我一关门 他们就会说
那个男人 女孩别接近他
当你去诊所检查 证实感染后 别人都会知道
When you go and you test positive,at a clinic,people will know.
前脚刚走 他们就议论纷纷
他们会告诉每个人 很八卦
非常大嘴巴 不愿意保密
对你们来说 保密性很重要
It’s so important for you to have some confidentiality.
要是我知道去就医 检验艾滋病毒
If I knew when I went and had an HIV test,and then went every month
以后每个月 还得去拿治疗的药
when I had to go and get my pills to be treated,
而且这事人尽皆知
everyone would know,you know what,
老实说 我可能也不会去做检验
honestly,I might not get tested.
我希望我会去 但我无法摸着良心说 这不会阻挠我去
I hope I would,but I can’t say hand on my heart that that wouldn’t push
诊所的意愿
me away from the clinic.
要是男人不愿意去诊所
So,if the men won’t come to the clinic,
一项开创性的科学试验 决定把诊所带到男人身边
a pioneering scientific trial is taking the clinic to the men,
希望能把艾滋病毒感染者的确诊率提高到九♥成♥
in a bid to diagnose 90% of people who have HIV.
过去四年来
For the past four years,
检验团队拜访了家家户户
testing teams have been visiting every home
在这个居住两万两千人的地区
in an area of 22,000 people.
没有人会特别挑出来
No-one is singled out,
因此可避免被左邻右舍知道
and people can avoid the stigma of their neighbours knowing.
你好吗 我的朋友?
How are you,my friend?
60岁的鳏夫坦巴
Themba,a 60-year-old widower,
也是艾滋感染者之一
was one of those who tested positive
外勤工作人员于2014年首度造访他家
when fieldworkers visited his home in 2014.
我们可以参观吗? -可以 请进
Can we see?Yes,you can come in.
我能坐床上吗?
Can I sit on the bed?
可以 请坐
这些是我的药
你喜欢服药吗?
Do you like taking the pills?
喜欢 这些药能救我的命
七点钟吃一片药？ -是啊 每天
One pill at seven o’clock?Yeah.Every day.
你知道你的病毒量吗?
Do you know your viral level?
我能不能看看报告?
Can we see the paper?
第一次的病毒量是一万八千
First viral load was 18,000,
他开始服药之后
and then,as soon as he started taking the drugs,
也就是8月到11月期间 变成LDL
so,what,August to November,LDL,
也就是低于可侦测范围
which is lower than detectable limit.
测不到 测不到 测不到 测不到
Undetectable,undetectable,undetectable,undetectable.
所以药效非常好
So the pills are working very well.
你以后 想要有女友或老婆吗?
Do you think you will ever have a girlfriend or a wife in the future?
(外语)
他在考虑
He’s thinking about it.
这种药物能让你长命百岁
This treatment,it helps you live
也让你无法继续散播病毒
a long time,but it also stops you passing the virus on.
所以这才是关键
So that’s the key thing.
有两个好处
There are two benefits.
它让你活下来 阻止你把病毒传染给别人
It makes you live and it stops you giving the virus to anyone else.
所以只要你的病毒量低于侦测值
So as long as your viral level
也就是你现在的情况
is undetectable,which yours is,
你就不会把病毒传染给别人
you won’t give the virus to anyone.
很高兴听到这个消息 孩子
(外语)
坦巴只是宏伟计划的一小部分
Themba is just one small part of a much bigger plan
希望在十年内消灭这种流行病
to try and end the epidemic within ten years.
但这项试验 距离达成联♥合♥国♥订的90 90 90目标
But has the trial come anywhere close to reaching
是否更接近了?
the UN’s 90-90-90 target?
诊断出90%的艾滋病毒感染者
To diagnose 90% of people with HIV,
为90%的感染者用药
to get 90% of them onto medication,
以及抑制感染者体内90%的病毒
and suppress the virus in 90% of them.
在非洲健康研究所
At the Africa Health Research Institute,
我和迪南皮莱教授见面
I’m catching up with Professor Deenan Pillay,
他想让我看看他们的杰出成果
who wants to show me how well they’ve done.
首先 诊断
First up,diagnosis.
我们的试验 确诊率高达
We were able to,in our trial,
92% -真的吗? -所有这地区
diagnose 92%…Really?..of those individuals
受感染的民众
who are infected in this area.
我们达到了这个目标
We achieved that target.
下一个问题是 当中有多少比例的人
So the next question is what proportion of these individuals
来到诊所? 很遗憾
come to clinics?And unfortunately,
我们发现只有47%接受治疗
what we find is only 47% get into care.
这个比例太低 根本不可能
And that’s too low to get anywhere near
抑制这种流行病
to start to reduce the epidemic.
所以只成功让不到一半的艾滋病毒感染者
So you’ve managed to get less than half of people with HIV
接受了治疗 为什么?
into treatment.Why?
