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1、www.XiYuS锡育软件People do stupid things.“人会干傻事。00:16Thats what spreads HIV.于是HIV就传播开来。”00:18This was a headline in a U.K.newspaper,The Guardian,notthat long ago.这句话是一家英国报纸的头条,不久之前出版的卫报。00:20Im curious,show of hands,who agrees with it?我很好奇,请大家举个手,谁同意这句话？00:24Well,one or two brave souls.哦,有一两位勇士。00:29Thi
2、s is actually a direct quote from an epidemiologist whosbeen in field of HIV for 15 years,worked on four continents,and youre looking at her.这句话实际上出自一位流行病学家之口 她研究HIV已有15年,足迹遍布四大洲,你们现在正看着她。00:31And I am now going to argue that this is only half true.我现在想说明 这句话只说对了一半。00:40People do get HIV because the
3、y do stupid things,but mostof them are doing stupid things for perfectly rationalreasons.有些人确实是因为做了傻事感染了HIV,但是其中的大多数人虽然做这些傻事 却有完全合乎理智的原因。00:44Now,rational is the dominant paradigm in public health,and if you put your public health nerd glasses on,youll seethat if we give people the information that
4、they need“理智”是公共卫生的 首要准则。现在你戴上公共卫生怪胎眼镜,你便会知道如果你提供给人们必要的信息00:52spreads:n.数扩展;广阔;纺桌布(spread的复数)/v.传播(spread的第三人称单数);打开;摆放 Guardian:n.法监护人,保护人;守护者/adj.守护的 quote:vt.报价;引述;举证/vi.报价;引用;引证/n.引用 epidemiologist:n.流行病学家 continents:n.地理大陆,大洲(continent复数)dominant:adj.显性的;占优势的;支配的,统治的/n.显性 paradigm:n.范例;词形变化表 ne
5、rd:n.呆子;讨厌的人about whats good for them and whats bad for them,if yougive them the services that they can use to act on thatinformation,and a little bit of motivation,people will makerational decisions and live long and healthy lives.告诉他们什么对他们好,什么不好,如果你给他们必要的服务 使他们能对上述信息做出反应,再加上一丁点的鼓励,人们就会做出理智的决定 从此健康
6、长寿。01:03Wonderful.好极了。01:15Thats slightly problematic for me because I work in HIV,andalthough Im sure you all know that HIV is about poverty andgender inequality,and if you were at TED 07 its aboutcoffee prices.但对于像我这样研究HIV的人,有一点小麻烦,虽然我确信大家都知道 HIV与贫穷和两性不平等有紧密的联系。如果你参加了TED07,就知道HIV与咖啡的价格紧紧相关;01:17Ac
7、tually,HIVs about sex and drugs,and if there are twothings that make human beings a little bit irrational,they areerections and addiction.实际上,HIV和性交,毒品脱不了干系。如果说世上有两样东西 使人类丧失理智,那就是勃起和上瘾。01:29(Laughter)So,lets start with whats rational for an addict.（笑声）那么,我们先说说瘾君子认为什么不和逻辑。01:39Now,I remember speaking
8、 to an Indonesian friend of mine,Frankie.我曾经和一位印尼的朋友,Fankie,聊天。01:44We were having lunch and he was telling me about when hewas in jail in Bali for a drug injection.我们一起吃午餐,他跟我讲 他在巴里岛监狱里注射毒品的经历。01:47motivation:n.动机;积极性;推动 problematic:adj.问题的;有疑问的;不确定的 gender:n.性;性别;性交/vt.生(过去式gendered,过去分词gendered,现
9、在分词gendering,第三人称单数genders,形容词genderless)irrational:adj.不合理的;无理性的;荒谬的/n.数无理数 erections:n.勃起;建造;建筑物;直立 addict:n.有瘾的人;入迷的人/vt.使沉溺;使上瘾It was someones birthday,and they had very kindlysmuggled some heroin into jail,and he was very generouslysharing it out with all of his colleagues.那天是一个人的生日,他们偷偷将一些海洛因
10、弄进了监狱,他非常大方地邀请牢房里的兄弟们 一起享用。01:52And so everyone lined up,all the smackheads in a row,andthe guy whose birthday it was filled up the fit,and he wentdown and started injecting people.于是每个人都排好队,所有瘾君子排成一排。过生日的那个人 准备好注射器,蹲下身,开始给兄弟们注射海洛因。02:01So he injects the first guy,and then hes wiping the needleon hi
