Westerhaus M J, Finnegan A C, Zabulon Y, Mukherjee J S
Harvard Medical School, Boston, MA 02115, USA.
Glob Public Health. 2008;3(1):39-46. doi: 10.1080/17441690600909294.
In settings of armed conflict, traditional HIV prevention programmes that promote risk avoidance via abstinence and fidelity and risk reduction via condom use and needle exchange are not viable. In such contexts, HIV risk depends less on personal choice than on exposure to physical, emotional and structural violence. War in northern Uganda has created three realities (internally displaced people's camps, night commuters and child abductions) which increase vulnerability to HIV transmission. Based upon this analysis of northern Uganda, we offer a conceptual framework for HIV transmission in conflict settings that recognizes the importance of local and global context in creating vulnerability to HIV infection. This framework is then used to delineate strategies for HIV prevention in northern Uganda, namely the provision of a safe physical environment and access to education, medical and psychological support, and the promotion of conflict resolution strategies and human rights law.
在武装冲突环境中，通过禁欲和忠诚来促进风险规避以及通过使用避孕套和针头交换来降低风险的传统艾滋病毒预防方案不可行。在这种情况下，感染艾滋病毒的风险更多地取决于遭受身体、情感和结构性暴力，而非个人选择。乌干达北部的战争造成了三种现实情况（境内流离失所者营地、夜间通勤者和儿童绑架），这些情况增加了艾滋病毒传播的易感性。基于对乌干达北部的这一分析，我们提出了一个冲突环境中艾滋病毒传播的概念框架，该框架认识到当地和全球背景在造成艾滋病毒感染易感性方面的重要性。然后利用这一框架来勾勒乌干达北部艾滋病毒预防战略，即提供安全的物理环境以及获得教育、医疗和心理支持的机会，并促进冲突解决战略和人权法。
