77 ( 266071) ht tp:/ / www.qdpub.com 13335059110 (0532)85814750 85814611-8662 (0532 )85814750 2005 11 1 1 32 (890mm 1240mm) ISBN - 7-5436 - 3501-1 14.00 (0532 )85814926 (, )
2004,, 1993 7000 2003 1.4, 10, 10%, 30%,,,,, 2000, 65%, 35%, 15 35 70%,, 2004 2003, 409.5,, 307.6 ; 318.5, 77.8 %, 2002 22.9, 15 39 78.1%, 1
, 57.8% ; 16.4% ; 10.7% 1.9%, 51%,, 15.1% ;, 8.8 % 5.6% ; 4.2 %,, 10% ; (, 77.8% ) ;, 15 35 70% ;, ;,,,, 20 90,,, 1995 10,,, 1985 20,, 34, 5 1: 1985 2000 15, 2
880 496, 2001 2002 1742 716, 2001 2000 206.4 %, 2002 2001 46.4%, 2001, 2003, 2003, 84 (65 102 ), 80 %, 20, 8 10 1985 2003 6, 102 ( 85 120 ), 0.09% 0.14%, 1995, 30%,,, 2:, 1995,,,,,,, 3
,,,, 10% 20%, 60%,,,,,, 3:,, 61.6%, 4
( ) 9.4%, 8.4 %, 1.6%, 0.3%, 18.7 %,, 79.4% 2004, 79.1 (, 8 10 ), 2033, 80%,, 50% 60%, 1995 2000 5, 500, 80%,, 9.4% 20 90,,,, 100,, 5
, 60 %,,,,,,,, 1995 2000, 66, 0.02% 1.32 % 2003, 1.7% 2.12%,,, 36.88% 22.94%,,,,,,,,,,,,,,,,,,, 6
, 4:,, 2003,,,,,,,,,,,,, 7
,, 5: 15 49, 94%, 20 39 82%,,,, 2001 14, 1 9 17,,,, 39% ( 68% ), 30% ( 10% ) ; 37% ( 60% ),,,, 80% 2003 11 10, AIDS SARS 8
( AIDS, SARS ),, 1500 3000,,,,,,, ( ),,, ;,,,, 9
,,,,,,,,,, 20,,, 10
,, ;,,,,,,,,,,,,,,,, 50%,,, 165,, 87 16 3 165 19%, 18 % 80%,,, 2000,, 10% 11
2004,,,,,,, 2% 4%,, 500 1000,,, 1996,, 48% ; 1998,, 2.5% 2001 5.9%,, 12
,, ;,,, 10 20, 70,,, 1984 0.2/ 10, 1989 13/ 10, 1996 33.94/ 10 1998 63, 1997 37.05%,, 20,, 300,,, 2000 10.7% 4.6 % : 35 10, 22 5% 40% 33,,, 2.1 15 24, 1991 1026,9 % 6% ; 1988 2409 13
, 73% ; 1992 870, 37% 27% ; 649 18 29, 31.6%,,, 1.4,,,,, 2004 12 14,,, 7, : 1,,,,, 14
, 80%,,,,,, 50 %,,,,, 70%,, 2001 2003, 58.6%,,,, 80%, 70%, 10,,,,,,,,,,,,, 15
,,,,,,,,,,,,,,,,,, 1 3,,,, 20 30, 16, 10, 3 ; 8 4 800, 5, 5 6, 0.25%, 6%, 24 16
,,,,, ;,,,,,,,,,,,, 17
,,,,, 90 1994,, 1999 21,,,,, 18
, 1993 25, 1995 52, 1998 59.6 2004, 79.1 2004 2.2, 19.7%,, 35 72.2%,, 57.3, 300, 120 2000, 10 19
, 17%,, 22 27, 3 4 ; 41.7% 73.7%,,, 8.3% 79%, 1.4% 29.2%,, 50 %,,, 41.7% 55.9 %,,, 9.5 % 80.4%, 88.1%,,,,,,, : 0.3, 390, 20
