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"易告知"系统，网络科技对性病艾滋病防治的新尝试 告知，是一种保护也是一份责任
2010年11月12日08:25 来源：人民网-《健康时报》
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| 图示∶2010年12月即将出版的《中国特色医疗金鉴》登载的刘君主任及其机构 |
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2010年的元旦对瞳文（化名）来说就像噩梦一样。
刚吃过午饭，他的手机便响了，跳出一条来自13560029690的短信：“广州市疾病预防控制中心提醒您：您的朋友在本中心检测后给您留言，请登录http://www.gztellthem.org查看或致电查询15920181069/020-83826875文医生或刘医生，您查询的验证码是XXXX”。怀着好奇的心理，瞳文登录了网站。输入验证码后，屏幕上显示出一条信息：“我刚刚被检测出感染艾滋病，我们有过性行为，你也去查查吧！”
看到信息后，瞳文本能地以为这只是一个恶作剧。但他转念想到， 2009年自己曾交过几个同性男友，“也许真是他们中谁给我发的？”瞳文有些犹豫不决。“当时，我每天晚上都睡不着，也无心上班，”瞳文回忆着当时的情景，“我又担心、又害怕，甚至跑去买了意外保险。”
在经历一个月的心理挣扎后，瞳文决定去广州市疾病预防控制中心做检查，结果是阴性。压在他心头的包袱终于落地，晚上他睡了整整10个小时。
最初，瞳文一直想弄清是谁感染了艾滋，但现在他认为这并不重要，“至少他告诉了我，让我去检查，对我是一种保护。”他说，“正是由于匿名，他才会告诉我，我能理解，当面告知是很困难的一件事。”
在中国现在的社会文化环境下，对于性病艾滋病的认识虽有一定的改善，但是短期内还是难以改变长期以来形成的偏见和歧视。将自己感染性病的事告诉性伴侣是很尴尬的事情，但是尽早将这件事告知他们却是非常重要的，因为他们可以及时寻求检测和获得专业治疗。对固定伴侣的告知就更为重要，因为一方没有治疗，就会在两个人之间造成重复感染，甚至加重病情。
梅毒、淋病和衣原体的感染使用抗生素进行规范治疗，是可以治愈的。但如果任其发展，不进行治疗，梅毒会侵犯和损害内脏器官和神经系统，而淋病和衣原体感染会扩散到身体其他部分。因此，将感染性病的事实告知性伴侣，不但有利于自己的健康，也有利于性伴侣的健康，甚至可以使整个社群获益。
瞳文是幸运的，有人告诉他患病的风险，使他及时得到诊断。但在更多男男性接触人群（MSM）中，危险仍然存在。“如果我感染了艾滋病或其他性病，但又不能匿名告知，我就不会去说。”男同志昊天说。
男男性接触人群目前是我国艾滋病感染高危人群，而在他们中性病感染率也较高。2008年全国61个城市开展MSM疫情调查，结果显示全国MSM人群的梅毒感染率为11.9%。
“很多人得知自己感染性病或艾滋病后，不愿意去告诉别人，”小烦（志愿者）说，“他们会担心被歧视，或者被别人恨。” 他表示，由于MSM人群大多是多性伴关系，且这种关系往往不固定，因此告知工作尤其困难。
瞳文朋友所使用的“易告知”解决的就是这个问题。“易告知”是由广州市疾控中心与广州小奇文化传播有限公司合作开发的网络—手机艾滋病性病性伴匿名通知平台。这个平台通过匿名的方式，在保护个人隐私不被泄露的同时，告知潜在感染人群，尽快接受检查或治疗。全国各地的人群均可以使用该平台进行告知。
“易告知”网站主要为感染性病或HIV的朋友提供一个机会，可以用匿名的方式通知性伴侣感染的风险，让他/她们能及时检测、了解自身健康情况。虽然网站主要为与男性有过同性性行为的同志或双性恋群体服务，但任何有需要的人都可以使用本网站。
“易告知”项目实施的资金来自广州市艾滋病防治专项经费，属于中盖艾滋病项目广州市级项目配套经费。广州小奇文化传播有限公司旗下的广同网和岭南伙伴等组织参与了部分广东省中盖艾滋病项目的具体实施。
2008年4月，广州有幸参加了中盖艾滋病项目在青岛举办的“艾滋病高危行为干预培训班”。在培训班上，接触到了国外最新的MSM人群艾滋病预防干预理念和方法，了解到新的性伴告知方式——匿名一对一在线性病艾滋病性伴告知项目“in SPOT”。中盖培训在MSM人群性伴告知的工作上，给了广州很大的启发和指引，培训之后，广州根据项目所学，结合本地实际情况，在深入讨论实施的可行性之后，开始策划和实施“易告知”项目，旨在帮助MSM感染者更好地进行性伴告知，促进检测和控制二代传播。
“易告知”系统建立过程中，一直强调对个人隐私的保护。“我们的基础设施是安全的，目前，未发生过数据失窃情况。”小奇文化传播有限公司项目负责人若哲表示，“我们的系统自动化程度很高，并且对数据进行了加密，不会泄露个人隐私。”
“我们鼓励艾滋病和性病感染者对其性伴进行告知，这是控制艾滋病性病传播的重要策略之一，对及时发现病例和控制二代传播有十分重要的意义。” 广州市疾病预防控制中心艾滋病预防控制科科长徐慧芳说。
“易告知”目前尚处试运行阶段，很多技术也在不断完善中。试运行结果来看，其积极作用是十分值得肯定的。仅2009年12月1日至31日，一个月统计显示，“易告知”的综合浏览量为21956次，访问次数2478，其中独立IP访问者2106人，84.67%为新访问者。91个访问者使用了“易告知”进行性伴匿名告知，其中男性60人（65.9%），女性28人（30.8%），3人未回答性别。91个访问者共发送了159条告知短信，平均每人发送1.7条，其中有128条为HIV告知留言（80.5%），36条为性病告知留言（22.6%，疾病为多选项）。在发出的159条告知短信中，27.0%的收信者（43个）进行了回应，通过“易告知”网页查询了留言内容。可以看出，艾滋病、性病的知识和相关的检测信息以及匿名告知的需求仍然较大。
“易告知”立足广州，服务全国需要帮助的人。只要可以上网，就可以查看网页相关信息；只要拥有中国移动、联通或电信小灵通的通讯号码，就能够收到通过系统发送的信息。
“我相信，易告知将是医生进行告知工作非常好的辅助工具。”广东省皮肤性病防治中心的陈征宇医生说。“易告知”的推出，对艾滋病防制和干预的工作思路，是一种新的启示，也是现代网络科技用于艾滋病干预的一种新尝试。（顾小琛）
