2014年经济学人 艾滋病 幽灵般的转机

HIV/AIDS

A spectre returns

The fall in HIV infections conceals¹ a worrying rise among gay men

A TELEVISION campaign in the 1980s showed a volcano exploding and dark clouds looming² over a blackened tombstone chiselled³ with the word AIDS. “Don't die of ignorance”, intoned a grim voice. Panic about the HIV/AIDS epidemic⁴ was widespread. Now better treatment, and better understanding of how the virus spreads, means that HIV is no longer a death sentence. But amid the good news there is cause for concern; among gay men in Britain infections are rising.

According to statistics released on November 18th by Public Health England (PHE), part of the NHS, 110,000 people in Britain were living with HIV in 2013, the highest number ever. But that is cause for celebration. Those infected are living much longer. People are being tested more often and diagnosed sooner. Between 2004 and 2013 new infections among heterosexuals fell by half.

Over the same period, however, the estimated annual number of new infections among men who have sex with men rose by a third, to 3,250. Some 13% of gay men in London are living with HIV. Compare that to San Francisco; the prevalence is higher—fairly static at about 24%—but the rate of new diagnoses is falling. In London, it is rising. This is partly explained by better testing. But reckless behaviour is also to blame.

“Chemsex”—taking drugs, especially crystal methamphetamine, GBL, or mephedrone, just before or during sex—is the chief innovation. Such drugs fuel sex binges, enabling people to have sex for longer, risking trauma⁵ and abrasion⁶, and with a greater number of partners. Both increase the risk of transmission. The internet makes it easier to meet casual partners. David Stuart of 56 Dean Street, an NHS sexual-health clinic in Soho, says the centre sees around 100 gay men every month who use drugs for sex. Most have not had sober sex in six months, he says.

Cultural shifts may also be to blame. For some, fear of HIV may manifest itself in avoidance of the subject, via drugs and escapism, says Mr Stuart. But Amrou al-Kadhi, a magazine editor and drag performer, frets⁷ that others are in denial. Treatment has so improved that some assume they no longer need worry. He worries that some men treat post-exposure prophylactics⁸ like the morning-after pill. (Such medicine may stop infection if taken straight after exposure to HIV.) There is a divide, he suggests, between older gay men, who saw the horrors of the AIDS epidemic, and the young, who seem more complacent⁹.

Analysis by Colin Brown, a research fellow at PHE, suggests that testing may not be as widespread as some believe. In 2011, 58% of gay men in Britain said they had been tested for HIV within the past year. But figures from sexual-health clinics in the capital suggest that 20% or less of HIV-negative gay men there get tested every year, half the rate in San Francisco. That city has seen a steeper decline in the proportion of those infected but unaware¹⁰ of it—who are most likely to infect others—than London has.

Better treatments leave campaigners with a dilemma¹¹. They want to see transmissions decline and promote behaviour that minimises risk. But they also want to reassure¹² those who contract HIV that they can still live a long life. Some gay men appear to have taken the second message to heart at the expense of the first.

1 conceals   

v.隐藏，隐瞒，遮住( conceal的第三人称单数 )

参考例句：

• He conceals his worries behind a mask of nonchalance. 他装作若无其事，借以掩饰内心的不安。 来自《简明英汉词典》
• Drunkenness reveals what soberness conceals. 酒醉吐真言。 来自《简明英汉词典》

2 looming   

n.上现蜃景（光通过低层大气发生异常折射形成的一种海市蜃楼）v.隐约出现，阴森地逼近( loom的现在分词 )；隐约出现，阴森地逼近

参考例句：

• The foothills were looming ahead through the haze. 丘陵地带透过薄雾朦胧地出现在眼前。 来自《简明英汉词典》
• Then they looked up. Looming above them was Mount Proteome. 接着他们往上看，在其上隐约看到的是蛋白质组山。 来自英汉非文学 - 生命科学 - 回顾与展望

3 chiselled   

adj.凿过的，凿光的； （文章等）精心雕琢的v.凿，雕，镌( chisel的过去式 )

参考例句：

• A name was chiselled into the stone. 石头上刻着一个人名。
• He chiselled a hole in the door to fit a new lock. 他在门上凿了一个孔，以便装一把新锁。 来自《简明英汉词典》

4 epidemic   

n.流行病；盛行；adj.流行性的，流传极广的

参考例句：

• That kind of epidemic disease has long been stamped out.那种传染病早已绝迹。
• The authorities tried to localise the epidemic.当局试图把流行病限制在局部范围。

5 trauma   

n.外伤，精神创伤

参考例句：

• Counselling is helping him work through this trauma.心理辅导正帮助他面对痛苦。
• The phobia may have its root in a childhood trauma.恐惧症可能源于童年时期的创伤。

6 abrasion   

n.磨（擦）破，表面磨损

参考例句：

• Diamonds have extreme resistance to abrasion.钻石极抗磨损。
• This analysis is helpful to the research of derailment and abrasion machenism.该分析有助于脱轨和磨耗机理的探讨。

7 frets   

基质间片； 品丝（吉他等指板上定音的）( fret的名词复数 )

参考例句：

• The river frets away the rocks along its banks. 河水侵蚀了两岸的岩石。
• She frets at even the slightest delays. 稍有延误她就不满。

8 prophylactics   

n.预防剂( prophylactic的名词复数 )；预防用品；预防法；避孕用品

参考例句：

• The prospect of teachers passing out prophylactics to their pupils has infuriated some parents. 想到老师将分发避孕套给学生使一些家长愤慨不已。 来自柯林斯例句

9 complacent   

adj.自满的；自鸣得意的

参考例句：

• We must not become complacent the moment we have some success.我们决不能一见成绩就自满起来。
• She was complacent about her achievements.她对自己的成绩沾沾自喜。

10 unaware   

a.不知道的，未意识到的

参考例句：

• They were unaware that war was near. 他们不知道战争即将爆发。
• I was unaware of the man's presence. 我没有察觉到那人在场。

11 dilemma   

n.困境，进退两难的局面

参考例句：

• I am on the horns of a dilemma about the matter.这件事使我进退两难。
• He was thrown into a dilemma.他陷入困境。

12 reassure   

v.使放心，使消除疑虑

参考例句：

• This seemed to reassure him and he continued more confidently.这似乎使他放心一点，于是他更有信心地继续说了下去。
• The airline tried to reassure the customers that the planes were safe.航空公司尽力让乘客相信飞机是安全的。