艾滋病人生存环境调查:歧视造成恶性循环
 来源: 新华网
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图示∶2010年12月即将出版的《中国特色医疗金鉴》登载的刘君主任及其机构 |
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从第一例艾滋病发现至今的20多年里,随着科学研究的不断深入,人们对艾滋病的了解也越来越多,但是,艾滋病患者和病毒感染者的生存环境依然十分严峻。
法律与现实的矛盾
消除艾滋病歧视一直是国际社会和各个国家要共同实现的重要目标。在我国,这个问题也被提到社会公正和正义的层面,而且有不少公开的法律来保证。
例如,《中华人民共和国传染病防治法》第十六条指出,国家和社会应当关心、帮助传染病病人、病原携带者和疑似传染病病人,使其得到及时救治。任何单位和个人不得歧视传染病病人、病原携带者和疑似传染病病人。同时该法律也规定,疾病预防控制机构、医疗机构不得泄露涉及个人隐私的有关信息、资料。侵犯单位和个人合法权益的,有关单位和个人可以依法申请行政复议或提起诉讼。
疾病预防控制机构违反本法规定,有下列情形之一:故意泄露传染病病人、病原携带者、疑似传染病病人、密切接触者涉及个人隐私的有关信息、资料的,其负有主要责任的组织或个人将被处以不同级别的处罚,如警告、降级、撤职、开除等。
此外,我国的《艾滋病管理条例》也规定,艾滋病病毒感染者和艾滋病病人及其配偶、子女的就业、就学、就医和参加社会活动等权利受法律保护。任何单位和个人不得歧视艾滋病病毒感染者、艾滋病病人及其配偶和子女。
同样,美国也在消除艾滋病歧视方面做了大量工作。例如,2009年10月30日,美国总统奥巴马签署取消一条长达23年的禁止HIV病毒携带者在美国旅游和移民的规定。美国目前有超过100万人携带HIV或患有艾滋病,而且这一数字每年以超过5.6万人的速度递增。对这一人群取消禁止旅游和移民的规定,也是取消对他们的歧视。
但是,艾滋病病毒感染者和患者在现实中仍然受到歧视。
2009年11月27日,联合国艾滋病规划署联合我国卫生部和艾滋病病毒感染者组织在京发布了《中国艾滋病感染者歧视状况调查报告》。该报告对我国25个省区市的2000余名艾滋病病毒感染者进行了调查,其中41.7%的受访者称曾经受到过艾滋病相关歧视,超过2/3的人表示家庭成员曾因自己的感染状况受到过歧视。在知晓被感染者的感染身份后,1/4的医务工作者、超过1/3的政府官员和教师持有负面和歧视的态度。有超过12%的受访者表示,自检测出艾滋病感染后曾至少一次被拒绝就医。
在美国,人们对艾滋病的评价同样是负面的。因此,美国在2010年7月公布美国的艾滋病新战略时提出了一个重要任务,呼吁全社会根除因艾滋病带来的不平等和不公正。
就业歧视最为严重
艾滋病病毒感染者和患者遭受最严重的歧视是就业歧视,这一现象在中国几乎是百分之百。
2010年上半年,安徽青年小吴(化名)在安徽省安庆市市直学校招聘考试中连过笔试、面试两关,最后却因为体检中“艾滋病检测呈阳性”被挡在安庆教育局招录教师的门外。10月13日,小吴将安庆市教育局告上了法庭。由于顾及社会影响,此案还没有判决。小吴的经历只是成千上万艾滋病病毒感染者和患者的经历之一。
例如,四川现年27岁的小军于2010年6月报考盐边县小学音乐老师职位,通过笔试及面试,去学校报道前被告知携带艾滋病毒,被拒绝录用。小军在与相关部门的交涉过程中,个人隐私遭教育局、人事局泄露,10月20日,小军将该县教育局、人事局告上法庭,该案至今仍在审理中。
小吴和小军的经历还比其他艾滋病病毒感染者要好,至少法院还对他们的诉讼予以立案,但其他人却没有这么幸运。河南鹤壁的王秋云(女)曾任该县医疗系统妇幼专职干部,因输血感染艾滋病毒。2005年她第一次被查出携带艾滋病病毒,当年将医院告上法庭,但在立案后至今未开庭审理。
从现实的情况来看,尽管法院对小吴和小军的艾滋病就业歧视立案审理,但判决结果并不容乐观。而判决结果将会对包括小吴和小军在内的中国74万艾滋病病毒感染者至关重要,或许会让他们再次陷入无助和绝望的境地。
在中国的艾滋病就业歧视中,一个表面原因是,有关方面和决策者往往以行政规定来否定法律和法规。这是一个耐人深思的问题。