我们能够进入民众住家
It’s a tremendous success that we’ve been able
劝服他们做艾滋病毒检验 是很大的成就
to go into people’s homes and convince them to be tested for HIV,
但这么做的重点 是让他们接受治疗 -对
but the point of that is that they get onto treatment.Right.
我想了解的是 并不是因为药物短缺
I want to understand – that isn’t because of a shortage of drugs
或缺乏经费 资源其实准备就绪
or a lack of money.The resources are there
只需要鼓励病患
if you can get people
加以利用 对吗?
to use them.Is that right?
我们提供移♥动♥诊所
We provided mobile clinics,
也提供艾滋病毒感染的治疗 药物源源不绝
we provided the care for their HIV infection with no shortage of drugs
诊断也是 而且医护人员也很充足
or diagnostics and always with sufficient staff.
我认为要击败可怕的艾滋病
I think defeating this awful HIV epidemic
需要提高整个社会、个人
requires an understanding of society,as well as individuals,
以及医学界的认知
as well as medicine.
若少了任何一方的认知 我们永远不可能击败它
And without an understanding of all of those,we will never defeat it.
20年前 我想没有人
I think,you know,20 years ago,no-one…
应该没人想得到能走到这个阶段
I don’t think anyone thought we’d get to this point where,
也就是
basically,
我们克服了各种科学医药障碍
we’ve overcome all those kind of scientific,medical obstacles.
研发出效果极佳的疗法
We have highly effective treatment
几乎没有副作用
that works with very few side effects,
而且费用低廉 足以提供给所有病患
and it’s cheap,and there’s enough of it for everyone out there.
这个阶段我们正在对抗最棘手的难题
At this point,we’re batting up against the hardest problem of all,
感觉却很简单
that feels so simple –
也就是劝说人们拿出理性去做对的事
just persuading human beings to be rational and do the right thing –
我想
and…
我相信会走到那一步的 但这部分
I’m sure we will get there,but that…
我想就如同任何医学挑战 是最困难的部分
that,I guess…In any medical challenge,that is the hardest bit.
回到英国本土
Back here in the UK,
我们很容易会假定已经赢得对抗艾滋的战役
it’s easy to assume we are winning the battle against HIV.
坐在这里的感觉和夸祖鲁纳塔尔截然不同
Sitting here feels so different to KwaZulu-Natal
很难相信
that it is hard to believe
现在还有传染性的流行病存在
that there could be any epidemic of infection at all.
但面对英国每年新增6000名感染者 我们能怎么做?
But what can we do about the 6,000 new British infections every year?
虽然保险套让性行为变得更安全
Although condoms have made a huge difference to safer sex,
人们还是不太喜欢使用
people still don’t really like wearing them,
有选择的话 我也宁可不戴
and given the choice,I’d rather not wear one either.
那如果有别开生面的新方法可预防感染呢?
So what if there was a radical new way to prevent infection?
一 二 三
这位是哈利达德
This is Harry Dodd.
身为性生活活跃的年轻男人
As a sexually active young gay man,
他不愿冒任何险
he doesn’t want to take any chances.
所以他签署了临床试验
So he signed up to a clinical trial
一种革命性的新药 叫接触前预防性投药
of a revolutionary new pill called PrEP.
它包含两种抗逆转滤病毒药物
It contains two different anti-retroviral drugs
可防止感染艾滋病毒
and can prevent HIV being contracted.
好 完成了
OK.Well done.
哈利得固定做检验 确保药物发挥作用
And Harry has regular checkups to make sure it’s working.
什么是PrEP?
What is PrEP?
接触前预防性投药的缩写
PrEP stands for pre-exposure prophylactic,
指在曝险前采取的预防措施
so it’s prevention that you take ahead of being exposed to a risk.
你介意我看看吗 -请便
Do you mind if I have a look?Go ahead.
这些药物跟用来治疗艾滋病毒的一样吗?
Are the drugs the same as the ones we use to treat HIV?
是的 因为它们控制病毒的成效很好
They are.Cos they work brilliantly to control the virus,
这就是我们的目的
and that’s what you’re doing,
无论是要预防还是治疗
whether you’re preventing it or you’re treating it,
所以接触前预防性投药的优点是
so the advantage of pre-exposure,
如果你认为未来可能曝露在风险当中
if you think there’s going to be an exposure in the future,
药物随时准备做好保护
is that the drug is there ready and waiting.
如果你按照医嘱 每天乖乖服药
If you take the pill properly,every day as instructed,
感染艾滋病毒的机率微乎其微
the chances of contracting HIV are negligible.
对哈利来说 这让他免于感染艾滋的终生恐惧
For Harry,it’s removed a lifelong fear of contracting HIV.
© 2014-2024 pabulika.com 版权所有