11、s shirt,and he injects the next guy.他给第一个兄弟注射后,顺手用衣服擦擦针管,再注射下一个。02:12And Frankie says,Im number 22 in line,and I can see theneedle coming down towards me,and there is blood all overFrankie说:“我是第22个,我看见针管离我越来越近,地上到处都是血。02:19TED演讲者：Elizabeth Pisani|伊丽莎白.皮萨尼演讲标题：Elizabeth Pisani:Sex,drugs and HIV-let.s
12、 get rational|性交，毒品，HIV让我们理智起来内容概要：Elizabeth Pisani uses unconventional field research to understand how real-worldbehaviors influence AIDS transmission-and to overhaul antiquated,ineffective preventionstrategies.滴水不漏的逻辑，智慧，与“公共卫生怪胎”眼镜，Elizabeth Pisani揭开了当今政治体系中，种种妨碍资金有效防止HIV蔓延的不连续性问题。她的对高危人群的研究从监狱中
13、的瘾君子到柬埔寨街上的性工作者像我们展示了有时违背意愿的措施却能有效地阻止艾滋的传播。needle coming down towards me,and there is blood all overthe place.Its getting blunter and blunter.针管越来越钝。02:28And a small part of my brain is thinking,That is so gross andreally dangerous,but most of my brain is thinking,Pleaselet there be some smack left
14、by the time it gets to me.我脑子里在想,“真是恶心死了 太危险了,”但是我更关心的是,拜托,拜托到我的时候 针管里还有点海洛因。02:30smuggled:走私的 heroin:n.药毒物海洛因,吗啡 generously:adv.慷慨地;宽大地;丰盛地 smackheads:n.吸海洛因者,海洛因瘾君子 injecting:v.注射(inject的ing形式)injects:vt.注入;注射 wiping:n.擦拭;船消磁/v.擦干;使消失(wipe的ing形式)smack:n.滋味;少量;海洛因;风味/vt.掴;用掌击/vi.用掌击;带有风味/adv.猛然;直接地
15、Please let there be some left.拜托给我留一点。”02:43And then,telling me this story,Frankie said,You know.God,drugs really make you stupid.故事讲完后,Frankie说:“你知道,天,毒品真能让你蠢到极点。”02:45And,you know,you cant fault him for accuracy.而且,你知道,他这句话你挑不出一点毛病,02:55But,actually,Frankie,at that time,was a heroin addict and hew
16、as in jail.但是Frankie那时,是个瘾君子,而且他被关在监狱。02:58So his choice was either to accept that dirty needle or not toget high.所以他只能选择 要么接受那血迹斑斑的针头,要么就没法过瘾。03:03And if theres one place you really want to get high,its whenyoure in jail.如果真有什么地方你确实很想过过瘾,那就是监狱。03:08But Im a scientist and I dont like to make data ou
17、t ofanecdotes,so lets look at some data.但现在我是位科学家,我不会用八卦故事当数据,所以现在来看看数据。03:12We talked to 600 drug addicts in three cities in Indonesia,and we said,Well,do you know how you get HIV?我们采访在印尼的三座城市的 600名瘾君子,我们问他们:“你知道你怎么感染HIV的吗？”03:18Oh yeah,by sharing needles.“哦,当然知道。共用一个针头。”03:25I mean,nearly 100 perc
18、ent.Yeah,by sharing needles.我是说,差不多100%,对,都是共用针头害的。03:27And,Do you know where you can get a clean needle at aprice you can afford to avoid that?我们又问:“你知道在哪可以买到 干净又便宜的针头吗？”03:30anecdotes:n.奇闻轶事(anecdote的复数)addicts:有瘾的人/对.入迷的人(addict的复数)needles:n.针数,千针本;印刷折页顶针(needle复数形式)Oh yeah.Hundred percent.100%的人
19、都答道:“哦,知道。”03:34Were smackheads;we know where to get clean needles.“我们吸毒,我们当然知道上哪儿去弄干净的针头。”03:36So are you carrying a needle?“那你们会带着针头吗？”03:38Were actually interviewing people on the street,in theplaces where theyre hanging out and taking drugs.我们采访的那些地方就在街上,瘾君子们聚集在一起服毒。03:40Are you carrying clean n
20、eedles?“你们带着干净的针头吗？”03:44One in four,maximum.最多四分之一的人带着。03:46So no surprises then that the proportion that actually usedclean needles every time they injected in the last week is justabout one in 10,and the other nine in 10 are sharing.所以也难怪 在上周每次注射时真正 使用干净针头的比例 只有十分之一。另外十分之九共用一个针头。03:49So youve got
