《HIV的真相》--------译自Medhelp 看来美国支持6周检测3月复检

fjgoodluck

以下是Medhelp艾防社区“三巨头”（Teak，LIZZIE LOU，nursegirl6572）之一的nursegirl6572最近发的一篇反恐巨作。nursegirl6572是一位在几乎所有的医护领域工作过的有16年工作经验的注册护士。原始链接：http://www.medhelp.org/user_jour ... ersonal_page_id=434
"Delayed Seroconversion".  We have all heard horror stories of people who test negative for YEARS, even decades, somehow being infected without having a POS HIV test.  This is a bunch of "you know what".  It doesn't happen, it is an urban myth.  If a person has transmitted the virus, they will test pos, actually quite rapidly (usually within 6 weeks of exposure).  3 months will give a person with an exposure a conclusive result.  If a person does not test POS for HIV 3 months after an exposure, then they did not contract HIV.  The ONLY exception to this is people who have literally NO immune system who may take longer to produce antibodies.  This would include an extremely small portion of the population, and would include situations such as....a person taking anti-rejection meds post an organ transplant, a person on aggressive chemotherapy, or a person with terminal, end stage cancer, again...people who have NO immunity.  Even this "delayed" seroconversion among this small population is highly debated among medical professionals.  Even people in these categories usually test POS within the 3 month window period, but as a precaution, it is recommended that people with severely compromised immune systems test to 6 months post an exposure.  NO ONE ELSE NEEDS TO TEST BEYOND 3 MONTHS.  If a person was prescribed PEP ("Post Exposure Prophylaxis), then they need to test 3 months after their LAST dose of PEP.
“延迟的血清转化”。我们都听说过很恐怖的故事，比如不知道为什么感染之后几年，甚至几十年一直检测为阴性而检查不出来。这就是一堆“你知道吗？（译注：直译，应该就是以讹传讹的人的开头语）”。根本就没那么回事，仅仅是一个乡间传说。如果一个人感染了HIV病毒，实际来说很快就可以查出来（通常是高危后6周以内）。（译注：美国的版主一样支持6周论）3个月将是最终的结果。如果3个月之后的检查是阴性的话那么这个人没有感染HIV。唯一的例外就是那些免疫系统几乎完全丧失的人可能需要更长的时间产生抗体。这些人包括极小一部分先天免疫缺陷的，和后天免疫缺陷的，比如接受器官移植的采用了免疫抑制药物的，正在接受化疗的，癌症晚期的，还有，没有免疫能力的人。即使这些人血清转化的“延迟”在医学专业领域也饱受争议。即使这些人通常也在符合3个月窗口期之说，但是为了保险起见，还是建议那些有免疫缺陷的人查到6个月。再没有其他人需要查到3个月以后。如果服用了阻断药物（PEP），那要在服用最后一剂PEP的3个月之后检测。
"Autoimmune Disorders".   This is often confused with what I discussed above.  Autoimmune disorders (ie rheumatoid arthritis) are completely different from a person with a severely compromised immune system, from chemo, etc.  The presence of an autoimmune disorder does NOT change the testing guidelines whatsoever, and it will not affect the test results.
“自身免疫功能紊乱”。这经常和我上面所说的免疫缺陷混淆。自身免疫性疾病（比如风湿性关节炎）和由于化疗等原因造成的严重的免疫系统缺陷完全不同。自身免疫功能紊乱不影响检测时间的指南，也不影响检测结果。
The Great ORAL Debate.  This is probably our most common question.  Unprotected oral sex.  Is it a risk?  The short answer: NO.  The long answer....
关于口交的大讨论。这可能是我们最常见的问题。无保护的口交。有风险吗？简单回答：没有。拆开来说…
There is often a difference in the answers given by the docs in the expert forum vs us.  People have to understand that medical professionals and the CDC have a responsibility to be ULTRA conservative when discussing risks.  Therefore, there is a MINUTE "theoretical" risk assigned to oral sex.  If oral sex was TRULY a "real" risk, there would be new cases all the time of HIV being transmitted in this manner.  There absolutely is NOT.  And a "theoretical" risk is VERY different from an actual risk.  The docs have BOTH said time and time again in the expert forum that neither of them, in their combined DECADES of being specialists dealing with HIV have EVER seen a case of HIV as a result of oral sex, nor have they READ any convincing cases.  There is a physiological reason for that.  First, the virus isn't present in the saliva, making infection impossible for the receptive partner (the person receiving oral sex).  Secondly, for the person GIVING oral sex, THEIR saliva contains enzymes that inhibit the virus, should they be exposed to infected genital secretions.  Secondly, again, the virus has been exposed to the air and elements, rendering it inactive in an oral situation.  This debate will continue, but again, for anyone worrying about an oral "exposure"...think of the facts.  If it was truly a risk, there would be newly reported cases ALL the time.
