治疗艾滋的暴露前预防疗法

治疗艾滋的暴露前预防疗法

During the more than 30 years of the HIV/AIDS epidemic 1, the overwhelming majority of infections have happened during sex. Much has been done to promote safe sex, such as condom use, behavior change and even abstinence. But the growing use of antiretroviral drugs to prevent infection has changed the lives of many people living with HIV and their uninfected partners.

在艾滋病毒、艾滋病出现的30多年内，绝大多数感染是通过性传播的。我们在促进安全性行为方面做了很多努力，包括安全套的使用、行为改变甚至节欲。但用于预防感染的抗逆转录药物的推广使用改变了很多艾滋病毒携带者和被感染伴侣的生活。

A lot of science was presented at the International AIDS Conference on HIV Pathogenesis, Treatment and Prevention in Vancouver, also known as IAS 2015. But one of the presenters 2 was not a scientist. Damon Jacobs is a marriage and family therapist in New York City.

在温哥华举行的国际艾滋病协会的艾滋病病理、治疗和预防会议上(IAS 2015)宣传了很多科学知识，但其中一位发言人并不是科学家，达蒙·雅各布斯是纽约市的一位婚姻与家庭治疗师。

For the past four years, Jacobs has been on PrEP, or pre-exposure prophylaxis. Studies show the use of antiretroviral drugs dramatically reduces the risk of HIV transmission by lowering the amount of virus to near imperceptible levels. And when uninfected people take PrEP, it offers a lot of protection.

过去四年来，雅各布斯一直在接受暴露前预防(PrEP)，研究表明使用抗逆转录药物能将病毒量降低到几乎无法觉察的水平，从而极大地降低艾滋病毒传播的风险。当未感染的人接受暴露前预防时，这种方法能提供很多保护。

Jacobs began his presentation by swallowing a single pill as part of his daily PrEP regimen.

雅各布斯在开始做陈述前吞服了一片药丸，这是他每日暴露前预防疗法的一部分。

“Ok. Four years and one day – applause – It has now been four years and one day that I have been actively 3 using PrEP. And as Dr. Graham mentioned, toward the end of 2012 starting to speak and teach and help people learn about this.”

“我用暴露前预防疗法已经四年零一天了，正如格拉汉姆教授所说，从2012年底开始我就开始谈论这个，并帮助人们了解这个疗法。”

But Jacobs was not at the conference to talk about facts and figures relating to PrEP.

但雅各布斯来参加会议并不是要谈论有关暴露前预防疗法的事实和数据的。

He said, “I am just so in awe 4 of all the researchers here and all the research I’ve been hearing all week. But there’s one thing that I think gets left out of these conversations time and time again. And that is the role of pleasure in these talks. Why are we here? Why are we still at IAS? Why are we still having two million new infections in the world every year? Because people are having sex for pleasure. Because people want to feel good.”

他说，“整个一周，看到所有这些研究者，听到所有这些研究报告，我感到敬畏。但在我们的探讨中有一件事总是被漏掉，那就是乐趣在这些探讨中的角色，我们为什么来这里？我们为什么参加IAS 2015大会？为何全世界每年新增200万个新感染病例？因为人们是为了乐趣而进行性行为，因为人们只想感觉良好。”

The therapist said that people want “maximal pleasure with minimal 5 consequences and lower medical risks.”

这位治疗师称，人们想“以最小的后果和最低的医疗风险来换取最大的乐趣”。

“If we ignore that or dismiss that or judge that or condemn 6 it or somehow sort of leave it out of the room because we don’t think it’s really important, we’re missing a lot. We’re missing a lot of opportunities to reach out – to build that trust that you were speaking about, which is so very important in these relationships. And to help the communities that we care about and the people we love have these experiences that they want to have -- the freedom that was mentioned earlier that they want to have. And it would be so easy to forget about that,” he said.

“如果我们觉得这一点不重要，忽视或无视它，或者对之进行评价或谴责，或者置于一边不理，那么我们就会错失很多。我们会错失很多能抓住的机会：构建你们所谈论的信任，而信任是这些关系中很重要的东西。帮助我们关心的社区和我们所爱的人获得他们希望获得的体验，像我们之前提到的那样，获得他们希望获得的自由。这一点是很容易忘记的。”

While the acronym 7 PrEP is short for pre-exposure prophylaxis, Jacobs said it also means something else for users.

尽管PrEP这个缩写代表暴露前预防，雅各布斯说对使用者来说它还意味着很多。

“For myself and the actually now 7,500 members of the PrEP group online, PrEP has come to mean something very, very different. Well, not very different, but a little different. The acronym we like to use is Pro-active Responsible Empowered Pleasure.”

“对我和在线的PrEP组织7500名成员来说，PrEP必须意味着非常不同的东西。不是非常不同，而是有点不同。我们喜欢使用的词是‘积极、负责赋权的快乐’。”

He said it means users take “responsible action” in advance to ensure HIV does not spread in the community. He added it empowers men and women to have full control over their HIV status.

他说这意味着使用者事先采取“负责的行动”来确保艾滋病毒不在社区内传播，同时能赋权男人和女人，使之能完全掌控自己的艾滋病病情。

“After this week is over – after we’ve left Vancouver and those beautiful sunsets out there – and we’ve gone home to wherever it is – let’s please not forget the pleasure component 8 in our work. It is such an important part of life. It is such an important part of helping 9 our communities heal and move forward and implement 10 all these exciting, amazing changes that we’re hearing about this week here at IAS,” he said.

“这周结束后，我们将离开温哥华和这里美丽的傍晚，我们将各自回家，让我们不要忘记我们工作中的快乐成分，它是人生重要的组成部分，能帮助我们的社区愈合并前进，来做出我们在IAS大会山所谈论的所有令人激动、惊讶的改变。”

Jacobs is the author of several books, including "Rational Relating – The Smart Way to Stay Sane 11 in the Crazy World of Love."

雅各布斯写了几本书，包括《定量叙述—在疯狂的爱的世界保持明智的理智方法》。