a client refused to cooperate, he was not to be serviced. Brothels that did not enforce this rule were closed. In addition, the government distributed large quantities of free condoms. As a result, the STD infection rate among sex worlers decreased dramatically, more men than ever now use condoms, and the spread of HIV/AIDS has significantly slowed down.
These two different approaches are not necessarily successful in other countries, but they teach the same lesson:
Before any program of behavior change is launched anywhere, it is necessary to study the local culture and to devise a strategy appropriate to it. The program will then simply use “anything that gets results” in that particular locality because, in the end, only the results justify the effort and expense.

 

[Course 4] [Description] [How to use it] [Introduction] [Curable STDs] [Incurable STDs] [STD Prevention] [Abstinence] [Safer Sex] [Additional Reading] [Examination]