中国HIV新发病例趋势引发担忧

A rise in HIV cases among young gay men and people over 60 in China has raised the question of whether the disease is spreading undetected among people who do not consider themselves at risk.

中国年轻男性同性恋者和60岁以上人群艾滋病毒(HIV)感染病例增多，这提出了一个问题，艾滋病是否正在不认为自己有感染风险的人群中悄然传播。

Figures from the Chinese Center for Disease Control and Prevention released ahead of World Aids Day on Thursday, show 96,000 new HIV cases in the first nine months of this year, putting China on track to exceed the 115,000 new cases recorded in 2015.

中国疾病预防控制中心(CDC)在12月1日世界艾滋病日前发布的数据表明，今年头9个月新诊断发现艾滋病感染者9.6万人，使今年可能超过2015年录得的11.5万新发病例。

The country accounts for about 3 per cent of new HIV cases worldwide, and 2 per cent of the total global HIV-positive population.

中国约占世界新发HIV感染病例的3%，占全球HIV阳性人口总数的2%。

Trends among the new cases indicate government efforts to manage HIV may be missing the mark.

新发病例的趋势表明，政府控制HIV的努力可能未能达到目的。

China is one of the countries with the best data but that comes at a price, said Catherine Sozi, UNAids country director in China.

中国是数据最好的国家之一，但这是有代价的，联合国艾滋病规划署(UNAids)中国地区负责人苏凯琳(Catherine Sozi)说。

Chinese data reflect documented HIV cases, not the survey projections used in many other countries.

中国的数据反映记录在案的HIV病例，而其他许多国家使用调查预测的数字。

By the time you know every gay man who is HIV positive or every female sex worker the disease has moved elsewhere.

等到你获知每一个HIV阳性的男同性恋者或者女性性工作者，疾病已经转移到其他地方。

Of the new cases this year, 28 per cent involved men who have sex with men.

在今年的新发病例中，28%源于男男同性性接触行为。

Last year’s data also showed new cases rising among young people and particularly among gay college students.

去年的数据也表明，年轻人，尤其是男同性恋大学生中的新发病例出现上升。

Chinese commentators view this as a consequence of the stigma attached to homosexuality in China, which might prevent people from being tested for HIV, while non-government organisations worry that a crackdown on NGOs limits their ability to reach the gay community.

国内评论人士认为这是中国同性恋污名化造成的一种后果，人们可能因此不去检测HIV，而非政府组织(NGO)担忧，中国对NGO的打击限制了他们触及同性恋群体的能力。

But Dr Sozi believes the new cases among gay men reflect not a failure to reach them, but the Chinese gay community’s relative success in persuading people to get tested.

但苏凯琳认为，男同性恋群体中的新发病例反映的是中国同性恋群体在说服人们接受测试方面相对成功，并非相关机构未能触及这一群体。

Blued, a gay hook-up app with millions of users, has initiated Aids-education campaigns and operates several free testing centres in Beijing.

拥有数百万用户的男同性恋交友应用软件Blued发起了艾滋病教育运动，并在北京运营了几家免费检测中心。

Its campaign could be boosted by the introduction of self-testing kits that allow people to test in privacy, without having to out themselves at a state-run hospital.

引入自我检测套件或许有助于促进Blued的运动，因为这让人们能够私下进行检测，无需在国营医院暴露自己的身份。

The World Health Organisation this week formally recommended the use of self-testing to help reach the estimated 14m people globally who do not know they are HIV positive.

本周世界卫生组织(WTO)正式推荐使用自我检测手段，以帮助触及全球范围内那些不知道自己是HIV阳性的人，据估计这些人的人数达到1400万。

In China that includes young gay men who typically have very little sex education when they become sexually active in high school or college.

在中国，这个数字包含一些年轻的男同性恋者，他们在高中或者大学进入性活跃期时，通常接受的性教育极少。

Chinese society still has lots of misunderstanding toward homosexuality and Aids

Blued创始人耿乐表示：中国社会对同性恋和艾滋病依然存在许多误解。

so affected people are reluctant to receive help from the government and NGOs, says Blued founder Geng Le.

因此，受感染人群不愿接受来自政府和非政府组织的帮助。

In a sign of evolving social norms, Chinese social media cheered when Aids testing kits popped up at a handful of universities in Beijing and Chengdu.

当艾滋病试剂盒出现在北京和成都的几所大学时，中国社交媒体曾拍手称快，显示出中国社会规范的进步。

The school is so concerned about gays, one post said,

其中一个帖子表示：学校对同志如此关怀。

while others complained that testing kits should also be available in women’s bathrooms.

而其他人则抱怨称，女厕所也应该提供试剂盒。

But outreach to groups known to be at risk could bypass migrant workers or sexually active college students, populations that are unaware Aids is a risk.

不过，伸向已知高风险人群的援手，可能会忽略外来务工人员或性活跃的大学生，而他们正是没有认识到艾滋病风险的人群。

Chinese government officials and society believe Aids is limited to gay men, drug users, prostitutes and pockets of people who contracted the disease from blood sales or transfusions.

中国政府官员和中国社会都认为，艾滋病仅限于男同性恋者、吸毒者、妓女和通过卖血或输血感染上这种疾病的人群。

A whole generation may know about Aids, they are aware, but they don’t think it has anything to do with them, Dr Sozi said.

苏凯琳博士表示：整整一代人也许听说过艾滋病，他们知道艾滋病，然而他们却认为这和他们没有任何关系。

She points to the otherwise unusual rise of Aids among older people — a group that could reflect migrant workers who visited prostitutes far from home and the wives they returned to after a life on the road.

她提到了较年长人群中艾滋病病例的异常增长——这一人群可能代表着因远离家乡而买春的外来务工人员以及他们在外漂泊后返乡团聚的配偶。

Figures show 15 per cent of the new cases in 2015 were recorded among people over the age of 60.

数据显示，2015年新增病例中，15%的人年龄在60岁以上。

Chinese NGOs can apply for grants to do outreach to known at-risk groups, after Chinese premier Li Keqiang personally allocated money from the central government budget to fill a gap when international agencies stopped funding China programmes around 2013.

2013年左右，当多家国际机构停止为中国艾滋病项目提供资金时，中国总理李克强亲自从中央政府预算中拨款填补空缺。在那之后，中国非政府组织可以申请资金，向已知的高风险人群施以援手。

Provincial governments are also relatively flexible in allocating Aids spending to cities and regions where it is known to be prevalent.

在向已知的艾滋病流行城市和地区分配防艾资金方面，各省政府也相对灵活。

Only six provinces account for about 60 per cent of China’s known HIV cases.

目前中国已知艾滋病病例中，大约60%集中在仅仅6个省份。

While Chinese data track individuals diagnosed with HIV, it does not record the secondary infections that kill most Aids patients.

尽管中国的数据跟踪被诊断带有HIV病毒的人，该数据却不会记录导致多数艾滋病患者丧生的继发性感染。

In Africa, that is often tuberculosis, a disease that is common among segments of Chinese society including coal miners that are not categorised as at-risk groups for Aids.

在非洲，这种继发性感染往往是肺结核，这是在中国社会一些群体中十分常见的疾病，包括不被归为艾滋病高风险人群的煤矿工人。