, 80 %, 80% 60% 80 %,, 84, 8, 61.6%, 2003 22.25 6.15, ( ) 27, 29 48524, 10% 15%,, 5% 30%,,, 1982,, 1985, 4300 15000 1988,, 0.84%, 1991 4.04%, 1993, 3.34%, 1997, 0.7% 2000, 21
, 8.2 % 1985, 8, 30% ; 1996, 1806, 50.6%, 582,,,, 5000 12000, 10, 1800, 720, 40% 4000,,600,,,,,,,,,,,,, 22
, :,,,,, 25% 50%, 3, 5,!, 23
,,,,,,, 1999, 400, 33%, 51 % 15 49 85, 38%, 17 18 :,,, ;,,,,,,,, 60.3%, 67.3%,,10 5 6, 20, 4 6 2 3, 5 24
,,,,,,,,,,,,, 6, 1 14,, 2500, 1/ 3 20 1918, 2000, 25
4, 30, 13, 1000, 2700 60 20, 4000,,,,, 1981,,,,,,,, 20,, 1981, 152 15 1997,, 240,, 210 2003 11 25, 2003, 26
4200, 2003 500, 300, 250 15 2003, 1.6, 2000,, 8000,, 20,,,,,,?, 1969 1981,,,,, 27
,,,,,, 140 1978, ; 1972 1973, 2/ 3 ; 1959,, 20 70, 20 80, 10%, 25% 10%,,,,?,,,,, 20 60,,,,, 28
,,, 1981 6 5, : 5, 5,,, 5,, 31,,,, T,,,,,,, 29
, 23,,,,, ;,,,,,,,,, 26 51,,,,,,, 1982 1,, 55,,,, 1982 7 16, :,,, 1982 9 24,, 30
,, AIDS 20 80,,, ( U NAIDS ) 2004,2004 3940, 310,, 1981,,,,,,,,,,,,,,,, 1981, ( WH O), 152, 10 1988, 5 31
, 1992 2000 250,, 1996, ( W H O ), 2180, 7000 15, 600 2000, 3400, 1880 1320 ( ) 2002 12, 135, 5000,, 16 2660, 130 15,, 32
,,,, ( ),,,,, 1997 38.5%, 2001 44.9% 2002 2003,, 25 29 55.6%, 33.9%, 40.1%, 20 34 5 %, 300,, 2003, 9.6%, 1995 1.2%, 1 %, 397, 2%, 33
1%, 1998, 2000 20%, 50%,,,, 14%, 10%,,, 40%, 17%, 7%, 2001 25, 100 34
,,, 20 % 18 % 20,,,, ( 15 19 ),, 190 150, 42 20 (,, ) 1%,, ( 6% ) ( 4 % ),, 50,, 35
1%,,, 50,, 24%,,,,, ( ), 13 %, 54% 6, 23 29 30 %, 70 %, ( ) 36
21,, 10,,,,, 1992, 25, 2003 11, 2003, : ( ) 2500 2820, ( ) 460 820, 130 190, 120 180, 70 130, 79 120, 47 73, 52 68, 35 59, 1.2 1.8, 3400 4600, 10, 1, 95% 2004 12 17, 37
: 3940, 3590 4430, 3720, 3380 4170, 1760, 1630 1950, 15 220, 200 260 2004 490, 430 640, 430, 370 570, 15 64, 57 75 2004 310, 280 350, 260, 230 290, 15 51, 46 60, 4200,, 2010, 126 4500! 1985,, 5,,, 19, 4, 1995,, 1995 10 38
,, 1998 6, 4, 34,, 20% 30%, 2002,,, ; 2003,,,,, 8,, 1985 1995, 11170, 338, 184 1995, 2002, 40, 560, 2001 32%, 2639, 2001 65.6%, 1047 34 2002 9824, 2001 19.5%, 1045, 363,,, 39
1 2 40
