Henry K
Department of Medicine, St. Paul-Ramsey Medical Center, MN 55101.
Am J Public Health. 1988 Sep;78(9):1210-2. doi: 10.2105/ajph.78.9.1210.
The approach to the acquired immune deficiency syndrome (AIDS) taken by public health departments and clinicians varies. Public health programs often neglect the human side of AIDS while clinicians often overlook public health issues. Current research on AIDS has failed to address many fundamental questions including: the biology of the human immunodeficiency virus (HIV) in semen; whether present antiretroviral therapy has any effect on sexual infectivity; and whether adequate counseling was given to persons in HIV discordant partner studies. These unanswered basic questions highlight how research efforts framed from clinical, basic science, or public health viewpoints may have too narrow a focus. Three suggestions are made: 1) additional studies about the biology of HIV in the genital tract need to be conducted; 2) clinical trials studying drug therapy of HIV infection need to assess effect on HIV in the genital tract; 3) clinicians involved in studies and care of HIV infection need to implement educational strategies minimizing transmission of HIV from their patients. More interaction between public health and clinical approaches toward AIDS is needed.
公共卫生部门和临床医生应对获得性免疫缺陷综合征（艾滋病）的方法各不相同。公共卫生项目往往忽视了艾滋病患者的人性一面，而临床医生则常常忽略公共卫生问题。当前对艾滋病的研究未能解决许多基本问题，包括：精液中人类免疫缺陷病毒（HIV）的生物学特性；现有的抗逆转录病毒疗法对性传播感染性是否有任何影响；以及在HIV不一致伴侣研究中是否对相关人员给予了充分的咨询。这些未得到解答的基本问题凸显出，从临床、基础科学或公共卫生角度开展的研究工作可能关注点过于狭窄。现提出三点建议：1）需要开展更多关于HIV在生殖道中的生物学特性的研究；2）研究HIV感染药物治疗的临床试验需要评估对生殖道中HIV的影响；3）参与HIV感染研究和护理的临床医生需要实施教育策略，尽量减少患者传播HIV。在应对艾滋病方面，公共卫生和临床方法之间需要更多的互动。