21、 this massive mismatch;everyone knows that ifthey share theyre going to get HIV,but theyre all sharinganyway.你看,这前后矛盾。每个人都知道 共用针头会感染HIV,但是他们还是用一个针头。04:01So whats that about?Is it like you get a better high if youshare or something?这是为什么呢？是共用针头让你更过瘾吗？04:09We asked that to a junkie and theyre like,Are
22、 you nuts?我们这样问他们,他们说:“你疯了？04:12You dont want to share a needle anymore than you want toshare a toothbrush even with someone youre sleeping with.你当然不会愿意和别人共用针头,就像你绝不愿意共一把牙刷,就算他是你的情人也不行。04:15injected:充血的/注入的 junkie:n.有毒瘾者;废旧品商人 toothbrush:n.牙刷Theres just kind of an ick factor there.这是因为,你知道,ick的原因。04
23、:20No,no.We share needles because we dont want to go tojail.不是,不是。我们共用针头因为我们不想进监狱。”04:22So,in Indonesia at this time,if you were carrying a needleand the cops rounded you up,they could put you into jail.现在,在印尼 如果你被逮到藏有针头,就会被警察抓走,丢进监狱.04:26And that changes the equation slightly,doesnt it?这样看的话,情况就不一样
24、了,对吗？04:34Because your choice now is either I use my own needle now,or I could share a needle now and get a disease thats goingto possibly kill me 10 years from now,or I could use my ownneedle now and go to jail tomorrow.因为这时你的选择就是,要么用现在自己的针头,要么现在和别人用一个针头 感染上病 过个十年因此而死,或者我可以现在用自己的针头 明天就去蹲监狱。04:36And
25、 while junkies think that its a really bad idea to exposethemselves to HIV,they think its a much worse idea to spendthe next year in jail where theyll probably end up inFrankies situation and expose themselves to HIV anyway.虽然瘾君子们认为 置身于感染HIV的危险中绝不是什么好事,但是在监狱里过一年 更加糟糕,你很可能在监狱里遇上Frankie所说的情况 最终还是可能感染H
26、IV。04:55www.XiYuS锡育软件So,suddenly it becomes perfectly rational to share needles.这样,突然间,共用针头 就变得非常有道理了。05:09Now,lets look at it from a policy makers point of view.现在我们从政策决策者的角度看看这个问题。05:13ick:int.恶心！(表示厌恶时使用)rounded:adj.圆形的;全面的;丰满的 junkies:n.毒品贩子;吸毒者(junky的复数)point ofview:观点;见地;立场This is a really eas
27、y problem.实际上非常简单。05:15For once,your incentives are aligned.终于有一次,大家达成了一致意见。05:17Weve got whats rational for public health.从公共卫生角度,我们得出了理性的答案。05:20You want people to use clean needles-and junkies want touse clean needles.我们希望瘾君子用干净的针头,瘾君子也想用干净的针头。05:23So we could make this problem go away simply by
28、makingclean needles universally available and taking away the fearof arrest.所以我们只用使瘾君子们能随时拿到针头 同时让他们不必担心被逮捕 就能解决这个问题。05:27Now,the first person to figure that out and do somethingabout it on a national scale was that well-known,bleedingheart liberal而第一个想出这一招 并在全国执行的人 就是大名鼎鼎的“铁娘子”05:34Margaret Thatche
29、r.英国首相撒切尔夫人。05:41And she put in the worlds first national needle exchangeprogram,and other countries followed suit:Australia,TheNetherlands and few others.她推行了全球第一项 国家针头交换计划 其他国家竞相效仿,澳大利亚,荷兰和一小部分其他国家,05:43And in all of those countries,you can see,not more than fourpercent of injectors ever became in
30、fected with HIV.在这些国家里,你们可以看到,低于百分之四的吸毒人员 曾因注射而感染HIV。05:50incentives:n.激励;奖励;诱因(incentive的复数形式);奖励措施 aligned:adj.对齐的;均衡的/v.结盟(align的过去式);使成一直线 universally:adv.普遍地;人人;到处 bleeding:n.出血;渗色/adj.流血的;同情的/v.出血;渗出(bleed的ing形式);感到疼痛Thatcher:n.盖屋匠 injectors:n.注射器;注射者;注水器 infected:adj.被感染的/v.传染(infect的过去分词)Now
