Umphaŵi ndi boma sizikuyendera mavuto omwe akuchitikabe
Kusiyanasiyana kwa mtundu wa HIV ku United States kwafika podabwitsa kwambiri. Izi sizikuwoneka bwino kusiyana ndi anthu a ku Africa Amereka omwe, ngakhale kuti akuimira 12 peresenti ya anthu a ku United States, amawerengera 48 peresenti ya matenda atsopano.
Zifukwa izi ndi zovuta ndipo nthawi zambiri sitimvetsa. Ngakhale ena angaganize kuti chikhalidwe ndi khalidwe la kugonana ndilo chifukwa cha izi, vutoli ndilosalepheretsa chikhalidwe cha anthu komanso zachuma zomwe zingayambitse matenda onse opatsirana.
Umphawi, kupanda chilungamo kwa anthu, komanso kusowa kwa kayendetsedwe kabwino ka boma pamodzi kumathandiza kufalitsa matenda m'madera omwe alibe njira zothetsera vutoli.
Mu njira zambiri, mliri wa HIV uli chabe chithunzi cha kusiyana kwakukulu kwa chisamaliro chaumoyo chomwe chimapangitsa malo ambiri a ku America kuopsa kwake osati kokha kachilombo ka HIV, koma matenda ena omwe angapewe ndi matenda.
Mawerengero amakono a US
Kunena kuti pali kusiyana pakati pa kufalitsa mtundu wa HIV ku US ndi chinthu cholakwika. Pakalipano, anthu a ku Africa America amakhala ndi kachilombo koposa asanu ndi atatu kuposa azungu komanso pafupifupi Latinos. Azimayi a ku America ali pachiopsezo ku matenda atsopano, akuthamanga mobwerezabwereza kawirikawiri momwe amawonera azimayi oyera.
Ngakhale pakati pa amuna omwe ali ndi chiopsezo chachikulu chogonana ndi amuna (MSM) , kukhala amasiye ndi African American amachititsa munthu paziopsezo 50 kuti atenge kachilombo ka HIV nthawi zonse (poyerekezera ndi 9 peresenti ya amuna amtundu woyera).
Ziŵerengero izi zimangoyang'ana pamwamba pa vuto lomwe nthawi zambiri limakhala losokonezeka ndi kutsutsana. Ngakhale kuti anthu ambiri amavomereza mosavuta makhalidwe omwe amakhulupirira kuti ndi osiyana ndi chikhalidwe, mayankho amtunduwu amathandiza kupititsa patsogolo zolakwika zomwe zimayambitsa tsankho, tsankhu, ndi kusagwirizana pakati pa anthu.
Zambiri zomwe zimagwirizana kwambiri ("anthu akuda akugona mozungulira" kapena "kugwiritsa ntchito mankhwala osokoneza bongo zikufalikira pakati pa anthu akuda") zakhala zonyenga ponena za HIV. Mwachitsanzo:
- Azimayi a ku America amapezeka kuti alibe kachilombo koyambitsa matenda osokoneza bongo kuposa amayi oyera. Azimayi a ku America amapezeka ndi kachilombo koyambitsa matenda opatsirana pogonana, pomwe amayi oyera amakhala ndi kachilombo ka HIV.
- Palibe amuna kapena akazi a ku America omwe ali ndi chiopsezo choyambitsa chiwerewere kuposa gulu lina lililonse.
- Black MSM, makamaka, amawauza ochepa ogonana nawo, osagonana osatetezedwa , komanso mankhwala osagwiritsa ntchito mankhwala ochepa kuposa MSM.
- Amwenye Achimereka, omwe ali ndi kachilombo ka HIV, amatha kuyesedwa kwambiri kuposa achizungu (75 peresenti poyerekeza ndi 14 peresenti).
- Anthu a ku America amangofunafuna ndi kupitirizabe, chithandizo chamankhwala choyenera cha HIV monga azungu (54 peresenti peresenti 58 peresenti).
- Chiŵerengero cha matenda osadziwika ndi ofanana kwambiri kwa AAfrica Achimereka monga azungu (11 peresenti ndi 13 peresenti). Mwa mitundu yonse, anthu a ku Asia anali, makamaka, osadziwika (21 peresenti).
Pamene kusiyana komweku kulibe, sikumakhala kovuta kwambiri pakati pa anthu m'deralo ku HIV koma zinthu zina zomwe zimakhala zovuta kuziphwanya kapena kudzipatula.
