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我国老年人口艾滋病比例在上升
2010年01月12日11:01 来源：中国日报网站
英文《中国日报》1月11日报道：卫生部有官员表示，中国老年人口艾滋病感染的比例在上升，这其中暗娼和嫖客的感染比例最高。
中国卫生部疾病预防控制局副局长郝阳说，自2007年以来老年人口的感染病例增加了数百，南方城市尤为突出。仅在广州，去年一年50岁及以上感染的人数就超过了100人。专家们呼吁，多年来我国的艾滋病防治工作都是以年轻人和流动人口为主，却忽略了老年人口。
去年十月，卫生部官员透露，在我国32万HIV阳性的人口中，70%仍为20岁到49岁。
郝阳说：“老年人口从来都不是艾滋防控的重点，但是今后将加强这方面的工作。由于目前在疫情监测和报告方面的能力局限，老年人口中实际感染的数字可能比医生们所掌握的要更高。”
由于生活质量的改善，中国人普遍的寿命都更长，身体也更健康。因此，老年人，特别是老年男性的性活跃年龄会持续更久。郝阳说，有些老年人会找妓女，他们感染的风险非常大。其中很多人不使用安全套。
在广州一家艾滋病专科门诊外，70岁的钟平（化名）在候诊。他1999年去过几次桑拿房后感染。“我没有使用安全套。”和他一起在广州第八人民医院艾滋病门诊外等候的还有抱着婴儿的母亲、幼童、带着脚镣的犯人、怀孕的妇女以及一对70岁左右的夫妇。
据统计，性传播已经取代静脉吸毒成为中国艾滋病传染的主要途径。2009年的4.8万例新发感染者中，约70%经由性途径感染。
广州市第八人民医院感染病科主任蔡卫平说，老年人口中感染的比例在迅速上升。“每一年我都会看到更多的老年病人。”在该院收治的39名艾滋病患者中，有七人年龄在58岁以上，年龄最大的为73岁。
广州市疾病预防控制中心艾滋病预防控制科的徐慧芳科长介绍，目前发现的感染艾滋病年龄最大的为94岁，根据病理学研究，很有可能是通过性途径感染。
郝阳表示老年人艾滋病发病在全国大多城市都有发现，但没有透露具体的数字。有专家表示，这种增长的发现和艾滋病血检有关。自2006年起，所有医院都会给手术病人进行这类血检。
中国疾病预防控制中心性病艾滋病预防控制中心副主任汪宁指出，老年人口比年轻人得大病，需要手术治疗的几率更高，所以他们接受检测的机会也更多（自2006年起，卫生部规定在医院接受手术治疗的病人在术前的例行体检中要包含HIV病毒检测）。不过，目前我国74万感染人口中绝大多数仍为20至49岁，远高于老年感染人口。
有专家表示，老年人感染的数字在增加，这和大量的暗娼以及活跃的同性恋群体大有关系。他们提出，目前的艾滋病防控项目着重于大学和娱乐场所，但今后针对老年人也该推出更多的项目。
四川省皮肤病性病防治研究所所长万绍平研究发现，自80年代起，特别是2000年以后，暗娼行业发展迅速。“需求肯定存在。一部分人先富了起来，而一些暗娼的价格也越来越低。”
2009年万绍平和香港中文大学刘德辉教授的一份联合研究报告中提到，在中国大陆有四百万到一千万的性工作者，为约6%的20到64岁的男性提供服务。部分价格低至20到50元每次，他们的主要服务对象为老人和农民工。
蔡卫平说一些老人在妻子过世，或者更年期性功能衰退后会去一些伪装成桑拿、发廊、按摩店的色情场所。“中国的传统是避讳谈性。所以一些老人在妻子失去性趣后，也羞于启齿。”在第八医院工作的红丝带志愿者张红梅也说，一些丧偶和离异的男性也常由于子女的阻挠而不能再婚。人民大学性社会学研究所的潘绥铭教授说，社会应重视和尊重老年人的性需求。
74岁的北京人老黄2004年查出HIV阳性，他承认自10年前老伴去世后开始光顾色情场所，而从不使用安全套。“我觉得不用感觉更好，也从没想到这事会发生在我身上。我也不想说我觉得后悔，或者说是不怕死。我最大的担心是如果别人发现了，我的子女会被人看不起。”