例如,安庆教育局拒绝小吴的理由是,他们的公务员招考明确规定按照《公务员录用体检通用标准》进行,经体检不合格取消聘用资格。然而安庆教育局所指的依据是2004年国务院和人社部联合下发的《公务员录用体检通用标准(试行)》,其中第十八条中规定“艾滋病,不合格”。但是,《中华人民共和国就业促进法》明确规定:“用人单位招用人员,不得以是传染病病原携带者为由拒绝录用。”显然,前者是行政规定,而后者是国家法律。从法律的地位来看,后者重于前者,前者应服从于后者。
从更大范围看,目前的《公务员录用体检标准》、《公安机关录用人民警察体检项目和标准》以及保险相关的条款中,都对艾滋病患者都有明显的歧视条款,即规定不得录用HIV携带者和患者,这显然是与《中华人民共和国就业促进法》相悖的,是以下位法对抗上位法或以行政规定对抗法律。而且,这种不合法的对抗居然会通行无阻,说明社会对艾滋病的歧视非常之深。因此,现实中不仅对艾滋病病毒感染者和患者的歧视能得以实施,并且单位或个人即便对艾滋病病毒感染者和患者实施了歧视,也不会受到法律的制裁。这就造成了歧视艾滋病病毒感染者和患者的“违法成本”很低的现象,或者说人们根本认识不到这种歧视是违法。
歧视造成恶性循环
为什么艾滋病病毒感染者和患者会受到普遍歧视,根源还在于社会各方面,甚至包括医疗和卫生部门对艾滋病的不了解,对防控艾滋病知识的传播不力,当然还有根深蒂固的对性传播疾病的鄙视。
众所周知,艾滋病通过几种渠道传播,一是医源性感染,包括输血和各种侵入性医疗手段;二是母婴传播;三是性传播;四是吸毒,主要是通过共用针头传染。尽管性传播只是艾滋病传播的一种方式,世界各地经性传播艾滋病的比例各有不同,但一提到艾滋病,相当多的人都会把患者与不洁的性行为或淫乱联系在一起,因而认为这是一种“脏病”,在心理上早已把患者和病毒携带者打入另册。这其实在社会心理上已经造成对艾滋病病人和病毒感染的歧视。
当然,社会对艾滋病患者和病毒感染者的歧视还来自对他们传播疾病的担心,正常人如果与他们接触,可能会染上艾滋病。然而,艾滋病的基本知识告诉人们,艾滋病病毒是一种非常脆弱的病毒,对热和干燥十分敏感,只能在液体中存在。即使HIV经唾沫进入口中,也会被胃酸杀死。而且,即使蚊子叮咬过艾滋病病人的血,也根本不可能传播艾滋病。所以,正常人与艾滋病患者和病毒感染者共同工作和生活,包括共同进餐都不会染上艾滋病,只是共用牙刷、剃须刀、刮胡刀有可能感染HIV,但前提是,正常人的皮肤和黏膜有破损。因此,只要注意,这种途径染上HIV的可能性较小。
所以,艾滋病病人和病毒感染者是可以与正常人一道生活和工作的。
然而,对艾滋病病人和病毒感染者的歧视,尤其是就业歧视反过来又增加了艾滋病传播的可能性。正如联合国艾滋病规划署执行主任米歇尔·西迪贝所说,正是歧视和耻辱带来的恐惧,阻碍着公众获取艾滋病相关信息、进行艾滋病检测或寻求治疗。由于不能得到相关的信息和得不到检查和治疗,艾滋病病毒感染者会在与他人的交往中有意无意地扩大艾滋病的传染。
减少对艾滋病毒感染者和患者的歧视是确保战胜艾滋病的关键因素,要达到这一点首先要确保医疗卫生专业服务人员进行培训,提升他们的专业服务水平,同时对全社会进行防治艾滋病知识宣传,减少对感染者的歧视和侮辱。当艾滋病毒感染者和患者的权益得到保护,在生活、就业等方面享受与正常人一样的权利之时,阻遏艾滋病的传播才有可能实现,也才能谈得上社会公正的实现。(张田勘)来源文汇报)
Investigate the living environment of people with AIDS: a vicious circle of discrimination
Source: Xinhua at 08:17 on November 30th, 2010 I Laiyueliangju (0) copy the link to the print medium and small medium and small medium and small from the first case of AIDS found that more than 20 years since, with the deepening of scientific research, people understanding of AIDS is also increasing, however, AIDS patients and HIV-infected persons living environment is still very grim.