Masiku ano, kachilombo ka HIV kamakhala kachirombo kachisanu ndi chimodzi komwe kumayambitsa imfa mu amuna a ku America ku America komanso chifukwa chachinayi chakumwalira kwa amayi a ku Africa pakati pa zaka zapakati pa 35 ndi 44. Mosiyana ndi zimenezi, kachilombo ka HIV sikatchulidwanso kuti ndi imfa yaikulu mpikisano.
Zowonongeka Zambiri za Kutenga
HIV siimakhudza anthu onse mmudzi momwemo. Ngakhale kukhala African American, woyera, kapena Latino sikutanthauza njira yomwe munthu amachitira ndi matendawa, pali zovuta zomwe zingapangitse munthu wa mtundu umodzi kukhala ndi chiopsezo chachikulu chotenga matenda ndi matenda kuposa wina.
Tikuwona izi, mwachitsanzo, ndi mayankho osiyanasiyana pa chithandizo cha HIV.
Ngakhale kuti azungu 70 peresenti ya azungu amatha kupeza mphamvu yosawerengeka ya mankhwalawa pamene akuchiritsidwa, osachepera 50 peresenti ya a ku America amatha kuchita chimodzimodzi.
Zomwe zili choncho, chikhalidwe kapena khalidwe la chiwerewere silingathe kufotokozera kusiyana kumeneku. M'malo mwake, nkhaniyi ikuwoneka mozama kwambiri komanso yothandizidwa ndi zinthu monga:
- Umphawi
- Stigma
- Kusasowa kwa chithandizo chaumoyo
- Kulephera kwa boma, chikhalidwe, apolisi, ndi malamulo
- Mitundu yosamvetsetseka ya kumangidwa ndi kundende
- Anthu ambiri akumidzi
Zolakwika izi zimasewera mbali yotsatira mwa njira yomwe imayambitsa zovuta zomwe zimakhala zovuta kuphwanya.
Tawona izi, mwinamwake zowopsya, ndi African American MSM ndi HIV. Phunziro la 2014 lomwe linapangidwa ndi Rollins School of Public Health ku University of Emory linanena kuti, ngakhale kuti ali ndi zovuta zochepa zogonana kusiyana ndi awo oyera, chiŵerengero cha abambo chiyenera kukhala chaching'ono, osakhala ndi maphunziro apang'ono, osakhala ndi ntchito, ali ndi matenda opatsirana pogonana osachitidwa , ndipo musakambirane kwambiri za HIV ndi mnzanu wogonana.
Zinthu izi pamodzi zimapanga mphepo yamkuntho yopanda matenda.
Umphawi wa Mafupa Omwe Amayambitsa Matenda
Pafupifupi mmodzi mwa anayi aliwonse a ku Africa kuno amakhala umphawi, mobwerezabwereza kuchuluka kwa oyera. Pokha, umphawi umapangitsa zovuta polepheretsa anthu osauka kupeza ntchito zomwe zingalepheretse kapena kuteteza matenda.
Izi sizikutanthauza kupeza mwayi wothandizira zaumoyo koma zimaphatikizapo mbali zina za maboma, komanso. Mwa iwo:
- Kuperewera kwa apolisi ndi chitetezo chalamulo m'madera osauka amaika amayi omwe ali ndi chiopsezo, ana, ndi ena omwe ali pangozi yozunzidwa.
- Mapologalamu ogwira ntchito opindulitsa ndi omwe amapereka ndalama zothandizira anthu ambiri amalepheretsa ambiri kufunafuna chithandizo china chilichonse kusiyana ndi zosowa zawo.
- Kusagwiritsidwa ntchito kwa mankhwala osokoneza bongo kumapangitsa kufala kwa matenda osagwiritsidwa ntchito pakati pa ogwiritsa ntchito komanso ogonana nawo.
- Malingaliro ochepa a inshuwalansi ya zamankhwala, makamaka omwe amatsutsa kuwonjezereka kwa Medicaid , amagwirizanitsa mwachindunji ndi miyezo yapamwamba ya kachilombo ka HIV.
Pakapita nthawi, kulephera kwa mabungwewa kumapangitsa kuti anthu asamakhulupirire boma komanso maboma onse. Chotsatira chake, anthu nthawi zambiri amatha kupeza ntchito zomwe amawona kuti ndizofunika kwambiri (monga thandizo lachuma ndi zamankhwala ofulumira) ndikupewa omwe "angayembekezere" (monga thanzi labwino komanso chithandizo).
