Short R V
University of Melbourne Department of Obstetrics and Gynaecology 132 Grattan Street, Carlton Vic. 3053, Australia.
Philos Trans R Soc Lond B Biol Sci. 2006 May 29;361(1469):811-20. doi: 10.1098/rstb.2005.1781.
HIV infection is the greatest health crisis in human history. It continues to spread unchecked among the poor in the developing world because we have failed to design simple preventative methods that are available and affordable to those living on under Dollars 2 a day. Five new methods are discussed. (i) A natural microbicide. Intravaginal lime or lemon juice has been used for centuries as a traditional contraceptive. The juice can also kill HIV in the laboratory, but clinical trials are needed to see if vaginal application is acceptable, safe and effective. (ii) Intravaginal oestrogen. Monkeys can be protected from Simian immunodeficiency virus (SIV) infection by keratinizing the vagina with topical oestrogen. If women take the oral contraceptive pill vaginally it retains its contraceptive efficacy, and the oestrogen it contains should thicken the vagina and protect against HIV infection. Clinical trials are needed. (iii) Male circumcision. Removal of the inner foreskin removes the main site of HIV entry into the penis, resulting in a sevenfold reduction in susceptibility to infection. The practice needs to be promoted. (iv) Post-coital penile hygiene. Wiping the penis immediately after intercourse with lime or lemon juice or vinegar should kill the virus before it has had a chance to infect. A clinical trial of efficacy is needed. (v) PhotoVoice. Asking schoolchildren in developing countries to photograph their impressions of HIV/AIDS is a powerful way of getting them to discuss the subject openly, and develop their own preventative strategies.
艾滋病毒感染是人类历史上最严重的健康危机。它在发展中国家的贫困人口中持续 unchecked 地传播，因为我们未能设计出简单的预防方法，让那些每天生活费不足两美元的人能够获得且负担得起。本文讨论了五种新方法。（i）天然杀菌剂。阴道内使用石灰或柠檬汁作为传统避孕方法已有数百年历史。这种汁液在实验室中也能杀死艾滋病毒，但需要进行临床试验，以确定阴道给药是否可接受、安全且有效。（ii）阴道内使用雌激素。通过局部使用雌激素使阴道角质化，猴子可免受猴免疫缺陷病毒（SIV）感染。如果女性阴道内使用口服避孕药，它仍能保持避孕效果，且其中含有的雌激素应能使阴道变厚并预防艾滋病毒感染。需要进行临床试验。（iii）男性包皮环切术。切除包皮内板可消除艾滋病毒进入阴茎的主要部位，使感染易感性降低七倍。这种做法需要推广。（iv）性交后阴茎卫生。性交后立即用石灰、柠檬汁或醋擦拭阴茎，应能在病毒有机会感染之前将其杀死。需要进行疗效临床试验。（v）摄影发声法。让发展中国家的学童拍摄他们对艾滋病毒/艾滋病的印象，是促使他们公开讨论该主题并制定自己预防策略的有力方式。 （注：“unchecked”原词有误，推测可能是“unchecked”，意为“未受抑制的”，这里按此翻译）
