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本帖最后由 走走停停 于 2010-7-1 19:26 编辑
HIV的真相》强烈推举,译自Medhelp
HIV的真相, Medhelp, 推举
以下是Medhelp艾防社区“三巨头”(Teak,LIZZIELOU,nursegirl6572)之一的nursegirl6572最近发的一篇反恐巨作。nursegirl6572是一位在几乎只许的医护领域工作过的有16年工作经验的注册护士。看到这篇文章比较好,翻译过来以飨国内恐友。觉得好你就顶,反正我觉得灰常灰常好,尤其对于很多恐出心理题目的恐友来说。原始链接:http://www.medhelp.org/user_jour ... ersonal_page_id=434
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HIV:THEFACTS
May12,200907:51AM
Tags:hiv,HivRisks,HIVinfection,HIVSYMPTOMS
HIV的真相
2009年5月12日,上午7:51
标签:HIV,HIV风险,HIV感染,HIV症状
IamveryhonoredtobearegularcontributorontheHIVPreventionForumhereatMH.Theforumisverybusy,andweoftengetthesameinquiriesoverandover.Ifiguredthatputtingtogetherajournalentrycoveringthemostpopulartopics,andjustlayingoutthefactsmaybehelpful.IalsoinviteLizzieLouandTeaktosharetheirthoughts,andtocoveranythingImayhavemissed.
我很荣幸成为Medhelp艾防社区的定期撰稿人。这个论坛很繁忙,我们经常反复碰到同样的题目。我打算集中做一个能够覆盖大部分题目的流水账,同时告诉对大家有益的真相。我还请LizzieLou和Teak分享你们的见解,帮我补充遗漏的地方。
TheMyths:
神话:
Firstofall,sadly,thereisaveryoverlinflatedviewofHIVamongalargeportionofthegeneralpopulation.Ifeelthisisrelatedtoalotofthe"hype"andmediaaroundthevirus.TheFACTis,HIVisaverydifficultvirustotransmit.Comparabletootherviruses(ieinfluenza),itisaveryWEAKandunstablevirusthatsuccombstotheenvironmentrapidly.Itneedsbasicallyasetofnearperfectcircumstancestoallowforinfection.Therefore,apersonCANNOTgetHIVfromenvironmentalsurfaces,liketoiletseats,manicure/barberequipment,showerstalls,drinkingglasses,toothbrushes,etcetc.Thevirusquicklybecomesinactivewhenitisoutsideofitshost(thebody).Thisiswhyinfectionfrominanimateobjectsisimpossible.Thisisalsowhymutualmasturbationwithexposuretoapartner'sgentialfluidsisalsoNOTariskinanyway.Thisalsoisthecasewithcuts,abrasions,crackedcuticles,etc.Thosethingsmakenodifferencewhenitcomestorisk,asthevirusisoutsideofitshost,renderingitinactive.
首先,不幸的是,一般人群中有很大的一部分人对于HIV的传播的观点过于夸大。我以为这和关于这个病毒“天花乱坠的广告宣传”和媒体报道有很大关系。而真相是,HIV是非常难传播的一种病毒。和其他病毒相比(比如流感),它在外界环境中是非常脆弱和不稳定的。它需要根本上是近乎完美的条件才可能构成感染。所以,一个人是不可能从外界环境外表感染HIV的,比如马桶座,修甲/理发工具,淋浴室,饮料杯,牙刷,等等。病毒在离开寄主(身体)之后很快就失活了。这就是为什么从一个无生命的物体那里感染是不可能的。这也就是为什么暴露于对方生殖器体液的相互手淫无论如何都没有风险。这包括那些手上有口子的,破损的,倒刺等等。这些东西不增加任何风险,由于病毒是在寄主体外的,病毒失活了。"DelayedSeroconversion".WehaveallheardhorrorstoriesofpeoplewhotestnegativeforYEARS,evendecades,somehowbeinginfectedwithouthavingaPOSHIVtest.Thisisabunchof"youknowwhat".Itdoesn'thappen,itisanurbanmyth.Ifapersonhastransmittedthevirus,theywilltestpos,actuallyquiterapidly(usuallywithin6weeksofexposure).3monthswillgiveapersonwithanexposureaconclusiveresult.IfapersondoesnottestPOSforHIV3monthsafteranexposure,thentheydidnotcontractHIV.TheONLYexceptiontothisispeoplewhohaveliterallyNOimmunesystemwhomaytakelongertoproduceantibodies.Thiswouldincludeanextremelysmallportionofthepopulation,andwouldincludesituationssuchas....apersontakinganti-rejectionmedspostanorgantransplant,apersononaggressivechemotherapy,orapersonwithterminal,endstagecancer,again...peoplewhohaveNOimmunity.Eventhis"delayed"seroconversionamongthissmallpopulationishighlydebatedamongmedicalprofessionals.EvenpeopleinthesecategoriesusuallytestPOSwithinthe3monthwindowperiod,butasaprecaution,itisrecommendedthatpeoplewithseverelycompromisedimmunesystemstestto6monthspostanexposure.NOONEELSENEEDSTOTESTBEYOND3MONTHS.IfapersonwasprescribedPEP("PostExposureProphylaxis),thentheyneedtotest3monthsaftertheirLASTdoseofPEP.