Izi makamaka zimapereka chifukwa chake 22 peresenti ya anthu a ku Africa amachedwa kuchepetsa kuyezetsa kachirombo ka HIV mpaka atakhala ovuta, ndipo nthawi zina amadwala.
Koma sizomwe zimadalira mochedwa madokotala ali ndi nkhawa. Matenda opatsirana opatsirana pogonana monga gonorrhea, omwe akufalikira m'madera osauka, angathe kuonjezera chiopsezo cha HIV ndi 700 peresenti. Komanso, chithandizo chamankhwala chosagwirizana chimapangitsa munthu kuti asapindule kwambiri ndi kachilombo ka HIV ndipo akhoza kukhala ndi mankhwala osokoneza bongo .
Pamapeto pake, umphawi umayambitsa matenda chifukwa cholepheretsa / kapena kusokoneza zosankha zomwe munthu angapange. Kumeneko, madera olemera ali ndi njira zothetsera zovuta zambirizi, anthu osauka a ku Africa muno samatero. Kufalikira kwa HIV m'maderawa, kotero, kumachitika chifukwa chakuti palibe choletsa.
Kusokonezeka kwa HIV pakati pa aAfrica Achimereka
Ngakhale kusintha kwa maganizo a anthu, kunyansidwa kwa anthu omwe ali ndi kachirombo ka HIV kumapitirizabe. Zotsatira za kunyansidwa zimatha kugonjetsa anthu a ku Africa Ammera movuta, ponseponse pomwe amadziwika (akumva) ndi kuchitidwa (enieni).
Zotsatira za kusayera zingakhale zovuta. Kawirikawiri, anthu amalephera kufotokoza momwe aliri ndi kachilombo ka HIV chifukwa choopa kukafunsidwa za kugonana kwawo kapena kutchedwa "wonyansa," "wonyansa," kapena "wosayeruzika."
Izi zikuwoneka kuti ndi zoona makamaka mmadera kumene ziphunzitso zachipembedzo nthawi zina zingapemphe thandizo la anthu omwe ali ndi kachilombo ka HIV pamene akudzudzula khalidweli. Kafukufuku amene adachitika mu 2014 ndi bungwe la Public Religion Research Institute anapeza kuti 17 peresenti ya anthu ogwira ntchito ku tchalitchi ku US amakhulupirira kuti HIV ndi "chilango cha Mulungu" chifukwa cha makhalidwe oipa.
Amodzi mwa magulu omwe amavomereza kuti zikhulupiliro zimenezi ndi Ayera Chiprotestanti oyera (25 peresenti), Hispanic Catholics (21 peresenti), ndi Aprotestanti akuda (20 peresenti).
M'madera a ku America, komwe amai 95 mwa anthu 100 alionse amaona kuti chipembedzo ndi chofunika pamoyo wawo ndipo 50 peresenti amapemphera nthawi zonse kapena amapita kutchalitchi, maganizowa ndi ovuta kuthawa.
Chotsatira chake, a ku Africa Ammerika amatha kunena kuti pali chisokonezo ndi chisankho kwa anthu omwe ali ndi kachirombo ka HIV kusiyana ndi azungu kapena Latinos. Maganizo awa amadziwonetsera okha mwa njira zambiri zoipa:
- Anthu omwe ali ndi kachilombo ka HIV omwe amadziwa kuti ali ndi kachilombo kawirikawiri amamwa mowa kwambiri kapena amawagwiritsa ntchito mowa mwauchidakwa.
- Anthu omwe amaopa kachirombo ka HIV ndi kufotokozera amapewa kuyesa komanso chithandizo chamankhwala chokhazikika.
- Kuwonjezeka kwa chiwerengero cha kuvutika maganizo kumatanthawuzira kuwonjezeka kwa makhalidwe akuluakulu.
Kuwonjezera pamenepo, malingaliro a tsankho omwe anaphatikizidwa ndi zolephera kwenikweni mu kayendetsedwe ka boma zikuwonekera kulimbikitsa zikhulupiliro pakati pa anthu ambiri a ku Africa kuti kachilombo ka HIV sichingapeŵe kokha, komabe, mwachangu.
Kafukufuku amene anafalitsidwa mu Journal 2010 ya Journal of the American Medical Association anafotokoza kuti mwa anthu 1,351 a ku America omwe anafunsidwa, 49 peresenti amakhulupirira kuti kachilombo ka HIV kanakonzedwa ndi CIA kuti aphe anthu akuda.