The contradiction between law and reality
Discrimination against AIDS has been the international community and all countries should work together to achieve important goals. In China, the issue was referred to the level of social equity and justice, and many of the laws to guarantee open.
For example, the "People's Republic of Infectious Diseases Prevention Law" Article XVI pointed out that state and society should care for and help patients with infectious diseases, pathogen carriers and suspected patients of infectious diseases, to receive timely medical treatment. No unit or individual may discriminate against patients with infectious diseases, pathogen carriers and suspected patients of infectious diseases. The law also provides for the same time, disease prevention and control institutions, medical institutions not to disclose information involving personal privacy and data. Violations of the legitimate rights and interests of units and individuals, the relevant units and individuals may apply for administrative reconsideration or bring an action.
Disease Control and Prevention in breach of the provisions of this Law, one of the following circumstances: patients with infectious diseases intentionally leaked, pathogen carriers and suspected patients of infectious diseases, in close contact with the relevant information involving personal privacy, data, and its primary responsibility of the organization or individuals will be punished by different levels of punishment, such as warning, demotion, dismissal, expulsion.
In addition, China's "AIDS Management Regulations" also stipulates that HIV infected persons and AIDS patients and their spouses, children, employment, education, medical care and social activities and other rights protected by law. No unit or individual may discriminate against people living with HIV, AIDS patients and their spouses and children.
Similarly, the United States is also a lot of work to eliminate discrimination against AIDS. For example, the October 30, 2009, signed by U.S. President Barack Obama canceled a 23-year ban HIV virus carriers in the U.S. travel and immigration requirements. The U.S. currently has more than 100 million people living with HIV or AIDS, and the number to more than 5.6 million people per year rate of increase. Lift the ban on travel to this population and immigration requirements, but also abolish discrimination against them.
However, HIV-infected people and patients are still discriminated against in the real world.
November 27, 2009, the Joint United Nations AIDS Programme Ministry of Health and HIV organizations in Beijing issued a "discrimination against people living with HIV Survey Report." The report of the 25 provinces and autonomous regions in China more than 2,000 HIV-infected persons were investigated, of which 41.7% of respondents said they had been subjected to AIDS-related discrimination, more than 2 / 3 family members said their infection Zengyin The discrimination by the state. In knowing the identity of those infected after infection, 1 / 4 health workers, more than 1 / 3 of the government officials and teachers hold negative attitudes and discrimination. More than 12% of the respondents said that since the detection of HIV infection at least once after he was refused medical treatment.
In the U.S., the evaluation of AIDS is also negative. Therefore, the U.S. announced in July 2010 when the U.S. new strategy on AIDS made an important task, calling the whole of society brought about by AIDS eradication of inequality and injustice.
The most serious discrimination in employment
HIV-infected persons and patients suffer the most discrimination is discrimination in employment, a phenomenon that is almost one hundred percent in China.
First half of 2010, Anhui Youth Xiao Wu (pseudonym), directly under the school in Anqing City, had even written in the Common Recruitment Examination, interview two hurdles, but because the medical examination in the final, "HIV-positive," Education is recruiting teachers to stand in Anqing the door. October 13, Xiao Wu, the Anqing City Board of Education to court. Take into account the social impact because the case has not been sentenced. Xiao Wu's experiences in the thousands of HIV infected people and experiences of patients.
For example, Sichuan, 27-year-old armed forces in June 2010 job applicants elementary school music teacher in Yanbian, through written examination and interview, to be informed before the school reported that HIV was refused employment. Xiao Jun in the process of negotiations with the relevant departments, individual privacy was the Education Bureau, Personnel Bureau disclosure, Oct. 20, a small Army the county Department of Education, Bureau of Personnel to court, the case is still pending.
Xiao Wu, and small military experience also infected with HIV than other better, at least the court has to be filing lawsuits against them, but others are not so lucky. Henan Hebi Wang Qiuyun (female) former county maternal and child health care system, full-time cadres, HIV infection through blood transfusion. In 2005 she was first found to carry HIV, the year the hospital to court, but has not after placing the trial.
