Friedman Samuel R, Rossi Diana
1National Development and Research Institutes , New York, New York , USA.
Subst Use Misuse. 2015;50(7):899-902. doi: 10.3109/10826084.2015.1018752.
The term "Big Events" began as a way to help understand how wars, transitions and other crises shape long-term HIV epidemiology in affected areas. It directs attention to the roles of ordinary people in shaping these outcomes. Big Events themselves can take years, as in long-term armed struggles like those in Colombia and also long-term political and economic changes like the turn over the last 15 years of many Latin American countries away from neoliberalism and towards attempts to build solidarity economies of some form. The effects of Big Events on HIV epidemics, at least, may run in phases: In the short term, by creating vulnerability to epidemic outbreaks among existing Key Populations like people who inject drugs (PWID) or men who have sex with men (MSM); then, in their non-PWID (or non-MSM) risk networks; and perhaps, several years later, among youth who became involved in high-risk sexual or drug use networks and behaviors due to the social impacts of the Big Event. Issues of time loom large in other articles in this Special Issue as well. Some articles and commentaries in this issue point to another important phenomenon that should be studied more: The positive contributions that people who use drugs and other members of the population make towards helping other people in their communities during and after Big Events. Finally, this Commentary calls for more thought and research about an impending very Big Event, global climate change, and how it may exacerbate HIV, hepatitis C and other epidemics among people who use drugs and other members of their networks and communities.
“重大事件”这一术语最初是为了帮助理解战争、转型及其他危机如何塑造受影响地区的长期艾滋病毒流行病学情况。它将关注点引向普通人在塑造这些结果中所起的作用。重大事件本身可能会持续数年，比如哥伦比亚的长期武装斗争，以及过去15年许多拉丁美洲国家从新自由主义转向尝试构建某种形式的团结经济的长期政治和经济变革。至少，重大事件对艾滋病毒流行的影响可能会分阶段显现：短期内，会使现有重点人群（如注射吸毒者或男男性行为者）更容易爆发疫情；接着，在非注射吸毒者（或非男男性行为者）的风险网络中显现；或许在数年之后，在因重大事件的社会影响而卷入高风险性行为或吸毒网络及行为的年轻人中显现。时间问题在本期特刊的其他文章中也很突出。本期的一些文章和评论指出了另一个应深入研究的重要现象：吸毒者及其他人群在重大事件期间及之后对帮助社区内其他人所做出的积极贡献。最后，本评论呼吁更多地思考和研究一个即将到来的非常重大的事件，即全球气候变化，以及它可能如何加剧吸毒者及其网络和社区内其他人群中的艾滋病毒、丙型肝炎及其他疫情。
