Brady Martha
Family and Development Program, Population Council, New York, NY, USA.
Reprod Health Matters. 2003 Nov;11(22):134-41. doi: 10.1016/s0968-8080(03)02289-4.
The problems and risks of unprotected sex, unintended pregnancy and sexually transmitted infections are inextricably linked. In this context, the critical yet overlooked problem of infertility also needs to be addressed. Dual protection means concurrent protection against unintended pregnancy and STI/HIV. This paper argues for a more comprehensive notion of "triple protection" to include the safeguarding of fertility. This is intended explicitly to draw out the connection between infertility and STIs--using the "visibility" of fertility and infertility and people's immediate connection with them--and in so doing to bolster STI prevention and control efforts. It could also serve to highlight the connections between infertility and unsafe abortion and delivery practices, which still exist in many developing countries. Understanding differences in perception and weighting of protection concerns by young women and men, whether they wish to start, postpone or avoid pregnancy, is essential for the creation of effective programmes. Building on efforts to promote dual protection, a strategic opportunity exists to include prevention of infertility into safer sex messages and to address the fragmentation of reproductive health and HIV/AIDS programmes.
无保护性行为、意外怀孕和性传播感染的问题与风险紧密相连。在此背景下，不孕症这一关键却被忽视的问题也需要得到解决。双重保护意味着同时预防意外怀孕和性传播感染/艾滋病毒。本文主张一种更全面的“三重保护”概念，将生育能力的保护纳入其中。这样做的目的明确是要利用生育能力和不孕症的“可见性”以及人们与之的直接关联，来阐明不孕症与性传播感染之间的联系，从而加强性传播感染的预防和控制工作。这还有助于凸显不孕症与不安全堕胎及分娩做法之间的联系，而这种联系在许多发展中国家依然存在。了解年轻男女在保护问题上的认知差异以及他们对怀孕的意愿，无论是希望开始、推迟还是避免怀孕，对于制定有效的方案至关重要。在促进双重保护的努力基础上，存在一个战略机遇，可将预防不孕症纳入安全性行为信息中，并解决生殖健康和艾滋病毒/艾滋病方案的碎片化问题。