31、,places that didnt do this-New York City for example,Moscow,Jakarta-were talking,at its peak,one in twoinjectors infected with this fatal disease.再看,没有实行这一政策的国家,比如纽约,莫斯科,雅加达,在峰值时,每两个注射毒品的人中 就有一个感染了这种致命疾病。05:57Now,Margaret Thatcher didnt do this because she has anygreat love for junkies.撒切尔首相做这些 不是因为
32、她对瘾君子有恻隐之心,06:10She did it because she ran a country that had a nationalhealth service.她这样做是她执政的国家 有国家免费医疗系统。06:15So,if she didnt invest in effective prevention,she was goingto have pick up the costs of treatment later on,andobviously those are much higher.所以,如果她不在有效疾病预防方面投资,她以后就必须为疾病的治疗 付出昂贵的费用,而且治
33、疗的费用昂贵的多。06:20So she was making a politically rational decision.所以她做出了一个政治上很理智的决定。06:29Now,if I take out my public health nerd glasses here andlook at these data,it seems like a no-brainer,doesnt it?现在,如果我带上我 公共卫生怪胎的眼镜,再看看这些数据,这完全不合逻辑。06:32But in this country,where the government apparently doesnot
34、feel compelled to provide health care for citizens,(Laughter)weve taken a very different approach.但是在这个国家,政府显然不认为他们必须 为公民提供免费医疗,我们于是采取了大相径庭的解决方法。06:42So what weve been doing in the United States is reviewingthe data-endlessly reviewing the data.在美国,我们一直在做的事情是 验证数据,不断地验证。06:52prevention:n.预防;阻止;妨碍 la
35、ter on:adv.后来;稍后;过些时候 politically:adv.政治上 no-brainer:n.无需用脑的事;容易的事 compelled:v.迫使(compel的过去式及过去分词形式);强迫 reviewing:n.回顾;评估;修订/v.回顾;复习(review的ing形式);检验 endlessly:adv.不断地;无穷尽地So,these are reviews of hundreds of studies by all the bigmuckety-mucks of the scientific pantheon in the UnitedStates,and these
36、 are the studies that show needle programsare effective-quite a lot of them.于是上百个研究的数据 被大型的muckety-mucks美国科学界圣人验证,而大量的研究表明 针头计划是有效的。06:57Now,the ones that show that needle programs arenteffective-you think thats one of these annoying dynamicslides and Im going to press my dongle and the rest of itsg
37、oing to come up,but no-thats the whole slide.再看,这些表明针头计划无效的研究 你们认为在这张烦人的幻灯片上,我按一下手中的遥控器,剩下的数据就会出现,但是,没有,这张幻灯片上就这么多内容。07:09(Laughter)There is nothing on the other side.（笑声）另外一栏什么也没有。07:20So,completely irrational,you would think.那么,这完完全全没有道理。你肯定这样想,07:27Except that,wait a minute,politicians are ration
38、al,too,andtheyre responding to what they think the voters want.只是,等下,不对,政客们也是理智的,而且他们所做的事情是他们认为选民们想做的。07:31So what we see is that voters respond very well to things likethis and not quite so well to things like this.我们看到的是选民们都 十分愿意回应这种情况 而不愿意回应这种情况。07:37(Laughter)So it becomes quite rational to deny
39、 services to（笑声）所以拒绝向瘾君子提供服务 就显得很有道理。07:44(Laughter)So it becomes quite rational to deny services toinjectors.道理。07:44Now lets talk about sex.现在来说说性交。07:57reviews:n.综述;评论;复习(review的复数);复核/v.回顾;复习(review的三单形式);检验 pantheon:n.万神殿;名流群 dongle:n.电子狗;软件狗 and the rest:其他的;等等Are we any more rational about se
40、x?我们在性交上更理智吗？07:59Well,Im not even going to address the clearly irrationalpositions of people like the Catholic Church,who thinksomehow that if you give out condoms,everyones going torun out and have sex.呃,我根本不会去评论 天主教徒们那些 完全不和逻辑的想法。以为只要你免费发保险套,人们就会出去找乐子。08:02I dont know if Pope Benedict watches TED