From a realistic point of view, although the courts and the small army of Xiao Wu, AIDS filing employment discrimination trial, but the verdict and is not optimistic. The verdict will be on, including Xiao Wu and Xiao Jun 74 million in China, including HIV infection is critical, and perhaps make them relapse into helplessness and despair.
AIDS discrimination in employment in China, a surface reason is that parties to administrative provisions and policy makers tend to reject the laws and regulations. This is a twist of thought.
For example, Anqing, Xiao Wu Department of Education refused on the grounds that their civil service recruitment in accordance with clearly defined "common standard civil service recruitment examination" carried out by physical examination failed to cancel employment eligibility. However, within the meaning of Anqing is based on Department of Education State Department and others in 2004 the Department jointly issued the "General Standard for civil service recruitment examination (Trial)", in which the provisions of Article XVIII, "AIDS, failed." However, the "PRC Employment Promotion Law" clearly states: "Employers Zhaoyongrenyuan, infectious pathogen carrier shall not refuse Yishi employment." Clearly, the former administrative provisions, which is a national law. From a legal point of view the status of the latter is more important than the former, the former should be subordinated to the latter.
From a larger perspective, the current "standard of civil service recruitment examination," "public security organs employment physical examination items and standards of the People's Police" and the insurance-related provisions, all of AIDS patients have clear-discrimination clause, which provides that employment shall not carry HIV and patients, which is obviously the "PRC Employment Promotion Law," contrary to, the following counterpoint against the higher law against the law or administrative regulations. Moreover, this confrontation turned out to be unlawful obstruction-free access, indicating that social discrimination against AIDS is very deep. Therefore, in reality, not only for patients infected with HIV and discrimination can be implemented, and even for units or individuals and patients with HIV discrimination implemented, it will not be punished by law. This has resulted in discrimination against HIV infected people and patients with "illegal cost" phenomenon is very low, or that people do not realize that discrimination is illegal.
Vicious circle of discrimination
Why do patients with HIV infection will be widespread discrimination and the root cause lies in all aspects of society, including even medical and health departments do not know about AIDS, AIDS prevention and control of the spread of the poor, of course, deeply rooted on sexually transmitted diseases contempt.
As we all know, AIDS is transmitted through several channels, one iatrogenic infection, including blood transfusions and various invasive medical procedures; second mother to child transmission; third is sexually transmitted; Fourth, drug use, mainly transmitted through sharing needles. Although sexual transmission is only one way the spread of AIDS around the world, the proportion of sexual transmission of AIDS vary, but the mention of AIDS, a considerable number of people will put patients and a dirty or promiscuous sexual behavior associated with, so that This is a "heart disease", has already put in the mental patients and HIV carriers into the other register. In fact, this has resulted in the social psychology of HIV infection in AIDS patients and discrimination.
Of course, the community and the HIV AIDS discrimination but also from the spread of the disease they fear contact with them if normal, may be infected with AIDS. However, to tell people the basic knowledge of AIDS, AIDS virus is a very fragile virus, are very sensitive to heat and drying, can only exist in the liquid. Even if HIV through saliva into the mouth, stomach acid will also be killed. Moreover, even mosquito bites through the blood of AIDS patients, it is impossible to spread of AIDS. Therefore, the normal and AIDS patients and HIV infected persons living and working together, including sharing a meal are not infected with HIV, but sharing toothbrushes, razors, razor may be infected with HIV, but the premise is that normal skin and mucosa damage. Therefore, as long as the note that this approach are less likely to have contracted HIV.
Therefore, AIDS patients and HIV can be with normal people live and work together.
However, AIDS patients and HIV discrimination, particularly discrimination in employment, in turn, increased the likelihood of HIV transmission. As UNAIDS Executive Director Michel Sidibe said, it is the fear of discrimination and stigma, hinder public access to AIDS-related information, or to seek treatment for HIV testing. Unable to get relevant information and lack of screening and treatment, HIV infected people in dealings with others, intentionally or unintentionally, to expand AIDS.
Reduced in patients with HIV infection and AIDS discrimination is a key factor to ensure the defeat, to achieve this we must first ensure that the medical and health professional staff training to enhance their level of professional services, while the whole society to prevent and treat AIDS awareness, reduce discrimination and stigmatization of those infected. When HIV-infected people and the protection of the rights of patients, in life, employment, etc. to enjoy the same rights as normal people when deter the spread of AIDS be possible to achieve, and can we talk about the realization of social justice. (Zhang Tian Kan) Source Wen Wei Po)
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