"Easy to tell" system, the network of STD and AIDS prevention and control technology to a new attempt this, is a protection is a responsibility
At 8:25 on November 12, 2010 Source: People's Network - "Healthy Times"
New Year's Day 2010, the text of the pupil (a pseudonym) is like a nightmare.
Just had lunch, and his phone is ringing, out of a text message from 13560029690: "Guangzhou Center for Disease Control and Prevention to remind you: your friends in the center of post-test to your message, please visit http://www. gztellthem.org View or call 15920181069/020-83826875 Dr Lau, Dr or your query verification code is XXXX ". Curious psychology, pupil text log of the site. Enter the code, the screen showed a message: "I've just been detected in HIV infection, we had sex, you'll check into it!"
See the information, text can be to think that this pupil is just a joke. But he switched to expect that in 2009 he had had a number of gay boyfriend "is really about who may be issued to me?" Hitomi text some hesitation. "At that time, I can not sleep every night, and too busy to go to work," Wen recalled a pupil at the scene, "I am afraid, afraid, or even go buy the accident insurance."
After one month of the psychological struggle, the pupil decided to go to Guangzhou Wen CDC for check-ups, the result is negative. The burden of pressure in his mind finally landing at night he slept 10 hours.
Initially, the pupil Man has always wanted to find out who is infected with HIV, but now he thinks it is not important, "at least he told me, so I went to check, for me is a kind of protection." He said, "It is because of anonymous, he would tell me, I can understand, this is very difficult to face one thing. "
China is now in the social and cultural environment, AIDS awareness for sexually transmitted diseases, despite some improvement, but the short-term or difficult to change long-standing prejudice and discrimination. Sexually transmitted infection will be told their sexual partners is a very embarrassing thing, but inform them of this matter as soon as it is very important because they can seek prompt detection and access to professional treatment. This fixed the more important partner, because the party no treatment, would result in duplication between the two infections, or even worse.
Syphilis, gonorrhea and chlamydia infection in the standard treatment with antibiotics, can be cured. However, if left unchecked, untreated, syphilis may assault and damage to internal organs and nervous system, while gonorrhea and chlamydia infection may spread to other parts of the body. Therefore, the fact that this sexually transmitted infection in sexual partners, not only conducive to their health, but also conducive to the health of sexual partners, or even the whole community benefits.
