對當前藥物濫用和艾滋病預防策略的反思

Abstract

The prospect of drug use and HIV epidemic cannot be optimist in China. More and more people, mainly young men or women use drug and are infected with HIV, while the effective intervention is short. The preventive measures usually are aimed at the target of the general public, but cannot meet the demand of diverse social groups. Traditional ideology in China is that individual should be subordinated to community, community to the society at large, and marginalized group to mainstream group. It follows from th.is ideology that preventive method is stereotyped with same pattern to everyone and cannot meet various demands of various target groups. In China drug use is traditionally deemed as a sin or crime to her/his family, country and nation, and should be severely punished. But this attitude toward drug users is unfair. Drug use itself does not offend China's criminal Jaw, and does not do harm to others, society and country. There is no legal basis to treat drug users as criminals, and put them into addiction release rehabilitation farms that are built with the money of taxpayers. This practice is useless to control drug use and spread of HTV infection. The moral judgment of drug use as moral deterioration also caused negative impact on the control of drug use and HIV prevention. The change of a fixed behaviour is very difficult, but substituting a behaviour with another is easier than prohibiting it. It has been shown by the success of programmes providing methadone, clean needles or/and syringes, disinfected water etc. However, all of these programmes are difficult to be introduced and implemented in China, because one concept has to be built, i.e. a drug user is a patient, but not a criminal. 流行學的調查數據表明，我國目前藥物濫用和艾滋病發展的趨勢不容樂觀。本文力圖從倫理道德的角度和公共衛生的觀點討論我國現行的一些預防藥物濫用和艾滋病的策略和措施，并介紹一些國外在這方面工作的成功經驗。希望既往的教訓，他人的成功經驗以及現代科學技術的研究成果能改變我們對藥物濫用的負性態度和看法。從而能在公共衛生政策的制訂及實際項目的實施方面做出必要的調整，這樣才有利於保護公眾的健康和個人的正當權利。