3 (1986-2001) ( :,2001) 2003 12 1, ( WH O ) ( U N AIDS),,, 2003, 84 ( 65 102 ), 80%, 20, 8 10 1985 2003 6, 102 ( 85 120 ), 0.09% 0.14% 41
,, 1985 2003 6, 45092, 3532, 1800, 2003 1 6, 4532, 893, 584 2002, 20.3 %, 1401%, 279.4%, 1985 2003 6 1985 2002 6, 30.4%, 79.0%, 87.0%,, 2001, 2001 2003 6, 76%, 72%,, 80 %, ( ), 61.6%, ( ) 9.4%, 8.4%, 1.6%, 0.3 %, 18.7%, 4.6 1 15 49, 93.9%, 20 29 53.6%,,,,, 42
,, 2010, 3000,,, 2400 3200, 23,, ( WH O ),,,,,,, 2001 6 27, 2000, :,,, 43
, 2000 11,, 15 24 : 24 20 80 90,,,, 20,,, 6800,,, 2010, 5000 7500 95%, 1 10, 9,,,,,,,, 44
,,,,,,,,,,,,,,,,, 9, 64 47, 21 40, 2010, 58 48,, 90% 20 49 45
, 2010 1000, 1 1%, 10,,,,,, 5, 1.3, l/ 4, 1%, 2010,, 5%,, 1999, 10%,, 1996 l997 6650,,,, 46
,,,,,,,,,,,,,,,,,,,,, 2003 9,, 2003,,,,,,, 2003, 47
2004,,, 2003 7, 2003 11 30,,, 2001, 1500 1, 12.5, 10, 459 2003, 3.9, 2.7 2004, 8.1 2003 2.56 2004 4.21, 2004,, 2003 194 2004 247, 19 42, 400, 2002,, 127,, 48
, 2004 12 1,,,,,,,,,,,, 2004,,, 2002,, 2004 7, 51,, 49
55%,,,, 10, 37, 530 1, 260, 34% ; 335, 23 %,, 50
2001 12 1,,, 33,,,,? 1998,,,, 51
,,??,!?,,,, 1995,,,!,,,,?,? :,, 3, 240,,,,,,,,,,,,,,, 52
,,,,, :,,?, 2001,,,,,,,,, ;,,,,,,,,,, :,,,,, 53
,,,,,,, 2001 12 1,,,, :,,,??,,,,,,,, 2002 2 28 54
,,,,,,, :,,,,,,,,, 1998,,, 15 :,,,,,,,,, 15, 55
,,,,,,2000, H,,?,,,,,,, 500,,,,,,,,,,,,,,,,,,,,,,, :,,,,,,,, 56
,,,, :,, 4,, :,,, 20,,,? 4,,,,,,,,,,,,,,,!,,,,,,,, :,, 57
,,,,,,,,, ;,,,, ;,,,, ;,,,,, :,!!,,! 58
,,,,,,,,,!,,,,!,,,,,,,!,?,,,,,,!,,,,! 59
,,,,,,,,,,,,,,,,,, 1.70,,,,,,,,,,, 17000, 20000, 800, CD4,, 302,, 556, 26,, 60
,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, :, 4,,,,,,, 61
,,, 200,,,,, 30,,,,,,,, :,,,,,,,, 45,,?,,,,,, 62
,,,,,,,,,,,,,,,!,,,,,, :,,,,,,,,,,,,, 63
16,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 64
,,,,,,,,,, 700,,!,,,,,, 23,,, 4 ;,, ;,,, 5,,, 65
,,,,,,,,, ;,, ;,, 2,,, ; ; ;,,,,,,,,, 60,, 1560,, 237,, 66
300 60,,,,,,,,,,,,,,,,,,,,,, ; ;,,, 300 1,,,,, 67
,,,,,,,,,,,, 7,,,, :,,,,,,,, :,, :,,,? 68
9 1,,,,,,,,,,,,,, 5,, 69
,,,,?,,,! 1997 8 1,, : 460 400,,,,,, 5000,,,,,,,,,,,,,,,,, 5,?,,, 70
