区域差异视野下的艾滋病社区防治经验 云南L县之个案研究

Regional Variations in Community-Based HIV/AIDS Treatment and Prevention:A Case Study of L County,Yunnan

2003年之后,全国各艾滋病重度流行区域兴起了社区干预的高潮,各地干预的具体做法和社会后果之间存在明显差异。本文以此为出发点,以云南省L县为个案,探讨地方性防治经验的体制成因与实践过程。本文试图说明,L县经验的成功之处在于防治重心的体制沉降恰好契合了本土的族群关系及信任文化,在此基础上,良善的医患关系实践最终将村医制度打造成了连接官方防治体制与本土道德世界的制度及文化桥梁。

Since the year of 2003,there has been a movement to practice community-based HIV/AIDS intervention in highly affected regions in China. Large regional variations have been observed in practices and social outcomes. In this background,the paper selects a case,L County in Yunnan Province,to examine the system and practice factors that are associated with the treatment and prevention success in a local experience. This paper concludes that it is the optimal fit between the treatment-prevention system and the trust culture in the local ethnic groups’ relationships that has led to the L County success. Starting from here,the good doctor-patient relationship will nurture the village healthcare system to structurally and culturally bridge the formal treatment-prevention system and the local moral reality.