编者的话

据2005年最新评估显示,目前,中国现有艾滋病病毒感染者和病人约65万人,其中艾滋病病人约7.5万人。2005年新发生的艾滋病病毒感染约7万人,因艾滋病死亡约2.5万人。尽管2005年评估的存活艾滋病病毒感染者和病人数低于2003年的估计数,根据最新的评估结果,中国的艾滋病疫情仍呈上升趋势;新发生的感染以注射吸毒和性传播为主;发病和死亡依然严重;疫情由高危人群向一般人群扩散;存在疫情进一步蔓延的危险。近年来,中国政府加大了对艾滋病防治工作的领导,针对艾滋病防治工作的各个关键环节,采取了切实有效的应对措施,开展了大量的综合预防、治疗、…     

中国艾滋病社会预防模式研究（Ⅻ）

第三阶段／目前：中期模式与综合防治示范区模式的结合 SARS以后，中国政府应对艾滋病的重视程度明显提高，社会预防政策发生了标志性的转折。2003年10月，政府启动了“艾滋病综合防治示范区”工程，卫生部首批54个示范区，覆盖11个重点省份，同时提出了“四免一关怀”政策，即：国家实施艾滋病自愿免费血液初筛检测；对农民和城镇经济困难人群中的艾滋病病毒感染者／艾滋病病人实行争营抗病春治疗：     

我的思考

我国艾滋病预防存在的主要问题 上海社科院HIV/AIDS社会政策研究中心夏国美研究员等中外学者通过大量田野调查，对于我国的艾滋病防治工作存在的问题进行了深刻剖析，认为我国防治艾滋病不力的主要原因是：自一开始就将艾滋病与意识形态、道德作风等联系起来，致使决策者、执行者和公众都对艾滋病持敌视、恐惧心态，并影响到各自的社会活动之中，给当前的艾滋病有效防治带来许多思想上、制度上和行动上的障碍。“四免一关怀”政策是个进步，但由于前述原因在社会各方面、各层次造成的深刻影响，使得政府的政策在现实中常常找不到落实的对象。     

吸毒、贩毒对人口发展的影响

８０年代以来,吸毒、贩毒现象在我国沉渣再起并迅速蔓延,给人们的身心健康和社会带来了极大危害,造成了极为严重的社会问题。本文从人口学角度出发,揭示了吸毒、贩毒人口的年龄、性别、文化程度、职业、地域分布等特征,分析了其对人口发展、婚姻家庭和社会经济发展的影响,并进一步提出了防治吸毒、贩毒的人口学对策。     

艾滋病ABC

接上期）共用注射器吸毒是传播艾滋病的重要途径，因此要拒绝毒品，珍爱生命。吸毒是一种违法行为，不仅严重危害自己的健康和生命，也危害家庭和社会。远离毒品可以最大限度地避免因吸毒而感染艾滋病。与他人共用注射器吸毒的人感染艾滋病的危险特别大。与注射毒品的人性...     

中国艾滋病社会预防模式研究（Ⅺ）

将预防艾滋病与禁毒禁娼结合起来，是中国预防与控制艾滋病的政策核心之一。这一决策思想的不恰当性就在于它确定了这样一个前提，即：艾滋病是吸毒、卖淫、嫖娼等丑恶行为的产物。由此，对艾滋病病毒感染者／艾滋病病人的歧视和偏见也就具有了法律和理论的基础。     

为大学生构筑防“艾”堡垒——预防艾滋病校园青春同伴教育

遏制艾滋病,预防是根本,“防艾”教育是关键。大学生作为艾滋病的高发人群之一,对其进行“防艾”健康教育是预防和控制这种严重传染病的主要措施。在众多的健康教育活动中,同伴教育以其独特的优势越来越多地被用于不同人群艾滋病性病预防宣传,其在学校健康教育工作中的影响也越来越重要。同伴教育在提高人们预防艾滋病性病传播知识以及转变态度、行为方面发挥了十分有效的作用。     

