艾滋病暴露前预防用药技术推广应用的伦理困境及对策  

Ethical Dilemmas and Countermeasures in the Promotion and Application of HIV Pre-exposure Prophylaxis Technology

作　　者：潘蕴蛟[1] 林丽[1] 吴守丽[1] 谢剑锋[1] 蒋辉 PAN Yunjiao;LIN Li;WU Shouli;XIE Jianfeng;JIANG Hui(Department of AIDS/STD Control and Prevention,Fujian Center for Disease Control and Prevention,Fuzhou 350012,China;Ethics Committee,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou 363000,China)

机构地区：[1]福建省疾病预防控制中心艾滋病性病防治所,福建福州350012 [2]福建医科大学附属漳州市医院伦理委员会,福建漳州363000

出　　处：《医学与哲学》2024年第21期40-43,共4页Medicine and Philosophy

基　　金：2022年福建省卫生健康科技计划项目(2022RKB006);2020年福建医科大学医学人文研究中心开放课题(RW202002)。

摘　　要：暴露前预防用药是近年来推出的预防艾滋病的新技术手段,其有效性和安全性均得到了验证,但目前目标人群的使用率仍然较低。对该技术推广过程中的伦理困境,包括个人的健康行为责任与社会义务、社会歧视和污名化、卫生政策和经济负担、服务方式的可及性、使用合理性要求与耐药性隐忧、工作指南的权威性等问题进行辨析,并在增强目标人群的健康观念、探索广泛覆盖的服务网络、保障使用者权益、多元化的支付体系建设、全面权威应用指南的出台等方面提出对策建议,以更好地发挥暴露前预防用药在艾滋病防治工作中的作用。Pre-exposure prophylaxis(PrEP)is a new technological method for HIV prevention introduced in recent years.Its efficacy and safety have been effectively validated.But the current utilization rate among target populations remains low.This paper identifies the ethical dilemmas in the promotion of this technology,including individual responsibility for health behaviors and social obligations,social discrimination and stigmatization,public health policies and economic burdens,accessibility of service modalities,requirements for rationality of use and concerns about drug resistance,and the authority of clinical guidelines.In response,strategies are proposed to enhance health awareness among target populations,explore widely accessible service networks,protect user rights,develop a diversified payment system,and establish comprehensive and authoritative guidelines.Countermeasures and suggestions are put forward to optimize the role of PrEP in the prevention of AIDS.

关 键 词：艾滋病暴露前预防用药 男男性行为人群 伦理困境 

分 类 号：R-05[医药卫生]