Ngakhale kuti ena angapezeke ndi zida zoterezi zokhumudwitsa kapena zokhumudwitsa, akatswiri ambiri a maganizo amakhulupirira kuti ndizovuta kukana. M'malo molimbana ndi matenda omwe amawopa, nthawi zambiri anthu amawopseza mowopsya pofuna kuwongolera zomwe sakuchita komanso kusowa chiyembekezo.
Kumidzi ndi HIV
Ku United States, kachilombo ka HIV makamaka ndikumidzi. Chifukwa chakuti anthuwa ndi owopsa ndipo ali ndi chiwongola dzanja chokwanira, kuphulika kulikonse kumeneku kungafalikire mofulumira pokhapokha ngati anthu akuchitapo kanthu mwaukali kuti boma liime.
Kulephera kuchita zimenezi kungachititse kuti anthu ambiri asapitirire kudwala matenda oopsa omwe amawonekera kumwera, kumene ku California, Alabama, Florida, Georgia, Louisiana, Mississippi, South Carolina, Tennessee, ndi Texas. matenda atsopano.
Chifukwa chakuti anthu a ku America amatha kukhala osagwirizana pakati pa anthu omwe amagonana nawo (mosiyana ndi azungu omwe amatha kusankha osagwirizana nawo mafuko osiyanasiyana), kugonana kwa m'maderawa kumakhala kochepa komanso kosavuta. Chotsatira chake, matenda alionse m'deralo adzakhalabe mmudzimo, akuwonjezeka powerengeka pamene anthu ambiri akubwera kufunafuna mwayi wogwira ntchito.
Ambiri mwa midziyi, matenda opatsirana kachilombo ka HIV amathandizidwanso ndi ndondomeko za boma zomwe zimatsutsa osauka. Zina mwa zolakwa zambiri:
- Sizowopsa kuti masewera a kachilombo ka HIV ndi apamwamba kwambiri pofotokoza kuti anakana kukula kwa Medicaid, kuphatikizapo Alabama, Florida, Georgia, Mississippi, South Carolina, ndi Texas. Kafukufuku wochokera ku Women's Interagency HIV Study adanena kuti Medicaid, monga mwini wake, imapitirira kuchulukitsa mwayi wa munthu kuti akwaniritse chiwerengero cha tizilombo toyambitsa matenda.
- Mofananamo, akuti kuletsedwa kwa mapulogalamu osinthana ndi singano ndi amodzi omwe ali ndi chiwerengero chachikulu cha matenda atsopano. Izi zikuphatikizaponso Alabama, Florida, Georgia, Mississippi, South Carolina, ndi Texas.
Chifukwa cha zofooka izi ndi zina, kuthana ndi mliri wa HIV mu midzi ya ku America ku America kudzatenga zambiri kuposa mankhwala okhaokha. Zidzakhala kusintha kwakukulu m'maganizo a anthu ndi njira zomwe chithandizo chamankhwala ndi zina zofunika kwambiri zothandiza anthu zimaperekedwa kwa anthu omwe akusowa thandizo.
> Chitsime:
> Bogart, L .; Galvan, F .; Wagner, G; et al. "Zikhulupiriro Zotsutsa Zachilombo ka HIV Zimayenderana ndi Antiretroviral Treatment Kusagwirizana pakati pa Amuna a ku Africa Amayi omwe ali ndi HIV." Journal of Deficiency Immune Deficiency Syndromes. April 2010; 53 (5): 648-655.
> El-Bassel, M .; Caldeira, M .; Ruglass, L. et al. "Kufotokozera Zowonjezeka Zopadera za Azimayi a ku America mu Kupewa Kachilombo ka HIV." June 2009; 99 (6): 996-1001.
> Friedman, S .; Cooper, S .; ndi Osborne, H. "Zokambirana za Zachikhalidwe ndi Zachikhalidwe za Vuto Lachilombo Pakati pa Afirika ku America." Buku Lopatulika la Umoyo Wathanzi. June 2009; 99 (6): 1002-1008.
> Fry, V .; Bonner, S .; Williams, K. et al. "Kulunjika Kulankhula: Kupewa HIV kwa African-American Heterosexual Male: Zopangira Zopangira ndi Kukonzekera Kupanga." Sewero la maphunziro a Edzi. October 2012; 24 (5): 389-407.
> Sullivan, P .; Petersen, J ;; Rosenburg, E. et al. "Kumvetsa kusiyana kwa mtundu wa HIV / STI M'magazi Amtundu ndi Oyera Amuna Amene Amagonana ndi Amuna: Njira Yogwirira Ntchito." PLoS One. 2014; 9 (3): e90514.