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 "little 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."

词汇：

intrauterine 子宫内的 outset 开头，最初 contraception 节育，避孕

cervix .颈，宫颈(pl.cervices 或 cervixes) contraceptive 避孕的; n.避孕工具，避孕药物

shedding 脱落物 complication 并发症

obstetrics 产科学 gonorrhea 淋病 gyn(a)ecology 妇科学

chlamydia 衣原体(pl.chlamydiae) cervical 颈的(如宫颈的)

注释：

1.IUD = IUCD (为intrauterine contraceptive device的首字母缩写)：宫内节育器

2.HIV-positive：人类免疫缺陷病毒检查阳性

HIV为human immunodeficiency virus 的首字母缩写。

3....and there are really very little data...for HIV-infected women...: 有关什么样的避孕物品适合于感染了人类免疫缺陷病毒妇女，资料真的很少……本句中what引导的从句是on的宾语从句。

4.North Carolina：北卡罗来纳州

5.Nairobi,Kenya：肯尼亚的内罗毕

6....did find...：的确发现了……did在这里用做强调的助动词。例如：Do be careful! 一定要细心!He did accomplish the task in time.他的确按时完成了任务。

7....confirming current guidelines...not use IUDs.……这就进一步证实了现行指南的意见，即患有性传播疾病的妇女不应该使用宫内节育器。本句中confirming是分词，作结果状语。suggesting也是分词，作current guidelines的定语。suggesting后面that引导的是宾语从句，其谓语使用了虚拟语气，等于should not use。

8.the amount of virus the HIV-positive women were releasing from their cervix,or shedding：人类免疫缺陷病毒呈阳性反应的妇女从子宫颈排出的病毒(即脱落物)数量。此处从the HIV-positive women 至compared with 4 months 是the amount of virus 的定语从句，省略了关系代词that。

练习：

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

答案与题解：

1.B第二段主要是Morrison对世界卫生组织制定的"指南"做出评价，指出"指南"主要是根据理论制定的，而很少有关于什么避孕方法适合感染HIV妇女的资料。

2.A第三段讲的是Morrison等人对636名装了IUD的肯尼亚妇女进行的调查，他们搜集到的资料证明了IUD所引起的副作用，感染HIV的妇女与没有感染HIV的妇女没有什么差别。

3.C第四段说研究人员的确发现了患性传播疾病的妇女，其患IUD并发症的危险性增加，说明了二者之间的关系。

4.E最后一段是Morrison的研究结论，即有宫颈感染的妇女要避免使用IUD，因为发生并发症的危险性增加，而感染HIV的妇女并非如此。

5.E本题答案在第二段第一句。该句说到感染HIV的妇女应该避免使用IUD。

6.A第二段第二句说到"指南"中没有什么资料涉及什么样的避孕方法适合感染HIV的妇女，故基本上没有介绍。

7.D本题答案来自第四段，在confirming之前已肯定了危险性增加，而confirming之后证明了现有"指南"的意见是对的，故从现有"指南"和最新研究可以得出相同结论。

8.B文章第一段以及第三段中间"suggesting...for HIV-infected women"都表达了本题的意思。

译文：HIV呈阳性妇女的宫内节育器的安全性

新的研究结果表明，感染了HIV最常见形式的女性如果能够经常去看医生，可以采用宫内工具(宫内节育器)安全避孕。

世界卫生组织现行的指南规定，感染HIV的女性应避免使用宫内节育器。"那些指南主要是根据理论制订的，而很少有关于什么避孕方法适合感染HIV妇女的资料。"主要著北卡罗来纳州Charles S.Morrison这样说道。

Morrison和同事们对装了宫内节育器1个月、4个月和2年的636名肯尼亚内罗毕市的妇女进行调查，搜集相关并发症的信息。这些妇女当中有156名感染HIV，参与的医生不知道有病人感染HIV。"在所引起的副作用方面，感染HIV的妇女与未感染HIV的妇女相比几乎没有什么差别，这表明使用宫内节育器可能是妇女(实行安全避孕)的一种可行的途径。"莫里森说道。他补充说，"这是一个极为重要的问题，原因是，当今有1600万妇女感染HIV，她们大都急需避孕方法。"

研究人员的确发现，有淋病或衣原体感染的妇女在调查一开始就有更大的危险性，易于引发宫内节育器的并发症，这就进一步证实了现行指南的意见，即患有性传播疾病的妇女不应该使用宫内节育器。

研究人员在《大不列颠妇产科杂志》8月期刊中报道。此外，调查开始阶段与装入宫内节育器4个月后相比，人类免疫缺陷病毒呈阳性反应的妇女从子宫颈排出的病毒(即脱落物)的数量前后没有差别。一些研究从反面表明，宫颈脱落物增加与使用口服避孕药存在关系。

"这个研究所要说明的就是，避免使用宫内节育器应用于患有宫颈感染的妇女，不是感染HIV的妇女，"莫里森说道，"宫颈感染的妇女患并发症的危险大，而感染HIV的妇女则并非如此。"

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