Hitomi text is lucky, he was told that the risk of illness, so that he timely diagnosis. However, people in more MSM (MSM), the danger still exists. "If I'm infected with AIDS or other sexually transmitted diseases, but not anonymous told that I would not have to say." Gay Haotian said.
MSM population is currently at high risk of AIDS infection, sexually transmitted infection in them is higher. 2008, 61 cities nationwide MSM outbreak investigation showed that the national infection rate of syphilis among MSM was 11.9%.
"Many people learned that he infected with sexually transmitted diseases or AIDS, the reluctant to tell others," Little trouble (volunteer) said, "they would worry about being discriminated against or hated by others." He said most of the MSM population more than sex partnerships, and this relationship is often not fixed, so this work is especially difficult.
Hitomi friends using the text "Yi told to" resolve this issue. "Easy" Is the CDC and by the Guangzhou Municipal Culture Communication Co., Ltd. Guangzhou little odd to develop the network - an anonymous phone notify sexual partners of AIDS platform. This platform through an anonymous way, in the protection of personal privacy will not be disclosed at the same time, this potentially infected people, as soon as possible for examination or treatment. People across the country can be told to use the platform.
"Easy to tell" website is mainly sexually transmitted diseases or HIV-infected friends to provide an opportunity to anonymously notify sexual partners of infection risk, so that he / she can be detected in time to understand their own health. Although the site primarily with men have had sex with a gay or bisexual community service, but any person in need can use this site.
"Easy to tell" project funded by special funds of Guangzhou City, AIDS, belongs to the Guangzhou municipal projects cover AIDS projects in matching funds. Culture Communication Co., Ltd. Guangzhou little odd wide differently, and its partners and other organizations involved in the South part of Guangdong Province covers the specific implementation of AIDS programs.
April 2008, Guangzhou, have participated in the cover AIDS projects in Qingdao, "organized by the AIDS high risk behavior intervention training." In the training course, access to the latest foreign intervention in HIV prevention among MSM concepts and methods, learn a new partner this way - an anonymous one-line inform sexual partners of STD and AIDS Project "in SPOT". Of sexual partners among MSM cover this training in the work, gave a great inspiration and guidance in Guangzhou, the training, the Guangzhou Science under the project, local conditions, in-depth discussion of the feasibility of the implementation after the planning and implementation started "easy to tell" project, designed to help MSM infected partner for better informed, promote detection and control of second-generation transmission.
"Easy to tell" the system build process has been emphasizing the protection of personal privacy. "Our infrastructure is safe, now, did not occur, the data thefts." Little Church Culture Communication Co., Ltd. Zhe if the project leader said, "our system a high degree of automation and the data is encrypted and will not disclosure of personal privacy. "
"We encourage AIDS and sexually transmitted infections inform their sexual partners, it is important to control the spread of AIDS one of the strategies, timely detection of cases and controls on the dissemination of the second generation is very important." Center for Disease Control and Prevention, Guangzhou, AIDS Prevention and Control Section, Xu Huifang said.
"Yi told" There is still experimental stage, a lot of technology has been perfected. Test run results, the positive effect is very worthy of recognition. Only 1 December 2009 to 31, statistics show a month, "Yi told" to 21956 times pageviews, visits 2478, of which 2106 were independent IP visitors, 84.67% for the new visitors. 91 visitors using the "easy to tell" to inform sexual partners anonymously, of which 60 were male (65.9%), 28 females (30.8%), 3 did not answer the gender. 91 159 visitors were told to send the message, sending an average of 1.7, including 128 for the HIV this message (80.5%), 36, told a message for the sexually transmitted diseases (22.6%, diseases and more options.) In this text message sent in 159, 27.0% of the recipient (43) was to respond, through the "easy to tell" page check the message content. It can be seen, AIDS, sexually transmitted diseases related to the detection of knowledge and information and inform the demand is still greater anonymity.
"Easy to tell," based in Guangzhou, serving the whole country needs help. As long as you can access to the Internet can view Web pages related information; as long as the owners of China Mobile, China Unicom communications or telecommunications PHS number, to be able to receive messages sent through the system.
"I believe this will be easy to inform the work of a very good doctor aids." Skin and venereal disease prevention and treatment centers in Guangdong Province of Dr. Chen Zhengyu said. "Easy to tell," the introduction of AIDS prevention and intervention work of thinking, is a new revelation, but also for AIDS intervention in the modern network technology, a new attempt. (Guxiao Chen)
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