, :, :,,,,,,,,,, :,,,,?,,,,,,,, 4,, 71
,,, 5,,,, 30,,,, 1998, 16,,,, 1000CC,,, 304, HIV,,,, 72
,,,, :,,,,,,,, 8,,,,,,,,, 2003 11 10, AIDS SARS,,, : HIV, 21, 6,??,, 73
?? : 21? 6?,,,,,,,,,,, :,,,,,,,,,,,,,,,,, 74
,,,,,,,,,,,, 3 : 190, 800,,,,,,,,,,, 1994,,,,,,,,,,,,,,, 1998,,, 75
,,, :,,,,,,,, :,,,,,,,, 76
,,,,!,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 77
,,,,,,,,,,,,,,,,,,,,,,,, 78
,,,,,,,,,,,,, 20,,,,,,,,,,,,,,,,,!,,,,,,,,,,,,,,,,, ;,,,!, 79
, 10,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 80
,,,,,,,,,,,,,,, : 81
22,,,,,,,,,,,,,,, 1995, 17,,,, KTV,,,,,,,,,,,,,,,,,,,,,,,,,, 82
,,,,,,,, 1997,,,,,,,, :,,!,,,,,,,,,,,,, :,,,,, 83
, 3,,,,,,,,,,,,,,, :??? :,, :?, :!!, 84
,,,,! 10,, 10, 84,,,,!,, 18 50 1700,, 45.3%, 9.4% 13.4%, 57.7% 32.5% 19.8%, 46.7% ; 30% 10 %,,,, ( ),,, 85
( Acquired Immune Deficiency Syndrome, AIDS ),, ( ),,,,,,,,, 86
,,,,,,,,,, ;,,,,,, 1986, ( HIV ),, 87
T,, ; T ( H IV ),, 1959 HIV, 1986,, - 1, - 2, - 1, - 2, H IV,, H IV 1 HIV 2, H IV 2 HIV 1, 88
H IV, HIV H IV,, 90 150 ( 1 = 10 9 ), 16 /,, H IV,,,,,,,,,,,,,, ;,,, DN A ( ), T4, DNA,, 89
, T4,,,,,,,,,,,,,,,, : ; ;,,,,, :,, 90
,,,,,,,,,,,,, 91
,,,,,,,,,,,,,,,, 1/ 500, 1/ 1000,,, 2 3,,,, 10% 20%, 60%, 92
,,,,,,,,, HIV, HIV,,,,, 5000 12000, 10, 1800, 720, 40% 4000,, 600,,,, 93
,,,,,,,,,,,,,,,,,,,,,,,, 94
,,,,,,,, 240, 80,,,, HIV, 80 % 90 % HIV ; HIV 11% 60% HIV ; ( ) HIV 13 % 40%, H IV HIV, 3, 5 2004 11 8, 0.1% 0.6 %, 95
, 15 % 50%,,,, HIV,,, HIV HIV,, H IV,,,, HIV HIV, HIV,, HIV,,,,,,,, 4,,,,, - 180,, 96
,,, 6 10,,,,,,,,,,,,,,,,,,,, 97
,,,,,,,,,,,,,,,, 30%,, 50%,, ;, ;,, ( ),,, ( ), 98
, ( ), ( ), : ; ;,,,,, ( ), 9,,,, Kaposi ( ) 1972,,, 99
,,,,,, ( ) ( ),,,,,,,,, ( ),, 2 12, 6,,,, 6,,, ( ),,, 100
, : ; ; ; ( ) ; ;,?,,,,,,,,,,,,,,, 101
,,,,,,,,,, :, 1/ 3 : ; 2500 ;,, 1/ 3,,,, 102
,,,,,,,,,,,,,,,,,,,,,,,,, ( ) ( ),, 103
, ( GINS),,,,,,,,,,,,, ;,,,,, 104
,,, HIV, HIV,,,, H IV,,,,,,, 105
,,,,,,,,, : ( 1), ( 2),,,,, ; ( 3),, ( 4),,,, ( 5),,, ( 6),, ( 7),,, 106
,,,,,,,,,, ; ;, ;,, 107
, : ( 1) ( 2), ( 3) ( 4) ( 5) (, ) ( 6) 108
