经济学人248:艾滋病 幽灵般的转机

 　　HIV/AIDS

　　艾滋病

　　A spectre returns

　　幽灵般的转机

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

　　艾滋病感染率下降安抚了日益惶恐的男同性恋们

　　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.

　　20世纪80年代有一个这样的电视画面：火山喷发，乌云密布，天空下一座黑色的墓碑上刻着“AIDS”（艾滋病）字样。一个冰冷的声音反复出现“不要死于无知”。人们对艾滋病的惶恐情绪迅速蔓延。而今改善的医疗技术以及对艾滋病毒传播途径更为详细的理解都使艾滋病不再是死刑的代名词。但是伴随着好消息而来的也有些令人担忧的情况：伦敦男同性恋者中艾滋病感染率上升。

　　艾滋病.jpg

　　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.

　　11月18日英国全民医疗服务下属的英格兰公共卫生部门（PHE）公布的数据表明，2013年伦敦艾滋病毒携带者有110,000人，创下历史新高。但是也有值得庆祝的事情：这些艾滋病毒携带者的寿命将延长。人们接受检测的频率增多，也能更快得到治疗。2004年到2013年异性恋者之间的艾滋病感染新增人数减少了一半。

　　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.

　　然而，同期相比，男同性恋者中的艾滋病感染新增人数增至3250，增加了三分之一。伦敦13%的男同性恋者携带有艾滋病毒。相比之下的旧金山，患病人数就略高一些—大约保持在24%左右—但新诊断的人数所占比率在下降，而在伦敦，这个数量却有所上升。很大程度上得益于更精准的病情监测。但是轻率地行径同样是病患人数上升的一大祸源。

　　“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.

　　“化学性爱”——在性爱前或性爱后服用毒品，尤其是冰毒， 伽玛丁内酯（GBL）或是甲氧麻黄酮——是主要的诱因。此类药物刺激性欲，延长人们性爱时间，与大量的同伴性爱更易造成外伤和擦伤，二者都增加了艾滋病传播的几率。网络让人们更容易接触到随意的性爱伙伴。迪恩街56号英国全民医疗服务性爱健康诊疗中心的大卫·斯图尔特说，该中心每月大概会接待100位借助药物进行性爱的男同性恋。大多数在最近的六个月内都是服药性爱。

　　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.

　　文化观念的转变也是一个原因。斯图尔特表示，对一些人来说，借着毒品和逃避现实，对HIV的恐慌更可能使它变为一个逃避话题。。但是杂志编辑兼戏剧演员Amrou al-Kadhi担心其他人不肯接受现实。由于当前医疗技术进步不小，有人会认为无需担忧。他担心有些人将做爱后预防药看的跟避孕药似的，尽管此类药物可能会预防直接暴露于艾滋病后的感染。他建议，经历过艾滋病蔓延的年长男同性恋者和比较自满的年轻人需要分别对待。

　　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.

　　英格兰公共卫生部门（PHE）的研究员科林·布朗表明测试并不如大家所料的那样普遍。2011年，英国51%的男同性恋表明在过去的一年里做过艾滋病体检。但伦敦性爱健康诊所的数据表明只有20%甚至更低的艾滋病阴性的男同性恋者每年接受艾滋病测试，仅占旧金山的一半。较于伦敦，旧金山感染人数的比例—这些感染人群更易传染他人—已经骤降，但旧金山却并未意识到。

　　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.

　　较高的医疗水平让艾滋病活动者进退两难。他们既想降低艾滋病的感染率，又想宣传降低感染风险的行为。但是他们也想确保那些已感染了艾滋病毒的人们活的更久些。有一部分同性恋因为关注了那些宣传行为而感染了艾滋病。

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。