The Safeness of IUDs for HIV-positive Women
1. Women infected with the most common form of HIV may safely use the intrauterine device (IUD)for contraception, provided they see a doctor regularly, new study findings suggest.
2. World Health Organization guidelines currently state that, in general, HIV-infected women should avoid IUDs. “Those guidelines were essentially made on theoretical concerns, and there are really very little data on what contraceptive is appropriate for HIV-infected women,3” said the lead author Dr. Charles S. Morrison in North Carolina4.
3. Morrison and colleagues gathered information on IUD-related complications at 1, 4 and 24 months after placement of the device in 636 women living in Nairobi, Kenya5. Of these women, 156 had HIV infection. Participating physicians did not know the patients’ HIV status. There was “l(fā)ittle difference in any side effects in HIV-infected women compared with HIV-uninfected women, suggesting that the IUD is likely an appropriate method for HIV-infected women,” Morrison said. “This is an important issue, because there are now 16 million women living with HIV and a lot of them have a critical need for contraception,” he added.
4. The researchers did find6 that women with infections such as gonorrhea or chlamydia at the study’s outset were at increased risk of IUD complications, confirming current guidelines suggesting that women with sexually transmitted diseases not use IUDs.7
5. In addition, there was no difference in the amount of virus the HIV-positive women were releasing from their cervix, or shedding8, at the beginning of the study compared with 4 months after the IUD was inserted, the researchers reported in the August issue of the British Journal of Obstetrics and Gynaecology. Conversely, some studies have shown a relationship between increased cervical HIV shedding and the use of oral contraceptives.
6. “What this study suggests is that you need to avoid IUD use in women with a cervical infection but not women with HIV infection,”Morrison said. “Women with cervical infections are at increased risk of complications: women with HIV infection are not.”
詞匯：
intrauterine 子宮內(nèi)的 outset 開頭，最初 contraception 節(jié)育，避孕
cervix .頸，宮頸(pl. cervices 或 cervixes) contraceptive 避孕的; n.避孕工具，避孕藥物
shedding 脫落物 complication 并發(fā)癥
obstetrics 產(chǎn)科學(xué) gonorrhea 淋病 gyn(a)ecology 婦科學(xué)
chlamydia 衣原體(pl. chlamydiae) cervical 頸的(如宮頸的)
注釋：
1.IUD = IUCD (為intrauterine contraceptive device的首字母縮寫)：宮內(nèi)節(jié)育器
2.HIV-positive：人類免疫缺陷病毒檢查陽性
HIV為human immunodeficiency virus 的首字母縮寫。
3. ... and there are really very little data... for HIV-infected women...: 有關(guān)什么樣的避孕物品適合于感染了人類免疫缺陷病毒婦女，資料真的很少……本句中what引導(dǎo)的從句是on的賓語從句。
4.North Carolina：北卡羅來納州
5.Nairobi, Kenya：肯尼亞的內(nèi)羅畢
6. ...did find...：的確發(fā)現(xiàn)了……did在這里用做強(qiáng)調(diào)的助動(dòng)詞。例如：Do be careful! 一定要細(xì)心!He did accomplish the task in time.他的確按時(shí)完成了任務(wù)。
7. ... confirming current guidelines... not use IUDs. ……這就進(jìn)一步證實(shí)了現(xiàn)行指南的意見，即患有性傳播疾病的婦女不應(yīng)該使用宮內(nèi)節(jié)育器。本句中confirming是分詞，作結(jié)果狀語。suggesting也是分詞，作current guidelines的定語。suggesting后面that引導(dǎo)的是賓語從句，其謂語使用了虛擬語氣，等于should not use。
8.the amount of virus the HIV-positive women were releasing from their cervix, or shedding：人類免疫缺陷病毒呈陽性反應(yīng)的婦女從子宮頸排出的病毒(即脫落物)數(shù)量。此處從the HIV-positive women 至compared with 4 months 是the amount of virus 的定語從句，省略了關(guān)系代詞that。
練習(xí)：
1.Paragraph 2 ______
2.Paragraph 3 ______
3.Paragraph 4 ______
4.Paragraph 6 ______
A Morrison’s Survey and Findings
B Comments on Current Guidelines
C The Relation of Sexually Transmitted Diseases to IUD Complications
D The Concrete Contents of Current Guidelines
E A Conclusion of Morrison’s Study
F The Relationship Between Cervical HIV Shedding and Using IUDs
5.According to current guidelines, women should not use IUDs ______.
6.Current guidelines barely recommend ______.
7.From both current guidelines and the new study we may conclude ______.
