VOA标准英语2012--WHO: Better HIV Antiretroviral Strategies Needed

 

WHO: Better HIV Antiretroviral Strategies Needed

The World Health Organization says comprehensive HIV treatment strategies are needed in developing countries to overcome stigma¹ and discrimination. It says there are a number of vulnerable groups unable to get full access to antiretroviral drugs.

Recent studies have shown that antiretroviral drugs not only extend the lives of people infected with HIV, but can also prevent infection in the first place. It’s a strategy known as “treatment as prevention.” It now means countries have the potential to greatly slow the spread of HIV by using the drugs as a prophylaxis. However, often those in need of HIV treatment and prevention are unable to receive them because of their social status.

“We’ve seen in many countries that there remains² stigma against certain population groups. And in some countries these behaviors of these groups are criminalized. Being a sexworker in many African countries is criminal behavior. Being an MSN in some countries is criminalized and obviously injection drug use is,” said Dr. Gottfried Hirnschall, director of the WHO’s HIV/AIDS Department.

MSM is an acronym³ for men who have sex with men, one of the WHO’s and UNAIDS’ official groups of vulnerable people.

“We see barriers for these individuals to access services. And we obviously see that as a consequence in many places these groups have higher infection rates. They have higher mortality, etcetera,” he said.

Another part of a comprehensive strategy includes the question of when to start treatment. In the early days of antiretrovirals, the drugs were usually given to people when their immune systems had collapsed⁴ and were being attacked by opportunistic infections. The state of health is measured by the CD4 count. That is the number of particular immune cells a person has.

Hirnschall says, in recent years, the recommendation has been to start people on treatment much earlier.

“If you start as soon as possible – and that’s what’s happening now in the U.S. with the policy change that just took place – you may have a benefit to the patient. WHO now recommends initiation⁵ of treatment below a CD4 cell count of 350, which means that the immune system has already some signs of weakening, but that the patient is still not very sick yet,” he said.

By providing earlier treatment, many opportunistic infections could be avoided.

Two recent studies have proven the treatment as prevention strategy. One looked at discordant⁶ couples, where one person is HIV positive and the other is not. The drugs were 96 percent effective in preventing the HIV negative person from being infected.

Another study indicated the effectiveness of PrEP or preexposure prophylaxis.

“Even if you give drugs prior to exposure – in other words to HIV negative persons – referred to as preexposure prophylaxis – you may also protect this person from becoming infected. So the whole field of the use of antiretrovirals has become more and more exciting, but at the same time more complex,” said Hirnschall.”

The WHO official says it would cost more in the short-term to get more people on antiretrovirals sooner, probably billions more. However, he says in the long-term, the cost will drop and lives will be saved.

“You will have quite impressive reductions of both mortality and new infections. So we estimate over a period until 2020 more than 12 million new infections could be averted⁷ and 7.4 million deaths could be also averted. So in other words, yes, you need to invest. You need to front-load the resources, but you’re buying something for it,” he said.

Dr. Hirnschall says the World Health Organization is developing what are called consolidated⁸ guidelines. The aim is to help developing countries form care and treatment strategies for vulnerable groups.

1 stigma   

n.耻辱，污名；(花的)柱头

参考例句：

• Being an unmarried mother used to carry a social stigma.做未婚母亲在社会上曾是不光彩的事。
• The stigma of losing weighed heavily on the team.失败的耻辱让整个队伍压力沉重。

2 remains   

n.剩余物，残留物；遗体，遗迹

参考例句：

• He ate the remains of food hungrily.他狼吞虎咽地吃剩余的食物。
• The remains of the meal were fed to the dog.残羹剩饭喂狗了。

3 acronym   

n.首字母简略词，简称

参考例句：

• That's a mouthful of an acronym for a very simple technology.对于一项非常简单的技术来说，这是一个很绕口的缩写词。
• TSDF is an acronym for Treatment, Storage and Disposal Facilities.TSDF是处理，储存和处置设施的一个缩写。

4 collapsed   

adj.倒塌的

参考例句：

• Jack collapsed in agony on the floor. 杰克十分痛苦地瘫倒在地板上。
• The roof collapsed under the weight of snow. 房顶在雪的重压下突然坍塌下来。

5 initiation   

n.开始

参考例句：

• her initiation into the world of marketing 她的初次涉足营销界
• It was my initiation into the world of high fashion. 这是我初次涉足高级时装界。

6 discordant   

adj.不调和的

参考例句：

• Leonato thought they would make a discordant pair.里奥那托认为他们不适宜作夫妻。
• For when we are deeply mournful discordant above all others is the voice of mirth.因为当我们极度悲伤的时候，欢乐的声音会比其他一切声音都更显得不谐调。

7 averted   

防止，避免( avert的过去式和过去分词 )； 转移

参考例句：

• A disaster was narrowly averted. 及时防止了一场灾难。
• Thanks to her skilful handling of the affair, the problem was averted. 多亏她对事情处理得巧妙，才避免了麻烦。

8 consolidated   

a.联合的

参考例句：

• With this new movie he has consolidated his position as the country's leading director. 他新执导的影片巩固了他作为全国最佳导演的地位。
• Those two banks have consolidated and formed a single large bank. 那两家银行已合并成一家大银行。