基于文化作用机制分析的艾滋病预防控制对策研究——以云南为例

艾滋病的流行与扩散受多种因素的影响与制约,其中文化因素起着潜在的但效应极强的影响作用。通过分析文化与艾滋病流行扩散的相互关系,以及云南艾滋病亚文化的形成和发展,对云南艾滋病流行扩散的文化作用机制进行了分析．提出了基于文化作用机制的云南艾滋病预防控制对策,将文化因素融入到艾滋病的防治中,对于提高艾滋病的防治成效将起到积极的促进作用。     

中国艾滋病社会预防模式研究（Ⅱ）

本项研究的理论预设是：（1）对艾滋病病毒感染者和患者的歧视以及对边缘化人群的否定性裁决（惩处）妨碍了中国艾滋病社会预防模式的有效建构。（2）建立在政府、非营利组织（non—profit organization）、自然－人文－社会科学研究部门互动合作框架中的艾滋病社会预防模式，将有利于国家采用最有效的措施和最合理的社会经济成本控制艾滋病的流行。     

城市居民对农民工随迁子女的接纳状况及影响因素分析

通过对成都、义乌两地抽样问卷调查的资料,分析城市居民对农民工随迁子女的接纳态度及影响因素.结果发现,城市居民对农民工随迁子女的接纳态度处于中等水平,其中对农民工随迁子女的情感接纳程度＞行为接纳程度＞认知接纳程度.不同性别、政治面貌和主观阶层地位的城市居民对农民工随迁子女的接纳存在较大的差异性,而不同年龄、文化程度和收入水平的城市居民对农民工随迁子女的接纳差异性不大.回归模型表明,政治面貌、主观阶层地位、社会关系网络、政策认知认同、对两类子女素质差异的评价以及认知来源是影响城市居民接纳农民工随迁子女的重要因素.     

Impact of Acts of Discrimination on Quality of Life Among Injecting Drug Users in Delhi, India

The study examines the association between quality of life (QOL) and discrimination perpetrated against a vulnerable population like injecting drug users (IDU). Given that QOL affects self efficacy which in turn affects behavior, it is relevant to examine QOL among IDUs in the context of HIV prevention, and to study whether discriminations and human rights abuses impact QOL in this population. A cross sectional study was conducted in two research sites in Delhi, India among 343 IDUs recruited through a respondent driven sampling. A Hindi version of the WHOQOL Bref survey along with a survey questionnaire of discrimination were used to interview participants. After controlling for demographic characteristics, experiencing physical and verbal abuse (OR: 0.46, CI 0.27–0.79),arrests and imprisonment for carrying needles and/or using drugs (OR: 0.53, CI 0.31–0.90) and lacking health information (OR: 0.49, CI 0.29–0.85)was associated with lower social QOL, while being denied health care services was associated with lower psychological QOL. The more discrimination experienced, the lower was the quality of life in the social and psychological domains. Participants’ perceived well being in the four domains was related to their living conditions, discriminatory acts and to perceptions of social support. Discriminatory acts and abuses appeared to have a greater toll on their psychological well being and social relationships, thus indicating the need for human rights advocacy in order to influence law enforcement practices and to reduce stigma, while expanding social support through an extended comprehensive IDU programme.     

A gender comparison of HIV and drug use across the rural-urban continuum

Despite the central role of women drug users in escalating AIDS statistics, there is still a limited number of studies that examine the roles of gender and drug use type in HIV seroprevalence. This lacuna in the research literature has led to significant gaps in researchers' understanding of how and to what extent women may differ in their drug-using and HIV risk behaviors compared to their better-studied male counterparts. This study, derived from a sample of 3,555 out-of-treatment drug users residing in three South Florida urban and rural communities, attempts to compare the drug usage and needle and sexual risk behaviors of male and female drug users that put them at risk for HIV infection. The overall seropositivity rate for women drug users was 26.5% compared to 19.5% for their male counterparts. Results of multivariate analyses indicate that females compared to males were 1.4 times more likely to be HIV seropositive. Risk behaviors associated with this elevated seropositivity include living arrangements, homeless status, drug use, sexual trading behaviors, and history of STDs. Furthermore, there was a strong linear relationship between drug use type and HIV seroprevalence among women drug users. Compared to those who were neither crack smokers nor injectors of illicit drugs, those who were crack smokers only were 2 times more likely to be HIV seropositive, while those who were both crack smokers and injectors were 5 times more likely to be HIV seropositive, and those who were injectors only were 6 times more likely to be HIV seropositive. These findings indicate that among women, drug abuse and its associated risk behaviors, increase the vulnerability of this population for HIV and thus render them an extremely important priority population on which to focus HIV prevention and public health efforts and programs.     

