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The widely held assumption that people would volunteer for AIDS-tests in droves (成群结队) once treatment became available was wrong. And the reason for that appears to be that the government has not managed to reduce the stigma (耻辱) associated with AIDS, and thus with seeking out a test for it if you suspect you might be infected.
To combat this, the whole basis of AIDS testing in Botswana has just been changed. The idea is to “downgrade” the process into something low-key, routine and stigma-free. Until now, a potential test subject had to opt in, by asking for a test. Having asked, he was given 40 minutes of counseling to make sure he really knew what he was doing before any test was carried out. The new policy is to test people routinely when they visit the doctor. That way, having a test cannot be seen as an indication that an individual believes he may be infected. The test is not compulsory, but objectors must actively opt out. Silence is assumed to be consent, and no counseling is offered—just as would be the case for any other infectious disease.
This policy shift is probably just the first of many that will take place in Botswana, South Africa and other African countries that are planning the mass provision of anti-AIDS drugs in public hospitals. Dwain Ndwapi, a doctor at Botswana‘s largest AIDS clinic, thinks that there are circumstances in which testing should be compulsory. In particular, he believes that the currently high rate of transmission from mothers to new-born children could be reduced to zero if expectant mothers were always tested—and if those who proved positive were treated with an appropriate anti-retroviral (逆转录病毒) before they gave birth.
Another controversial change in the air is to reduce the frequency of two costly tests of patients‘ blood. Viral-load (病毒载量) tests and CD4-cell counts both measure how acute an individual‘s infection has become. That helps a patient‘s doctor to decide when to prescribe anti-retroviral. But laboratory capacity in Africa is inadequate for regular testing of the millions of people that need such drugs—at least if the tests are carried out as frequently as they would be in a rich country. Less frequent testing of each individual would allow more individuals to be given at least some tests.
But that must be balanced against the need to treat more people faster. Doctors in Botswana are staggered at how desperately sick many patients are when they first arrive. They had expected people to walk into clinics for AIDS tests. Instead, many come in on stretchers on the verge of death. Treating the very ill takes much more time and money than giving anti-AIDS pills to relatively healthy people, and it means that these people may have been inadvertently infecting others for longer. If routine tests persuade more patients to get help before they slump on a stretcher, all the better.
Why few people would volunteer for AIDS-tests if treatment is readily prepared? Because people ________.
细节题。 文章第一段首先提到了人们的一种错误观点， 随后解释了原因： 政府没有设法减少与艾滋病有关的耻辱， 因此如果你怀疑你自 己可能感染了艾滋病而去寻求检测也会带来耻辱。 这说明， 原因是人们无法承受艾滋病检测带来的耻辱。 D 项与原文相符， 为正确答案。
According to the text, how to “downgrade” the test process in Para.2?
细节题。 第二段在介绍人们采取的应对措施时提到， 博茨瓦纳艾滋病检测的所有准则完全改变了， 人们把检测过程“降级” 为低调、 常规并且没有耻辱感的事情， 也就是在人们看病时对他们进行常规检测。这说明， 人们是通过把艾滋病检测看成是患者看病时的常规检测来“降级” 检测过程的。 C 项与之相符。
It can be inferred from the text that ________.
推断题。 文章第二段介绍了人们采取的应对措施， 第三段指出， 这种政策上的改变可能只是博茨瓦纳、南非和其他非洲国家即将发生变化的第一步， 这些国家正计划在公立医院大量供应抗艾滋病的药物， 本段随后介绍了一名博茨瓦纳医生的新观点。 由此可知， 非洲一些国家将实施更多新措施。 B 项是对文中相关信息的概括， 为正确答案。
The purpose of reducing the frequency of two expensive blood tests is to ________.
细节题。 第四段首先提到了减少两种昂贵血检的次数问题， 并解释了这两种血检的目的， 随后指出， 非洲的实验室没有能力对数百万需要这类药物的人进行常规检测， 该段最后一句―Less frequent testing of each individual would allow more individuals to be given at least some tests.‖说明每个人的检测频率越少， 就会有更多的人有机会得到至少某些检测。 这说明， 减少这两种血检次数的目的是为了让更多的人可以接受检测。 B 项是对文中相关信息的概括， 为正确答案。
Persuading patients to get treatment early will have the following advantages except ________.
细节题。 最后一段提到， 相比于给相对健康的人发放抗艾滋病药物， 治疗非常严重的患者花费的时间和金钱多得多， 并且这还意味着他们可能已经无意中在更长的时间内感染了其他人。 随后该段提到如果常规检测可以说服更多患者寻求帮助的话， 那么一切都会更好了。 这说明， B 项“削减治疗费用”、 C 项“避免把病毒传染给更多的人” 和 D 项“缩短医生的治疗时间” 都是说服患者尽早治疗的好处。 只有 A项“给相对健康的人节省抗艾滋病药物” 不是文中提到的好处。 故选 A。