万绍平于05、06年选取了四川省三个城市调查了1000余位嫖客，发现特别在低价格暗娼中，安全套的使用率只有约40%。这些年龄在17到80之间的嫖客中，95%承认在最近半年中找过暗娼。每个嫖客在半年内平均与11个暗娼发生过性关系，最多达90个，平均花费36元一次。
低价格暗娼的年龄在30到60之间，通常来自农村或者城市下岗人群，最低的10元就能成交。超过90%的暗娼表示不会坚持要求客人使用安全套。“他们需要钱，为了钱不惜牺牲自己的身体。”万绍平估计，在这些低端暗娼中HIV的感染率达到5%。“待嫖客感染了，会把病毒传给更多的女性。”
彭夏民（化名）在去年12月查出艾滋病，并已处于较严重的阶段，住进了广州市第八人民医院。这位59岁的老人告诉《中国日报》，他还没有跟他的老伴说。“我自08年起体重就开始下降，最近得了感冒，怎么也看不好。经过一次彻底的检查，发现了艾滋病。我需要告诉我的老伴我得病的消息，以及我是怎么得病的。然后她也需要做一次检查。”
彭夏民说他在2000年时常和朋友去娱乐场所，然后带小姐去开房。“我是出于好奇去的，发现自己对年轻女人更感兴趣，因为她们更主动。我有的时候用安全套，有的时候不用。我记得去过七八次，也不知道是从哪一个感染的。”
蔡卫平说，在异性性关系中，基于各自的生理结构，男性更容易把病毒传染给女性：他的妻子或者其他性工作者。
目前社会上对艾滋病还存在歧视，这使得同性恋、妓女、嫖客等高危人群不愿意主动接触一些预防项目。在万绍平调查过的1000多个嫖客中，只有15%曾接受过免费安全套，3%接受过性病治疗，20%收到过艾滋病预防宣传材料。仅有3%的接受过HIV的测试。当被问到如果感到不适怎么办，52%的被调查者说他们会去私人诊所，28%自己去药店买药，14%的会去公立医院检查。
蔡卫平说，“现在对人们讲单一性伴已经没有意义。但应提倡安全性行为。”万绍平认为，应该有更多针对低价暗娼和老年人的艾滋病预防项目。疾控局副局长郝阳指出，将在社区开展更多宣传，来告知人们，特别是老年人如何预防艾滋病。
自2005年起，万绍平在四川主持了一个针对低价暗娼的干预项目。这个项目是由全球基金赞助的。“我们一开始先接触低价小姐，通过她们开展同伴教育。然后通过她们认识低价场所的老板和嫖客。”
万绍平和他的志愿者们经常针对嫖客开展健康教育，给参加者提供小礼物。到现在的出席率都很高。“我们告诉他们不要去玩。如果去了应该怎么办，如果发现有问题了，去哪里求助。我们现场公布检测电话，就看到有人当场在拨打。”万绍平说这其实不像听上去那么难，也不需要花太多的钱。仅仅经过一年，项目干预过的嫖客安全套的使用率已经上升到70%。
长沙市第一医院艾滋病研究所所长王敏认为，政府应该鼓励更多的民间组织来加入性安全的宣传。“政府做很难，因为这原本在中国就是非法的，政府以打击为主。而单靠疾控部门也没有力量来完成这样庞大的工作。”她认为所有的社区、街道以及妇联组织都应该动员起来参与防艾。“应该把防艾列入他们的日常工作中。”
China's elderly population is increasing the proportion of AIDS
At 11:01 on January 12, 2010 Source: China Daily website
English word "China Daily" reported January 11: Ministry of Health officials said that the Chinese elderly population in the proportion of HIV infections is rising, of which commercial sex workers and their clients the highest percentage of infection.