The spread of HIV into the general population of the USA: A simulation

The spread of HIV from injection drug users and male homosexuals into the general US population is simulated, using survey data on sexual behavior. We estimate that approximately 150,000 persons are currently infected with HIV through heterosexual transmission, the majority of whom are female partners of drug-using or bisexual men. The estimated number of AIDS cases generated by the model is close to the CDC statistics for males, but much higher for females. We conclude that prevention efforts should be targeted towards these high risk groups rather than the general population.Abbreviations IDU injection drug users - NORC National Opinion Research Center; Chicago - STD sexually-transmitted disease     

流动人口行为特征及其空间过程与HIV/AIDS扩散

流动人口的行为特征及其空间过程是HIV/AIDS扩散的重要因素之一,其行为特征的高危性和流动性使流动人口成为HIV/AIDS的易感人群,在其流动的空间过程中与不同类型人口的相互接触,当发生与HIV/AIDS人群的高危行为时,一方面容易使自己感染HIV;另一方面,流动人口成为HIV携带者后与其他人发生高危行为则会成为HIV的传染源之一,其结果是导致了HIV/AIDS在感染者数量和感染空间上的扩散。因而,针对流动人口高危行为特征及其空间过程提出防控HIV/AIDS扩散的对策是可行的。     

Gender comparisons of injection drug use practices in shooting galleries

Previous research studies and anecdotal evidence portray shooting galleries as locales that place injection drug users at great risk for HIV infection, drug use and violence. Collectively, these studies highlight the need to intervene with injectors who frequent shooting galleries. However, few researchers have studied an often-forgotten risk group – women injecting drug users who frequent shooting galleries – and compared their risk behaviors to their male counterparts. To address this gap in the research literature and to evaluate the functionality of the shooting gallery as a setting for HIV prevention, we collected data on risk practices from 201 injectors (101 men and 100 women) who were recruited from eight shooting galleries in Miami, Florida. Results indicate that, compared with men, women injectors engaged in a similar variety and frequency of injection risk behaviors and had more shooting companions. While only minor gender differences were apparent, relatively few injectors – male or female – adhered to current recommendations for needle hygiene practices. Needle hygiene practices existed equally among injectors of both sexes, however very few adhered to current recommendations. Furthermore, contrary to common images of shooting galleries, use of other drugs was infrequently reported, episodes of violence or victimization were uncommon, and sexual contact almost never occurred. Operators of shooting galleries, both men and women, indicated their willingness to participate in HIV prevention efforts. Implications of these findings for HIV intervention indicate that (1) there is a great need to intervene with both men and women IDUs who frequent shooting galleries and that (2) shooting galleries can be an optimal setting for HIV prevention.     

The Social Environmental Context of Resilience Among Substance-Using African American/Black Men Who Have Sex With Men

ABSTRACT

Resilience theory has been suggested as a framework for research on HIV prevention among men who have sex with men. Among this population, literature indicates that African American/Black men who have sex with men experience additional health disparities including elevated HIV incidence rates, victimization, and poor physical health. Conceptualizing resilience as a part of one’s social environment, this qualitative study investigates resilience processes and HIV transmission risk among a sample of 21 substance-using African American/Black men who have sex with men. Data from in-depth interviews describe the social environmental context in which resilience is exhibited and document the influence of homophobia, expressions of agency, and access to social, economic, and cultural capital on resilience processes. Central to this are expressions of hidden resilience, in which African American/Black men who have sex with men mitigate risk and experience their lives as subjectively successful, whether or not outsiders see it as such.     