“延迟的血清转化”。我们都听说过很恐惧的故事,比如不知道为什么感染之后几年,甚至几十年一直检测为阴性而检查不出来。这就是一堆“你知道吗?(译注:直译,应该就是以谣传讹的人的开头语)”。根本就没那么回事,仅仅是一个乡间传说。假如一个人感染了HIV病毒,实际来说很快就可以查出来(通常是高危后6周以内)。(译注:美国的版主一样支持6周论)3个月将是终极的结果。假如3个月之后的检查是阴性的话那么这个人没有感染HIV。唯一的例外就是那些免疫系统几乎完全丧失的人可能需要更长的时间产生抗体。这些人包括极小一部分先天免疫缺陷的,和后天免疫缺陷的,比如接受器官移植的采纳了免疫抑制药物的,正在接受化疗的,癌症晚期的,还有,没有免疫能力的人。即使这些人血清转化的“延迟”在医学专业领域也饱受争议。即使这些人通常也在符合3个月窗口期之说,但是为了保险起见,还是建议那些有免疫缺陷的人查到6个月。再没有其他人需要查到3个月以后。假如服用了阻断药物(PEP),那要在服用最后一剂PEP的3个月之后检测。
"AutoimmuneDisorders".ThisisoftenconfusedwithwhatIdiscussedabove.Autoimmunedisorders(ierheumatoidarthritis)arecompletelydifferentfromapersonwithaseverelycompromisedimmunesystem,fromchemo,etc.ThepresenceofanautoimmunedisorderdoesNOTchangethetestingguidelineswhatsoever,anditwillnotaffectthetestresults.
“自身免疫功能紊乱”。这经常和我上面所说的免疫缺陷混淆。自身免疫性疾病(比如风湿性关节炎)和由于化疗等原因造成的严重的免疫系统缺陷完全不同。自身免疫功能紊乱不影响检测时间的指南,也不影响检测结果。
"BloodtoBloodExposures".Wegetquestionsaboutthisallthetime.HIVisclassifiedasa"bloodbornepathogen",whichiswherealotofthisfearcomesfrom.Itbasicallymeansthatthevirushastoreachthebloodstream.Insexualexposures,itdoesthisthroughthemucousmembranesofthevaginaoranus,whichareVERYvascular,withveryeasyaccesstothevascularsystem.Inaneedlesharingscenario,apersonisinjectinginfectedbloodDIRECTLYintotheirbloodstream.ThesesituationsareVERYdifferentfromasuperficialskin"exposure":
“血液到血液的暴露”。我们总能碰到这样的题目。HIV被列为“血源性病原”,这也就是很多恐惧来源的地方。简单来说就是病毒要进入血液循环系统。性暴露中,病毒通过阴道或直肠的的粘膜,这些粘膜有着丰富的血管,是病毒极易进入血管系统的通道。对于共用针具的情况,就是一个人直接将感染者的血液注入他们的血液循环系统中。这些情况和表皮曾所谓的“暴露”有极大的不同。
Someonehasacutandwasexposedtosomeoneelse'scut.Thisdoesnotposeariskformanyreasons.First,theskinservesasanEXCELLENTbarriertothevirus.Theskiniscomprisedofseverallayers,andinjuries,likepapercuts,etc...beginhealingIMMEDIATELYfromtheinsideout.Therefore,evenifthereISasuperficialabrasion/laceration,itwillnotallowthevirustopenetratedeepenoughtoreachthebloodstream,whichiswhathastohappenforinfection.InaVERYseverescenario,theremaybearisk....forexample,twopeoplebeinginacaraccidentwithlargemajorhemorrhaginginjurieswherethereisHUGEexposuretotheotherperson'sbloodthroughaverysignificant(deep)injury.However,again...beingexposedtosomeoneelse'sbloodinsmallamounts,evenwithasmallcut,willNOTplaceyouatrisk. |
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