( 7) ( 8), ( 9),,, ( 10 ),, 20 30,,,,, 96,,,, 2,, 2 4,,,,,,,,,, 109
,,, 100%, 70% 100 %,, 100 %,,,, 1/ 2000, 107 108,,,,,,,,,,, 100 %,,,,,, 110
,,,, : ( 1), ( 2) ( 3), ( 4), ( 5) ( 6),, ( 7),,, 111
( 8), ( 9), 20 80,,,,, 5 50,, : ( 1),, ; ( 2),, ; ( 3),,,,,, 112
,,,?,,, ;, ;,,,,,,,,,,,,,,,,,,,,, 110 113
,, : ( 1) 20%, 1 2, ( 2), 10000 2 4 2 ( 3),, 30 ( 4), 3% ( 5) 10 20, ;, 114
( 6), ; ( 7), 0.2%, : ( 1),,,,, ( 2),,,,, 70% 75%, ( 3),, 5%, 30 ; 2 %, 5 ; 2%, 2, 115
( 4),,,, 1% 5% 30 60, ( 5),,, 2%, ( 6),,,,, 20% 25%, 1 10,,, : ( 1),, ( 2 ) ( 3) 116
( 4) ( 5), ( 6) ( 7),, ( 8) ( 9) ( 10 ),, : ;,, ;,,,,, 117
,,,,,,,,,, 118
, ( ),,,,,,,,,, 7 :,,, ( 1) (3 6 ) 10%, 38 1 ( 2) (3 6 ) 10%, ( 3 5 ) 1 ( 3) ( 4) ( K.S.) ( 5) 119
,, ( 1) CD4/ CD8 ( / ) < 1, CD4 ( 2) ( 3), ( 4) 2,, : ( 1) ( 2),, ( 3) CD4 + T, AIDS, H IV ( 4) :,, AIDS ( 5) : ( KS ) ( 6) : AIDS, ( 7) :,, VCT ( Volunt ary Counseling Test, VCT ) 120
,,,,,,,,, 1 3,,,, 3 ( ELISA ) ( PA ) ( LA ) ELISA, ELISA ELISA, ( SPOT ) ELISA,, ; ; ;, 121
,, ELISA 2 8 ELISA, ELISA,,,, 3 ( ) ;,,,, ; ;,,, 2,,,,,,,,,,, 122
,,,,,,,,, HIV 3, ;,,, 3 3,, :,, HIV2 ( O ), 123
,, H IV P24 ( ),,,,,,, ( AZT ),,, ( H AAR T ) 1995 (, ) 2 3 [ ( AZT ) ( 3 TC ) ] ( ), ;, H IV HIV,,,,,,,,, 0.001%, 124
,,,,,,,,,,, 4 : ( 1), ( AZT + 3 TC), ( d4 T ) ( ddi) ( 2), ( Stocrin ) ( Niverapine) ( 3), ( Indinavir) ( 4), T - 20 HIV, ; HIV, ( ) ; ( T - 20),,,, 125
,,,,,, 95%, 10% ; 80 %, 87%,,,,,,,,,,,,,,,,,,,,, 126
,,,,,,,, ;,,,,,,,,,,,,,,,,,, 127
;,,,,,,,,,,,,,,,,, ;, ;, ;,,, 128
2004 11 30,,,,,, 1991, 15,,,,,,, 3000,, 129
,,,,,,,,, ( W H O ), 1988 1, 1988, 1988, 12 1, ( ),,, 1989,,,, 130
2003 9,, 2003 5000,,,,,, 1998,,,,,,,, 2003,, 131
,,, ;, ;,, 1999,,,, :, :,,,,,, 132
,, 2003 12 1,,, 3,,, 2003 11 10,, 21 2004,,,,,,,, 2003,,, 12 1,,,,, AIDS,,, 133
,, :,,,, ( ),, 3 4,,, 1988 7 HIV,,,,,,,, HIV,,, ( ),, HIV 134
HIV,,,, ( ),,,,,,,,,,,,,,,,, 135
,,,,,,,,, 20,,, 44, 1, 3,,,,,,,,,,,,,,,,,, 136
:?,,,, 2004,,,,,,,,,,,,!,,,,,,,,,,,,,,,, :,, 137
:,,,,,,,,,,,,,,,,,,,,,,,,,, 138
,,,,,,, ( ) : ( 1),,, ( 2), ( 3), ; ;,,,,,,,,,,,,, 139