HIV diffusion patterns and mobility: Gender differences among drug users

Researchers have recently expanded the scope of study of transmission patterns of AIDS to incorporate spatial and geographical questions. United States diffusion patterns of this disease appear to indicate that it may emanate from urban area epicenters to areas of low and moderate prevalence. The travel patterns of injecting drug users (IDUs) and the extent to which they engage in high risk drug and sexual activities was examined as an explanation of diffusion of the HIV virus from one community to another. The study population of 49,621 was comprised of subjects recruited from approximately 60 sites nationwide from 1988–1991. While the data are limited in some ways, they partially support a diffusion explanation of HIV transmission for males and females. The analysis demonstrates that low prevalence cities were significantly more likely to have been the destinations of both men and women who engaged in high risk drug and sexual activities. In addition, HIV seropositive drug users who engaged in high risk drug and sexual behaviors in destination cities were more likely than seronegatives to travel to high or low seroprevalence areas than to moderate prevalence areas. The findings suggest a need for effective HIV prevention educational messages about the risks of traveling and participating in high risk activities.     

From "Male Bonding Rituals" to "Suicide Tuesday": A qualitative study of issues faced by gay male ecstasy (MDMA) users

Use of MDMA and other club drugs has increased among gay men, but questions remain concerning the use, context, and popularity of these drugs; and views of their side effects. We interviewed in-depth 12 gay MDMA users in New York. MDMA had specific appeals to gay men, who often described isolation and stigmatization. Users underwent a period of initiation and social networks often became comprised of greater numbers of other users. Club environments fostered drug use and vice versa. Awareness of potential adverse effects varied and was minimized. Appropriate educational and prevention programs are needed to address these issues, and must take into account the specific contexts of these gay men's lives.     

关注一孩政策后续效应：老年人晚年照料意愿及其影响因素分析

伴随着迅速的社会变迁,老年人晚年照料的被期待支持者与实际支持者之间出现了些许矛盾。基于CLASS 的调查数据,对老年人晚年照料负责的主体划分为四类,分别是正式支持、子代支持、非典型自我支持和协同支持。通过交叉分析和逻辑回归发现,虽然独生子女父母和非独生子女父母认为晚年照料由正式支持来负责的比例都不高,但是独生子女父母在该项的责任认定方面明显高于非独生子女父母。相比于非独生子女父母对于子代支持责任的依赖,独生子女父母对于照料责任的认定比较分散,呈现出正式支持、子代支持、非典型自我支持和协同支持平分秋色的特点。个人基本特征、经济状况因素、健康状况因素以及生活态度因素等变量均对老年人晚年照料责任意愿的认定影响显著。     

Introducing the female condom to drug users in Brazil

Brazil is currently the number two country in the world for reported cases of AIDS, and the rate of heterosexually acquired cases is on the rise. Moreover, because of the changing focus of the epidemic, the ratio of male to female cases dropped from 28 : 1 in 1984 to 2.7 : 1 in 1997. While women's risk of infection continues to grow, there is evidence to suggest that traditional approaches to HIV risk reduction have not effectively addressed women's special needs. Within such a setting this study sought to introduce drug-involved women to the female condom – a female-controlled method of protection from HIV. As part of a larger HIV/AIDS intervention study targeting low-income, cocaine users, the primary aim of this initiative was to assess the level of acceptability of this new device among women at high-risk for HIV infection in Rio de Janeiro, Brazil. In conjunction with individual pre-test HIV prevention counseling, clients participated in a detailed education/demonstration session with the female condom. Women were asked to try the female condom with their partners and to report their experiences at two points of contact. Outcome data indicate that a sizable proportion (71.1%) of the sexually active women used the female condom during vaginal sex on one or more occasions. In addition, many women continued to use the female condom as a method of risk reduction over the three-month follow-up period. These data suggest that the female condom can have an important role in HIV prevention efforts in Brazil.