Chinese Ministry of Health, Bureau of Disease Control and Prevention, said Hao Yang, deputy director, since 2007 infections in the elderly population has increased by hundreds, the southern city of particularly prominent. Only in Guangzhou last year, aged 50 and over the number of people infected with more than 100. Experts have called for many years China's AIDS prevention work is mainly aimed at young people and mobile populations, but neglected the elderly population.
Last year in October, the Ministry of Health officials in the country's 320,000 HIV-positive population, 70% is still 20 years old to 49 years old.
Hao Yang said: "The elderly population has never been the focus of HIV prevention and control, but in the future will strengthen work in this regard. As the current epidemic monitoring and reporting capacity constraints, the elderly population the actual number of infections than the hands of doctors to be higher. "
As the improvement of the quality of life, the Chinese people generally have a longer life expectancy, the body is also more healthy. Therefore, the elderly, especially older men sexually active age will continue much longer. Hao Yang said that some elderly people will find prostitutes, their risk of infection is very great. Many of them do not use condoms.
In Guangzhou, an AIDS specialist out-patient, the 70-year-old Zhong-Ping (a pseudonym) in the waiting. In 1999, he visited several times after the infection sauna. "I did not use condoms." With him in Guangzhou 8th People's Hospital were waiting outside the AIDS clinic mothers with babies, young children, with fetters of prisoners, pregnant women, and a pair of 70-year-old couple.
According to statistics, sexually transmitted has replaced intravenous drug users as the main means of transmission of AIDS in China. In 2009 to 4.8 million new infections were, about 70% of the infection through sexual means.
Guangzhou 8th People's Hospital, said Cai Weiping, director of infectious diseases, the elderly population the proportion of infections is growing rapidly. "Every year I will see more elderly patients." In the hospital admitted 39 AIDS patients, there are seven people over the age of 58 years old, the oldest for 73 years.
Guangzhou Center for Disease Control and Prevention AIDS Prevention and Control Branch, Xu Huifang chief, at present the oldest found in HIV-infected for 94-year-old, according to pathological studies, most likely infected through sexual means.
Hao Yang said the incidence of AIDS among the elderly across the country found that most cities have, but did not disclose specific figures. Some experts said the discovery of this growth, and AIDS related blood tests. Since 2006, all hospitals will be given for such patients undergoing blood tests.
Chinese Center for Disease Control and Prevention of STD and AIDS Control and Prevention, said Wang Ning, deputy director of the elderly population than the young man was ill, were more likely to require surgery, so they accept the chance of detecting more (since 2006, the Ministry of Public Health surgical treatment in hospital patients before surgery in a routine physical examination to include HIV virus detection). However, at present China's 740,000 infected with the vast majority of the population is still 20 to 49 years old, far higher than the infection in the elderly population.
Some experts said the number of infection in older persons is increasing, this and a lot of clandestine prostitution, as well as an active homosexual groups in a great relationship. They suggested that the current AIDS prevention and control project focused on universities and places of entertainment, but in the future for the elderly should also launch more projects.
STD prevention and control in Sichuan Institute of Dermatology 10000 chopim study found that, since the 80's, and particularly after 2000, commercial sex workers industry is developing rapidly. "Demand certainly exists. Some people get rich first up, and some commercial sex workers are also getting lower and lower prices."
2009 10000 chopim Professor Liu Dehui the Chinese University of Hong Kong and a joint research report mentioned in mainland China 4000000-10000000 sex workers, for about 6% of 20-64 year-old male service. Part of the price as low as 20-50 yuan each, their main service target for the elderly and migrant workers.
CAI Wei-ping said that his wife passed away a number of old people, or after menopause, sexual function recession will go to some disguised as saunas, hair salons, massage parlors of vice establishments. "China's tradition of talking about sex is taboo. Therefore, some elderly, after his wife lost interest in sex, but also ashamed." In the eighth hospital volunteers, the Red Ribbon Zhang Hongmei, also said a number of widowed and divorced men, often because of their children obstruction can not remarry. People's University Institute of Sociology Professor Pan Suiming, said society should value and respect the sexual needs of the elderly.