8. The new study maintains that the IUD is a safe contraceptive method for HIV-infected women ______.
A what contraceptive is good for HIV-infected women
B if they go to see the doctor at regular intervals
C what a relationship between increased cervical HIV shedding and the use of oral contraceptives
D that sexually transmitted diseases may increase the risk of IUD complications
E if they are HIV carriers
F that taking oral contraceptives is much safer than using IUDs for HIV-infected women
答案與題解：
1.B第二段主要是Morrison對(duì)世界衛(wèi)生組織制定的“指南”做出評(píng)價(jià)，指出“指南”主要是根據(jù)理論制定的，而很少有關(guān)于什么避孕方法適合感染HIV婦女的資料。
2.A第三段講的是Morrison等人對(duì)636名裝了IUD的肯尼亞婦女進(jìn)行的調(diào)查，他們搜集到的資料證明了IUD所引起的副作用，感染HIV的婦女與沒有感染HIV的婦女沒有什么差別。
3.C第四段說研究人員的確發(fā)現(xiàn)了患性傳播疾病的婦女，其患IUD并發(fā)癥的危險(xiǎn)性增加，說明了二者之間的關(guān)系。
4.E最后一段是Morrison的研究結(jié)論，即有宮頸感染的婦女要避免使用IUD，因?yàn)榘l(fā)生并發(fā)癥的危險(xiǎn)性增加，而感染HIV的婦女并非如此。
5.E本題答案在第二段第一句。該句說到感染HIV的婦女應(yīng)該避免使用IUD。
6.A第二段第二句說到“指南”中沒有什么資料涉及什么樣的避孕方法適合感染HIV的婦女，故基本上沒有介紹。
7.D本題答案來自第四段，在confirming之前已肯定了危險(xiǎn)性增加，而confirming之后證明了現(xiàn)有“指南”的意見是對(duì)的，故從現(xiàn)有“指南”和最新研究可以得出相同結(jié)論。
8.B文章第一段以及第三段中間“suggesting...for HIV-infected women”都表達(dá)了本題的意思。
譯文：HIV呈陽性婦女的宮內(nèi)節(jié)育器的安全性
新的研究結(jié)果表明，感染了HIV最常見形式的女性如果能夠經(jīng)常去看醫(yī)生，可以采用宮內(nèi)工具(宮內(nèi)節(jié)育器)安全避孕。
世界衛(wèi)生組織現(xiàn)行的指南規(guī)定，感染HIV的女性應(yīng)避免使用宮內(nèi)節(jié)育器。“那些指南主要是根據(jù)理論制訂的，而很少有關(guān)于什么避孕方法適合感染HIV婦女的資料�！敝饕笨_來納州Charles S. Morrison這樣說道。
Morrison和同事們對(duì)裝了宮內(nèi)節(jié)育器1個(gè)月、4個(gè)月和2年的636名肯尼亞內(nèi)羅畢市的婦女進(jìn)行調(diào)查，搜集相關(guān)并發(fā)癥的信息。這些婦女當(dāng)中有156名感染HIV，參與的醫(yī)生不知道有病人感染HIV。“在所引起的副作用方面，感染HIV的婦女與未感染HIV的婦女相比幾乎沒有什么差別，這表明使用宮內(nèi)節(jié)育器可能是婦女(實(shí)行安全避孕)的一種可行的途徑。”莫里森說道。他補(bǔ)充說，“這是一個(gè)極為重要的問題，原因是，當(dāng)今有1600萬婦女感染HIV，她們大都急需避孕方法。”
研究人員的確發(fā)現(xiàn)，有淋病或衣原體感染的婦女在調(diào)查一開始就有更大的危險(xiǎn)性，易于引發(fā)宮內(nèi)節(jié)育器的并發(fā)癥，這就進(jìn)一步證實(shí)了現(xiàn)行指南的意見，即患有性傳播疾病的婦女不應(yīng)該使用宮內(nèi)節(jié)育器。
研究人員在《大不列顛婦產(chǎn)科雜志》8月期刊中報(bào)道。此外，調(diào)查開始階段與裝入宮內(nèi)節(jié)育器4個(gè)月后相比，人類免疫缺陷病毒呈陽性反應(yīng)的婦女從子宮頸排出的病毒(即脫落物)的數(shù)量前后沒有差別。一些研究從反面表明，宮頸脫落物增加與使用口服避孕藥存在關(guān)系。
“這個(gè)研究所要說明的就是，避免使用宮內(nèi)節(jié)育器應(yīng)用于患有宮頸感染的婦女，不是感染HIV的婦女，”莫里森說道，“宮頸感染的婦女患并發(fā)癥的危險(xiǎn)大，而感染HIV的婦女則并非如此。”
