Mane P, Aggleton P, Dowsett G, Parker R, Gupta G R, Anderson S, Bertozzi S, Chevallier E, Clark M, Kaleeba N, Kingma S, Manthey G, Smedberg M, Timberlake S
Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland.
AIDS. 1996 Dec;10 Suppl 3:S123-32.
This review summarizes the main issues discussed during Track D, which examined the societal impact of HIV/AIDS, and responses to the epidemic by individuals, families, communities and societies worldwide. Micro- and macrolevel issues addressed included the development, implementation and evaluation of programmes for prevention and care; policy development and implementation; structural issues such as the impact of gender relations, development and migration on the development of the epidemic; and the social and economic impact of HIV/AIDS on affected societies and communities.
Presentations provided strong evidence that peer-led, community-based programmes offer particularly effective ways of working, and that participatory research involving affected communities provides useful results for the design and evaluation of programmes and policies. This is the case across settings, issues, populations and countries.
Emerging needs include how best to ensure sustainability of national and international responses, how best to scale up successful interventions for wider reach, and how best to work with systematically marginalized, neglected groups and populations. Research priorities include the characterization of the multiple determinants of HIV-related vulnerability, and the evaluation of interventions that take these complex determinants as their starting point. A more coherent and strategic response requires less separation between the different constituencies involved in AIDS work, and the more sustained involvement of people living with HIV/AIDS themselves.
本综述总结了D专题讨论的主要问题，该专题审视了艾滋病毒/艾滋病对社会的影响，以及全世界个人、家庭、社区和社会对这一流行病的应对措施。所涉及的微观和宏观层面的问题包括预防和护理方案的制定、实施和评估；政策制定和实施；诸如性别关系、发展和移徙对该流行病发展的影响等结构性问题；以及艾滋病毒/艾滋病对受影响社会和社区的社会和经济影响。
发言提供了有力证据，表明由同伴主导、基于社区的方案提供了特别有效的工作方式，并且涉及受影响社区的参与性研究为方案和政策的设计与评估提供了有用成果。在各种背景、问题、人群和国家都是如此。
新出现的需求包括如何最好地确保国家和国际应对措施的可持续性，如何最好地扩大成功干预措施的规模以扩大覆盖面，以及如何最好地与系统性边缘化、被忽视的群体和人群合作。研究重点包括确定与艾滋病毒相关的脆弱性的多重决定因素，并评估以这些复杂决定因素为出发点的干预措施。更连贯和更具战略性的应对措施需要减少参与艾滋病工作的不同群体之间的分隔，并需要艾滋病毒/艾滋病感染者更持续地参与。
