Ku US, kwadziwika kale kuti, ngakhale atalangizidwa za phindu la mankhwala oyambirira ochepetsa kachilombo ka HIV (ART) , chiwerengero chachikulu cha odwala oyenerera kuchipatala chidzachiletsa. Ndipotu, malinga ndi bungwe la US Centers for Disease Control and Prevention (CDC) , anthu 902,000 a ku America omwe anapezeka ndi kachilombo ka HIV, ndi 363,000 okha omwe anali achangu pa ART mu 2012.
Ambiri amaganiza kuti kusowa mtima ndikumvetsetsa kunali pamtima pa chiwerengero ichi. Komabe, kafukufuku wopangidwa mu 2013 ndi University Hospital Zurich wasonyeza kuti kukana kuyambitsa ART sikungowonjezera odwala okha komanso madokotala awo.
Phunzirolo, lomwe linayendetsedwa m'madera 34 ku Ulaya ndi Australia, adafufuza odwala omwe anapezeka kuti ali ndi kachilombo ka HIV ndipo adakali ndi chithandizo cha dokotala kwa masiku osachepera 180. Mwa odwala m'gululi, 67% anapezekapo kuyambira zaka imodzi mpaka zinayi zapitazo, pamene 28% anali atapezeka zaka zisanu kapena zambiri zapitazo.
Mwa ofufuza omwe anafukufuku, 78% anali ndi zaka zisanu kapena kuposerapo zokhudzana ndi HIV, pamene 90% anali ndi oposa 50 omwe ali ndi kachilombo ka HIV.
Zolepheretsa Zakale Zopatsira HIV
Kafukufuku wakale adapeza kuti zifukwa zazikulu zothandizira odwala ndizopiritsira mapiritsi apamwamba komanso zowonjezereka zokhudzana ndi mankhwala.
Madokotala adakayikira, makamaka chifukwa cha kusintha kwa chithandizo cha mankhwala ndi zotsutsana ndi akatswiri okhudza nthawi yoyenera kuyamba ART.
Ndili ndi mankhwala omwe amayamba kudzitamandira chifukwa chokhala ndi katundu wochepa wa mankhwala a piritsi ndi zochepa zochepa-komanso njira yochezera kachilombo ka HIV pa CD4 za 500 / mL komanso pamwambapa - zoletsedwazo zimawonedwa makamaka.
M'malo mwake, odwala lerolino amaoneka osadziŵa ubwino wa mankhwala oyambirira, pamene madokotala akuwona kuti ambiri mwa odwala awo sali okonzeka kuchita chithandizo, nthawi zambiri amachedwetsa ART, osati miyezi, koma zaka panthawi. Malingana ndi kafukufukuyo:
- Odwala 47 peresenti "sankakonda kuganiza za HIV."
- 50% mwa iwo omwe ali oyenerera kuchipatala akuti iwo "sali okonzeka," pamene 33% amawona "ambivalent."
Zifukwa zikuluzikulu zomwe zinatchulidwa ndizo "kusowa kwa zizindikiro" kapena kuti "ndikudalira thupi langa kundiuza nthawi yoyamba."
Mosiyana ndi zimenezi, madokotala ankachedwa kuchepetsa ART chifukwa chakuti "sanadziwe wodwalayo mokwanira" kapena anamva kuti wodwalayo "akuvutika maganizo kwambiri" kuyamba. Kuwonjezera apo:
- Madokotala 93 pa 100 alionse anafufuza kuti amakhulupirira kuti kulandira thandizo la mankhwala masiku ano kunali koyenera kwa odwala awo.
- Komabe, muchitidwe weniweni wa moyo, 51% okha adayambitsa ART kwa odwala omwe ali ndi CD4 chiwerengero pansi pa maselo 500 / mL, pamene 16% okha amakhulupirira kuti ndizoyenera odwala okhala ndi CD4 ma cell / mL 500.
Kusiyana pakati pa ziwerengerozi kukuwonekera osati kungowonongeka pakati pa ochiritsa. Zikhozadi kusonyeza kukayikira pakati pa anthu omwe awona njira zogwiritsira ntchito njira imodzi m'mbuyomu, koma kuti athake zaka zingapo pambuyo pake zotsatira zake zisanachitike.
Kuwonjezera pamenepo, kuoneka kuti sangakwanitse kuthana ndi zolepheretsa kugonana kumasonyeza kuti mwambo wa chidziwitso chokhudzana ndi kukhala wodwala sikunasinthike kuti uwonetsetse kuti tsopano "kusalidwa kwa HIV" kwapitirira zaka makumi anayi zapitazi, pomwe chidziwitso cha odwala nthawi zambiri chimasokoneza chisamaliro cha odwala. Ngati ndi choncho, zingakhale zovuta "kusewera" pamene otsogolera amayesetsa kuthetsa kusiyana pakati pa umboni wa zachipatala ndi zachipatala.
Ndi kuyesedwa kwa kachirombo ka HIV tsopano kulimbikitsidwa kwa onse a ku America zaka 15-65-osati anthu omwe ali "magulu akuluakulu" -kuyembekezeredwa kuti manyazi ndi malingaliro olakwika ogwirizana ndi kachirombo ka HIV atakweza.
Zotsatira:
Zachigawo za US za Kuletsa ndi Kupewa Matenda (CDC). "CDC Fact Sheet | HIV ku United States: Maphunziro a Care." Atlanta, Georgia; inasindikizidwa mwezi wa July 2012.
Fehr, J ;; Nicca, D .; Goffard, J .; et al. Zifukwa Zosayambira Matenda a Antiretroviral: A Survey International Survey pakati pa Odwala ndi Amayi awo. " Msonkhano wa European AIDS Clinicians Society (EACS); Brussels, Belgium; October 16-19, 2013; Zosamveka PS11 / 1.