41、Talks online,but ifyou do,Ive got news for you Benedict-我不知道本尼迪克特教皇 是否会在线看TED的演讲,但是教皇,您看的话,我有话要跟您讲。08:15I carry condoms all the time and I never get laid.我随身带着保险套,但从来没机会用。08:22(Laughter)(Applause)Its not that easy!（笑声）这种机会可不容易找。08:27Here,maybe youll have better luck.接着,也许你的运气好一点。08:31(Applause)Okay,
42、seriously,HIV is actually not that easy totransmit sexually.（掌声）OK,严格地说,HIV不是很容易 通过性交传染。08:33So,it depends on how much virus there is in your blood andin your body fluids.是否传染取决于你血液和体液所含的 病毒数量08:46And what weve got is a very,very high level of virus right atthe beginning when youre first infected,th
43、en you startmaking antibodies,and then it bumps along at quite lowlevels for a long time-10 or 12 years-you have spikes ifyou get another sexually transmitted infection.当某人感染HIV后,在感染最初期 病毒含量非常,非常高,然后你的身体开始产生抗体,之后很长的一段时间内 10年或12年,病毒的含量都保持在相当低的水平,如果你有与他人发生关系而受到感染,youhave spikes,08:50Catholic:adj.天主教的;
44、宽宏大量的/n.天主教徒;罗马天主教 give out:分发,发出;公布,发表;用尽,精疲力竭 condoms:n.医避孕套;橡皮套(condom复数形式)run out:用完;耗尽;跑出;到期;伸向 Benedict:n.本尼迪克特(男子名)fluids:n.流流体(fluid的复数形式);物液体 at the beginning:首先;从一开始;起初;从头开始 antibodies:n.免疫抗体(antibody的复数)bumps:碰撞(bump的第三人称单数)/碰撞(bump的复数)spikes:n.钉鞋(spike的复数)/v.把钉牢(spike的第三人称单数)But basicall
45、y,nothing much is going on until you start to getsymptomatic AIDS,and by that stage,youre not lookinggreat,youre not feeling great,youre not having that muchsex.但一般而言,在你开始出现艾滋病的 症状之前,不会发生什么。而到了那一阶段,这里,你会看起来很糟,感觉很不好,不会发生很多性交。09:04So the sexual transmission of HIV is essentially determined byhow many
46、partners you have in these very short spaces oftime when you have peak viremia.所以通过性交感染HIV基本取决于 当你体内的病毒达到高潮时 的那一段非常短的时间段内 你有多少位同伴。09:14Now,this makes people crazy because it means that youhave to talk about some groups having more sexual partnersin shorter spaces of time than other groups,and thatsc
47、onsidered stigmatizing.这一来人们就要发疯了 因为这意味着你必须谈论有些人在较短的时间内 比另外一些人有更多的同伴,这样就太侮辱人了。09:24Ive always been a bit curious about that because I thinkstigma is a bad thing,whereas lots of sex is quite a goodthing,but well leave that be.我一直都对此很好奇 因为我认为侮辱是件很不好的事情,而然性交频繁却是件很好的事,不过这事就这样吧。09:36The truth is that 20
48、years of very good research have shownus that there are groups that are more likely to turnoverlarge numbers of partners in a short space of time.事实是20年来 很出色的研究 告诉我们 有一些人更倾向于 在短时期内有很多伙伴,09:45And those groups are,globally,people who sell sex and theirmore regular partners.而基本上这些人,都是出卖色情,有更多的同伴,09:56s
49、ymptomatic:adj.有症状的;症候的 stigmatizing:vt.诬蔑;玷污;给打上烙印 stigma:n.植柱头;耻辱;污名;烙印;特征turnover:n.翻覆;贸易营业额;流通量;半圆卷饼;失误/adj.翻过来的;可翻转的They are gay men on the party scene who have,on average,three times more partners than straight people on the partyscene.在派对上的同性恋拥有的伙伴数量 平均比派对上的异性恋 多出两倍,10:01And they are heterose
50、xuals who come from countries thathave traditions of polygamy and relatively high levels offemale autonomy,and almost all of those countries are ineast or southern Africa.还有些异性恋 他们来自的国家 有一妻多夫的传统女性有较强的自主权,大多数此类国家都在南部非洲的东部。10:07And that is reflected in the epidemic that we have today.这些都反映在现在大范围流行的疾病上