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(单词翻译:双击或拖选)
By Carolyn Weaver1
Uganda
31 May 2006
watch Uganda and AIDS report
Experts say Ugandan women and children remain at special risk of HIV infection
Uganda's program promoting abstinence, being faithful in marriage and condom use is often credited with arresting the spread of HIV-AIDS in that country. But Ugandan officials and activists3 say the ABC program, as it's called, isn't a cure-all. There are still huge challenges in controlling and preventing AIDS, such as providing antiretroviral drugs to all in need -- and preventing the rise of drug resistance, when microbes evolve defenses that render medicines powerless.
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Uganda has been a case study for slowing the AIDS epidemic4, but AIDS control chief Dr. Elizabeth Madraa says there are signs the epidemic may no longer be declining. She says married women remain especially vulnerable to infection by unfaithful husbands.
Elizabeth Madraa is Uganda's AIDS control chief
"Culture-wise, it's very difficult to promote condom use in marriage,” Dr. Madraa said in an interview at the health ministry5 in Kampala, “and that's the challenge we really do have."
Ugandan AIDS activist2 Beatrice Were
Ugandan AIDS activist Beatrice Were agrees. She was infected by her first husband, who has since died. Ms.Were notes that African women often lack control over sex in marriage. Marital6 rape7, for example, is not recognized as a crime in Uganda. "From my own experience, I abstained8, and when I was married, I was faithful to my spouse9, but it didn't protect me from HIV.” Ms. Were said. “The school of thought that believes in abstinence and faithfulness in marriage ignores the fact that HIV has a lot to do with gender10 and power relations."
AIDS researcher Francis Mmiro of Makerere University
Makerere University medical professor Francis Mmiro says the second largest route of HIV infection in Uganda is from mothers to children: prenatally, during delivery, and through breastfeeding. Dr. Mmiro helped invent one of the most effective protocols11 for preventing mother-to-child transmission in pregnant and nursing women – known as PMTCT -- using a drug called nevirapine. "Our objective was to find something cheap, simple and effective,” he says, noting that while better drugs have since been developed, even now nevirapine remains12 the one that Uganda can afford.
He says the program has cut mother-to-child transmission in Uganda half, to fewer than 15 percent of babies born to HIV-infected mothers. Critics of nevirapine note it is toxic13, but Dr. Mmiro says that isn't true when it's used as a one-time preventative. "Nevirapine as used for PMTCT doesn't provide any toxicity14, because it's just a single dose, a single tablet."
For those needing ongoing15 drug treatment, Dr. Elizabeth Madraa says social support is also important. “We have a kind of organization, of people living with HIV and AIDS, who came voluntarily and trained the relatives to become what they call treatment supporter or buddies,” she says. “So, if you have been initiated16 on treatment, you can come with your relative, who sees you through the first weeks to comfort you during that reaction, because some drugs are very strong, at the beginning they feel so bad, but if there's somebody who's gone through it is there to tell you, 'that's how I felt, after some time I felt better,' at least you're given that hope."
Dr. Madraa says Uganda's goal is to provide free antiretroviral drugs for every person in need. Currently they're reaching 38 percent of the 156,000 Ugandans who need them. But she adds that prescribing practices must be tightly regulated as part of the effort to reduce the chances of anti-microbial resistance, virus strains that become resistant17 to the medication.
1 weaver | |
n.织布工;编织者 | |
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2 activist | |
n.活动分子,积极分子 | |
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3 activists | |
n.(政治活动的)积极分子,活动家( activist的名词复数 ) | |
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4 epidemic | |
n.流行病;盛行;adj.流行性的,流传极广的 | |
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5 ministry | |
n.(政府的)部;牧师 | |
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6 marital | |
adj.婚姻的,夫妻的 | |
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7 rape | |
n.抢夺,掠夺,强奸;vt.掠夺,抢夺,强奸 | |
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8 abstained | |
v.戒(尤指酒),戒除( abstain的过去式和过去分词 );弃权(不投票) | |
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9 spouse | |
n.配偶(指夫或妻) | |
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10 gender | |
n.(生理上的)性,(名词、代词等的)性 | |
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11 protocols | |
n.礼仪( protocol的名词复数 );(外交条约的)草案;(数据传递的)协议;科学实验报告(或计划) | |
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12 remains | |
n.剩余物,残留物;遗体,遗迹 | |
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13 toxic | |
adj.有毒的,因中毒引起的 | |
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14 toxicity | |
n.毒性,毒力 | |
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15 ongoing | |
adj.进行中的,前进的 | |
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16 initiated | |
n. 创始人 adj. 新加入的 vt. 开始,创始,启蒙,介绍加入 | |
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17 resistant | |
adj.(to)抵抗的,有抵抗力的 | |
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