,,,,, 140
: 1988 1 14, 7, : 1989,,,,, : 1995,, : 1998 10 1, 141
,, ( ),,, : 1999 4,,,,,,, ( 1998 2010 ) : 1998 10 2002, 100 % ;, 100%, ( ) 85%, ( ) 70% 142
( World AIDS Conference) 1985 1994 : 1985, 1 1986, 2 1987, 3 1988, 4 1989, 5 ( The Scientific and Social Challenge of AIDS) 1990, 6 90 : ( AIDS in the nineties: from science to policy) 1991, 7 ( Science challenging AIDS ) 1992, 8 ( A world united against AIDS) 1993, 9 1994, 10 : ( The global challenge of AIDS : together for the future) 1996, 11 ( One world one hope) 1998, 12 ( Bridging the gap) 143
2000, 13 ( Breaking the silence) 2002, 14 ( Knowledge and Commitment for Action) 2004, 15 ( Access for All),,,,,, 1988 1 12 1 ( World Aids Day),,, 1988, Join the Worldwide Effort :,, 1989, Our Lives, Our World Let s Take Care of Each Other :,,, 144
1990 Women and AIDS :, 1991 Sharing t he Challenge :, 1992, A Community Commitment :,, 1993, T ime to Act :,,, 1994 AIDS and the Family :, 1995, Shared Rights, Shared Respon sibilities : ;, 1996, 145
One World, One Hope :,, 1997 ( ) Children Living in a World with AIDS : 18, People 1998 Force for Change : Worl d AIDS Campaign wit h Young :,,, 1999, Listen, learn, live! :,, ( ), HIV HIV, H IV, 2000, Man make a difference :,,, 2001,! I care, do you? : 146
2002, Live, let live : HIV,,,, 2003, ( ) Live, let live :,,, 2004 Women, Girls, HIV and AIDS :,,, 2005, Stop AIDS, Keep the Promise (025 )5422117 (010 )64266958 (010 )62238683 (010 )63293342 (010 )64211031 2339 (022 )24322222 147
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(027 )5878840 (0731) 4422425 (028 )6647680 (028 )6649718 (028 )6670735 (023 )63854242 (023 )63846333 (023 )68813616 (0871) 3611773 (0871) 5151846 (0871) 7172835 (020 )84457336 (020 )87724313 (020 )83587047 (0755) 5618773 (0756) 2227455 (0771) 2809100 (0771) 3213030 (0898) 5363244 (0898) 5354418 (0591) 7511114 (0591) 7810808 (0591) 3259768 (0592) 2022280 62212 (0991) 2327659 (0991) 2623453 (0951) 4091173 (0971) 6145332 (0931) 8413459 (0851) 6829731 (00852 )25130513 149