Stigma of AIDS needs to be overcome
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《英国医生杂志》
EDITOR—With reference to the editorial by Ruger, combating HIV-AIDS in industrialising countries requires improving the conditions under which people are free to choose safer life strategies and conditions for themselves and future generations.1
Sexually transmitted infections have always been imbued with stigma because of their association with behaviours considered deviant or immoral.2 Drug use should be treated as a public health issue, not a criminal one. Despite a dearth of research on the topic, it is increasingly acknowledged that effective prevention and treatment strategies require an understanding of cultural frameworks, including stigmatisation.3
Many groups whose behaviour puts them at high risk for contracting HIV infection, such as men who have sex with men, commercial sex workers, and injecting drug users, are stigmatised and abused, and in some cases their behaviour is criminalised.4
Many countries with successful HIV policies and programmes do not implement effective HIV prevention policies and programmes for drug users because of a misperception that these are in conflict with supply control, endangering the lives of millions of drug users, their sex partners, and families.
Harm reduction programmes have been developed most thoroughly in Europe, Australia, and Canada. Such programmes seem to have had an impact in reducing the spread of AIDS and other diseases without raising levels of drug use in the general population.5
Effective prevention efforts will have to both acknowledge and challenge cultural mores, which often prevent frank discussion of issues surrounding sex and drug use, and will need to overcome the stigma that surrounds the disease and encourages its spread.
Ediriweera B R Desapriya, research associate
Department of Paediatrics, University of British Columbia, Centre for Community Child Health Research, 4480 Oak Street, L 408, Vancouver, BC, Canada V6H 3V4 edesap@cw.bc.ca
Competing interests: None declared.
References
Ruger JP. Combating HIV/AIDS in developing countries. BMJ 2004;329- 121-2. (17 July.)
De Bruyn T. HIV related stigma and decriminalization the epidemic continuous. Can HIV AIDS Policy Law Rev 2002;7: 8-14.
Goldin CS. Stigmatization and AIDS: critical issues in public health. Soc Sci Med 1994;39; 1359-66.
Heffernan J. Best practices for preventing AIDS. J Ambulatory Care 2004;27: 190-1.
Fischer B, Haydon E, Rehm J, Krajden M, Reimer J. Injection drug use and the hepatitis C virus: consideration for a target treatment approach—the case study of Canada. J Urban Health 2004;81: 428-47.
Sexually transmitted infections have always been imbued with stigma because of their association with behaviours considered deviant or immoral.2 Drug use should be treated as a public health issue, not a criminal one. Despite a dearth of research on the topic, it is increasingly acknowledged that effective prevention and treatment strategies require an understanding of cultural frameworks, including stigmatisation.3
Many groups whose behaviour puts them at high risk for contracting HIV infection, such as men who have sex with men, commercial sex workers, and injecting drug users, are stigmatised and abused, and in some cases their behaviour is criminalised.4
Many countries with successful HIV policies and programmes do not implement effective HIV prevention policies and programmes for drug users because of a misperception that these are in conflict with supply control, endangering the lives of millions of drug users, their sex partners, and families.
Harm reduction programmes have been developed most thoroughly in Europe, Australia, and Canada. Such programmes seem to have had an impact in reducing the spread of AIDS and other diseases without raising levels of drug use in the general population.5
Effective prevention efforts will have to both acknowledge and challenge cultural mores, which often prevent frank discussion of issues surrounding sex and drug use, and will need to overcome the stigma that surrounds the disease and encourages its spread.
Ediriweera B R Desapriya, research associate
Department of Paediatrics, University of British Columbia, Centre for Community Child Health Research, 4480 Oak Street, L 408, Vancouver, BC, Canada V6H 3V4 edesap@cw.bc.ca
Competing interests: None declared.
References
Ruger JP. Combating HIV/AIDS in developing countries. BMJ 2004;329- 121-2. (17 July.)
De Bruyn T. HIV related stigma and decriminalization the epidemic continuous. Can HIV AIDS Policy Law Rev 2002;7: 8-14.
Goldin CS. Stigmatization and AIDS: critical issues in public health. Soc Sci Med 1994;39; 1359-66.
Heffernan J. Best practices for preventing AIDS. J Ambulatory Care 2004;27: 190-1.
Fischer B, Haydon E, Rehm J, Krajden M, Reimer J. Injection drug use and the hepatitis C virus: consideration for a target treatment approach—the case study of Canada. J Urban Health 2004;81: 428-47.