74-year-old Beijinger Huang in 2004 found HIV positive, he admitted that since his wife died 10 years ago, began to patronize a vice establishment, but never use condoms. "I think not feel better, but also never thought that that would happen to me. I do not want to say I feel sorry, or that is not afraid of death. My biggest fear is that if someone discovered that my children will be look down upon. "
10000 chopim in selected years, 05,06 survey of three cities in Sichuan Province More than 1,000 clients and found that especially in the low-priced commercial sex workers in condom usage is only about 40%. Those aged between 17-80 clients, 95% acknowledged commercial sex workers looked in the past six months. Within six months per client on average and 11 had had sex with commercial sex workers, up to 90, with an average cost of 36 yuan once.
Low price of clandestine prostitution, between the ages of 30 and 60, usually from rural or urban laid-off people, the lowest 10 yuan can be traded. More than 90% of commercial sex workers indicated they would not insist that customers use condoms. "They need money, for money at the expense of their own bodies." 10000 chopim estimated that in these low-end commercial sex workers in HIV infection rates to 5%. "Once the clients of prostitutes infected, the virus passed to more women."
Peng XIA Min (a pseudonym) in December last year, identified AIDS, and has been in a more serious stage, was admitted to the Guangzhou 8th People's Hospital. The 59-year-old told the "China Daily", he has not with his wife, said. "I have gained weight since starting in 2008 began to decline, recently had a cold, how could not see well. Following a thorough examination and found the AIDS virus. I need to tell my wife I am sick of the news and how sick I was. Then she also needs to do an inspection. "
Peng XIA Min said he was in 2000, and friends often go to places of entertainment, and then with Miss to open the room. "I go out of curiosity, found himself more interested in younger women, because they are more active. I sometimes used condoms, sometimes without. I remember been 78 times, do not know where a of infection. "
CAI Wei-ping said that in heterosexual relationships, based on their physical structure, and men are more likely to transmit the virus to women: his wife or other sex workers.
Currently, there are still discrimination against AIDS, which allows homosexuals, prostitutes, clients and other high-risk groups do not want the initiative to contact a number of prevention projects. In the 10000 chopim surveyed more than 1,000 clients, only 15% had received free condoms, 3% received STD treatment, 20% received HIV prevention information materials. Only 3% had received HIV testing. When asked how to do if they felt unwell, 52% of respondents said they would go to private clinics, 28% of their own to pharmacies to buy drugs, 14% would go to a public hospital.
Cai Weiping said, "People talk about single-sex partners now have no meaning. But it should be to promote safe sex." 10000 chopim that there should be more for the low-priced commercial sex workers and the elderly, AIDS prevention project. Hao Yang, deputy director of disease control bureau pointed out that more publicity will be carried out in the community, to inform people, especially the elderly how to prevent AIDS.
Since 2005, 10000 chopim in Sichuan hosted an intervention project for low-cost commercial sex workers. The project is sponsored by the Global Fund. "We started the first contact with a low-cost, Miss through them to carry out peer education. And then they know the boss of low-cost sites and clients."
10000 chopim and his volunteers often carry out health education for clients, to provide participants with a small gift. Up to now very high attendance rate. "We tell them not to play. If you go to that should be how to do, if problems are detected, and where to seek help. Our on-site call are announced, they see someone on the spot in the dial." 10000 chopim, said that this sounds like so difficult, do not need to spend too much money. After just one year, project interventions, condom usage over the clients had risen to 70%.
First Hospital of Changsha Research Institute of AIDS Wong believes the Government should encourage more non-governmental organizations to join the safe sex propaganda. "The Government is doing is difficult, because it was originally in China is illegal, and the Government to crack down on the main. The disease control departments have no power alone to accomplish such a huge job." She believes that all of the communities, streets and women's organizations should be mobilized to participate in AIDS Prevention. "AIDS Prevention should be included in their daily work."
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