Barnett T, Whiteside A, Khodakevich L, Kruglov Y, Steshenko V
School of Development Studies, University of East Anglia, Norwich, UK.
Soc Sci Med. 2000 Nov;51(9):1387-403. doi: 10.1016/s0277-9536(00)00104-0.
Present and immediately foreseeable medical knowledge suggest that HIV infection cannot be avoided by vaccination and that an affordable cure for the resulting syndrome, AIDS, is a long way off. There is a strong possibility that Ukraine is confronted by an HIV epidemic which will spread into the general population and that the most common mode of transmission will be through heterosexual intercourse. The epidemic in the Ukraine is currently concentrated among intravenous drug users. It is estimated that between 60,000 and 180,000 people may currently be infected. In present economic and social circumstances there are many features of Ukrainian society that may add to the probability of the epidemic becoming widespread in the general population. It is likely that this process may have already commenced. The result of this will be numerous additional deaths and illness over the short (5 year) (19,000-23,000 deaths), medium (10-15 year) (61,000-111,000), and longer terms (>20 year) (in excess of 40,000-160,000 deaths). The research reported here was undertaken in 1997-8 and describes the potential medium to long term social and economic impact of an HIV/AIDS epidemic in Ukraine. Using the concepts of risk environment, susceptibility and vulnerability, it reports the problems which might be expected to develop in relation to care of excess orphans, the elderly, vulnerable households and regions as well as among those working in the "third sector", a social sector upon which exponents of the importance of developing sound "civil society" in "transitional economies" place heavy emphasis.
目前及近期可预见的医学知识表明，无法通过接种疫苗避免感染艾滋病毒，而且找到一种可负担得起的方法治愈由此引发的综合征——艾滋病，仍遥遥无期。乌克兰极有可能面临一场艾滋病毒疫情，疫情将蔓延至普通人群，而最常见的传播方式将是异性性行为。乌克兰的疫情目前集中在静脉注射吸毒者中。据估计，目前可能有6万至18万人受到感染。在当前的经济和社会环境下，乌克兰社会的许多特征可能会增加疫情在普通人群中广泛传播的可能性。这一过程可能已经开始。其结果将是在短期（5年）（1.9万至2.3万人死亡）、中期（10至15年）（6.1万至11.1万人死亡）和长期（超过20年）（超过4万至16万人死亡）内出现大量额外的死亡和疾病。此处报告的研究于1997年至1998年进行，描述了艾滋病毒/艾滋病疫情在乌克兰可能产生的中长期社会和经济影响。该研究运用风险环境、易感性和脆弱性等概念，报告了在照顾过多孤儿、老年人、脆弱家庭和地区以及“第三部门”工作人员（在“转型经济体”中，倡导建立健全“公民社会”的重要性的人士高度重视这一社会部门）方面可能出现的问题。
