Loewenson R
Training and Research Support Centre (TARSC), UNRISD Programme on Community Responses to AIDS, Geneva, Switzerland.
AIDS Care. 2007;19 Suppl 1:S83-90. doi: 10.1080/09540120601114733.
This paper situates the findings of the diverse studies reported in this journal supplement in a global context that both fuels the epidemic through inequality and poverty and also provides new opportunities for global commitments, solidarity and resources. The studies in this issue signal that, while information and awareness about HIV and AIDS is now high, there is still poor access to services for people to know their own risk and a deeper need to address the asymmetries of power and access to resources that influence the control people have over their sexual relationships and lives. The studies in this supplement describe, in very different contexts, responses to the impact of AIDS that are grounded within the actions of individuals, households and extended families, against a background of existing disadvantage in assets, endowment and access to state and private sector resources. Community networks reduce social isolation and provide solidarity to households struggling to respond to AIDS. The extra work involved is often done by women, particularly where the weakening of the state has left communities disadvantaged. The paper argues that connections across communities to support survival need vertical links to national and global resources, services and markets to support, sustain and transform lives. The studies demonstrate the positive effect of this through primary healthcare systems, non-government organisation support and the social movements of people living with HIV and AIDS. If the first wave of the global response to AIDS built awareness and an emergency response to prevention, treatment and care, there is now need for a 'second wave' that provides strong measures to connect communities to social, national and global resources. Elements of this 'second wave' include people's--especially women and young people's--access to services to know their individual risk, measures that enhance their autonomy and the need for a massive increase in investment in and access to decent work.
本论文将本期刊增刊中所报道的各类研究结果置于一个全球背景之下，这一背景既通过不平等和贫困助长了这一流行病，同时也为全球承诺、团结及资源提供了新机遇。本期的研究表明，虽然目前人们对艾滋病毒和艾滋病的信息及认识程度较高，但人们了解自身风险的服务获取情况仍然不佳，而且更迫切需要解决影响人们对其性关系及生活掌控权的权力不对称和资源获取问题。本增刊中的研究描述了在截然不同的背景下，个人、家庭及大家庭在资产、禀赋以及获取国家和私营部门资源方面存在现有劣势的情况下，针对艾滋病影响所做出的应对措施。社区网络减少了社会孤立，并为努力应对艾滋病的家庭提供了支持。额外的工作往往由女性承担，尤其是在国家力量削弱导致社区处于不利地位的情况下。本文认为，社区之间为支持生存而建立的联系需要与国家和全球资源、服务及市场建立纵向联系，以支持、维持并改变生活。研究通过初级医疗保健系统、非政府组织的支持以及艾滋病毒感染者和艾滋病患者的社会运动证明了这一点的积极效果。如果全球对艾滋病的第一波应对建立了认识并对预防、治疗和护理做出了应急反应，那么现在就需要“第二波”应对措施，即采取有力措施将社区与社会、国家和全球资源联系起来。这一“第二波”应对措施的要素包括人们——尤其是妇女和年轻人——获取了解自身个体风险的服务、增强其自主权的措施，以及大幅增加对体面工作的投资并改善获取体面工作机会的必要性。