通常我们的回答和专家论坛的答案有所不同。大家要明白一点，医学专家和CDC在讨论行为风险的时候有必要保持过度的保守。所以，口交是有一个极小的所谓的“理论”风险。如果口交真有“事实”的风险的话，那么应该总能发现一些通过这种行为感染的新病例。但是绝对没有。同时“理论”的风险和实际的风险有很大的不同。专家版块的两位专家（译注：Dr.HHH和Dr.Hook）经常说，在他们两个作为HIV专家几十年从来没见过一例通过口交感染的例子，和没有看到过任何可信的报道。这里有一个生理学的原因。首先，口水中是没有病毒的（译注：不足以感染的病毒含量）所以口交的接受方是不可能感染的。其次，对以口交的主动方，他们的口水中有多种酶可以抑制病毒，如果他们暴露于感染性的生殖器分泌液。再次，在口交的过程中，病毒已经暴露于外部环境中，已经失活。这个争论还会继续，但是再说一次，如果谁担心口交的风险，那么请想想这些事实。如果真是个有风险的行为，那应该总有新的案例报道。
HIV is classified as an STD, which means, basically, one has to have SEX to be at risk.  This leads me to the primary REAL risks of becoming infected.  They are UNPROTECTED VAGINAL OR ANAL SEX, sharing IV drug works, and from mother to infant.  Sexually, there are certainly higher risks.  Homosexual men having sex with other men still remains a higher risk, with a "bottom" anal sex partner having unprotected sex being about the highest risk factor.  HOWEVER...despite this information....HIV is still on the rise among heterosexual partners.  While it is less of a risk, it is still a risk!  And, despite the "odds" out there, it IS possible to get HIV from only ONE episode of unprotected hetero sex.  Who wants to take those kinds of chances?  Therefore, remember to protect yourself at all costs.  ONE moment of pleasure for a lifetime of dealing with a chronic illness?  Seems like one heck of an exchange!
保护措施。HIV是可以100%预防的疾病。安全套是有用的。所以，坚持正确使用安全套几乎可以担保一辈子都与HIV无缘。口交过程中是否使用安全套由个人决定。安全套也是推荐用来预防其他性病的措施，这些性病要流行的多得多，而且很容易通过口交感染。当发生性行为时，遵守一个规则，首先，和对方开诚布公地谈一下彼此的交往史，尽量问清楚他们的过去，是否检测过等。谁要是逃避这个问题，或者拒绝回答，那么请你走开。除非双方都检测过的一夫一妻的性行为，否则无保护的行为绝不可取。男性，选择一款合适大小的安全套，一次只使用一只安全套。有些人认为两只安全套提供双重的保护。恰恰相反，两只安全套增加了安全套失效的风险。使用水性的润滑剂，比如KY果冻；如果怀疑安全套的质量就换一只。确定安全套没有过期，因为这也会增加安全套破裂的风险。如果安全套破裂，是有风险的。这是无疑的。所以，如果你使用一只安全套，在性行为结束之后，安全套是完整的，那么安全套的保护是有效的。还要记住一点，在抽出的时候用手握住安全套，者可以防止滑落，这个和HIV的风险无关，主要是考虑预防其他性病。HIV病毒可以穿透完好的安全套也是一个相见传说。唯一的例外是羊皮套，它不能预防HIV（译注：估计很多人见都没见，不用管他）。只有乳胶或聚亚安酯安全套可以预防HIV。
Lastly, if you feel you've had a risk, then get tested.  There is NO reason not to.  Anxiety is NO excuse not to get tested.  "Not knowing" doesn't change your test result...it just delays possible life-saving treatment, not to mention, may keep you from the likely relief of a negative result.  HIV education is vital....and in this day and age, not ONE more person should be getting infected.  It is completely avoidable.
最后，如果你认为你有过高危行为，那么就去检测。没有理由不去。焦虑不是去检测的理由。“不敢去检测”也不能改变检测的结果。而这仅仅是拖延了救命的时间而已，更别提在绝大多数的情况下这只是让事实阴性的你在恐惧中煎熬的更久而已。HIV的宣传教育很重要，就目前来说，不应该有更多的人被感染。这完全可以避免的。
If you have been tested, and your result is NEG at 3 months, you do NOT have HIV, despite any "symptoms" you are sure you have.  One can NEVER EVER gauge a risk by physical symptoms.  Newly infected people many times do not experience any ARS symptoms, not to mention that ARS symptoms are also VERY consistent with thousands of other common, non-HIV illnesses, infections.  If you have had a NO RISK situation, or have tested NEGATIVE at 3 months, or both...and you simply CANNOT move on, cannot convince yourself that you do not have HIV, then it is time to seek professional help for yourself.  HIV phobias/anxiety is sadly pretty common.  One can see that by reading either of the HIV forums here on MH.  Continuing to search the internet is the absolute WORST thing you could do in that situation.  That would be synonomous with a person with a severe snake phobia throwing themselves into a snake pit day after day..  Doesn't make much sense, does it?
如果你检查完了，3个月的检查结果是阴性的，那么你没有被感染，尽管许多“症状”然你觉得你感染了。不要用身体的症状来判断你的风险。大多数的新近的感染者是没有任何急性期症状的，更别谈所谓急性期症状和其他成千上万的普通，非HIV的感染相似。如果你的行为没有风险，或者说3个月之后的检查是阴性的，或者两者都是，而你却不能脱恐，不能说服自己没有感染HIV，那么是寻求专业人士帮助的时候了。恐艾症如此普遍令人感觉遗憾。大家可以看看我们的两个论坛就知道了（译注：支持版块和专家版块）。不断搜索网络可能是在这种情况下你所能做的绝对是最糟糕的事。相当于一个惧怕蛇的人日不一日地反复把自己扔进蛇窟的愚蠢的行为。这有意思吗？