Kodi kachilombo ka HIV kataya chiyani?

Ndipo Chifukwa Chake Iyenera Kuchita Nkhawa Kwa Ife Tonse

Kachilombo ka HIV Kachilombo ka HIV ndi kachitidwe kamene kakugwiritsidwa ntchito ndi mabungwe a federal, boma ndi am'deralo kuti athe kupeza bwino mipata yosamalira anthu omwe ali ndi HIV. Wodziwika kuti ndi HIV / AIDS Care Continuum , chitsanzochi chimapereka chithunzi chomveka cha chiwerengero cha Amereka omwe akugwira ntchito iliyonse yothandizira HIV potsika kuchokera ku:

1. Chiwerengero cha anthu omwe ali ndi HIV;

1. Chiwerengero chomwe chapezeka;
2. Chiwerengero chomwe chikugwirizana ndi chisamaliro;
3. Chiwerengero chomwe chimasungidwa mosamala;
4. Chiwerengero chomwe chikufuna mankhwala opatsirana pogonana;
5. Chiwerengero chomwe chimalandira mankhwala, ndi;
6. Chiwerengerocho chingathe kukhalabe ndi mavitamini osadziwika omwe amawoneka kuti ndi opambana.

Chitsanzocho choyamba chinalongosolezedwa ndi Dr. Edward Gardner ndi anzake ku Dipatimenti ya Dokotala ya Denver mu March 2011. Kufufuzako kunapeza kuti kudutsa kwakukulu pakati pa gawo lililonse lakupitirira mpaka kufika piramidi yosasinthika zojambulazo ( onani fanizo ).

Powopsya kwambiri, zomwe kachilombo ka HIV kachitetezo kawonetsa ndizo za anthu pafupifupi mamiliyoni 1.2 a ku America omwe akuganiza kuti ali ndi kachilombo koyambitsa matenda a Edzi, pafupifupi 25 peresenti yatha kuyendetsa bwino chithandizo choyendetsa matenda a HIV.

Choipa kwambiri, cha 66% omwe amayamba kugwirizana ndi chisamaliro, pafupifupi theka la iwo (pafupifupi 219,000 anthu) amatha kuthamangira kapena samatha kupeza chisamaliro choyenera cha HIV.

Ngakhale kuti pakhala pali chithandizo cha odwala ndi kulumikizana kuti chisamalire kuyambira 2010 mpaka 2012 (kuchuluka kwa 2% ndi 4%, motero), kutayika kwa pakati pa 3% ndi 4% kunawonekera m'magulu ena onse.

Chomwe Chitetezo cha HIV chimatiuza

Ziwerengero izi zikutsindika mavuto omwe akutsogolera omwe akutsogolera machitidwe monga momwe zilili panopa ku US akuyitanitsa kuti anthu onse a ku America azaka 15-65 akuyezetsa kachirombo ka HIV komanso akuyitananso kuyambitsa kachilombo ka HIV panthawi yomwe akudziŵa ngati palibe vuto la CD4 count.

Pamapeto pake, cholinga cha ndondomekozi ndi kuthandiza anthu ambiri kuti athetse chiwerengero chotchedwa "chiwerengero cha tizilombo toyambitsa matenda" (CVL) pakati pa anthu ambiri. Pochita zimenezi, kufalikira kwa HIV kungachepetse kwambiri chifukwa cha kuchepa kwa chiwerengero cha anthu.

Komabe, zikupempha kukayikira ngati zolingazi zingathe kupindula bwino chifukwa cha mipata yofunika kwambiri yopitiliza chisamaliro, makamaka pakati pa anthu a ku America omwe sangafanane ndi chisamaliro (62%) komanso kuchepetsa kupatsirana kwa ma ARV (21% ).

Achinyamata a ku America (a zaka zapakati pa 25-34) amaipiraipira, ndipo 56 peresenti yokha amagwirizana ndi chisamaliro ndipo 15% okha ndi omwe amapeza zowonongeka za tizilombo.

Kuwonjezera apo, ena adatsutsa kuti, monga chida, CVL ndi chizindikiro cholakwika cha matenda opatsirana chifukwa chimakhala ndi zotsatira za anthu omwe ali ndi mavairasi akuluakulu pamene akudalira mavairasi a iwo omwe sadziwa.

Phunziro lina lopangidwa ndi University of Chapel Hill, North Carolina likusonyeza kuti CVL ikhoza kukhala kawiri yomwe ikudziwika pamene kusintha kwa epidemiological kunapangidwa.

Kutseka Ziphuphu

Pofuna kuchepetsa zina mwa mipata muchisamaliro choyendetsa, njira zowonjezera zosamalidwa zowonongeka zikufufuzidwa ndi akuluakulu a zaumoyo ndi a municipalities ambiri. Zina mwa zolinga zazikuluzi:

• Kupereka mwayi wochuluka wa chisamaliro chapadera cha kachirombo ka HIV, makamaka kwa anthu olekanitsidwa. Kupititsa patsogolo ku Medicaid ndi inshuwalansi ya umoyo payekha pansi pa Care Affordable Care Act kungathandize kuchepetsa kusiyana kwa thanzi la anthu omwe akukhudzidwa.

• Kuwunikira kumadzulo poyesedwa, kulumikizana ndi kusamalira, ndi kuchiza odwala mu malo ophatikizidwa (njira yotchuka kwambiri yotchedwa TCL-Plus). San Francisco, Los Angeles, Birmingham, ndi Washington, DC ndi amodzi mwa mizinda ya US yomwe imatchulidwa nthawi zonse ngati kusonyeza njira zabwino kwambiri za TLC-Plus.
• Yesetsani kuyesetsa kuti mupeze odwala "otayika" ndi kuwagwiritsanso kuti asamalire. Mu 2013, Dipatimenti ya zaumoyo ku New York City inapeza anthu 689 a 797 omwe adatetezedwa ndi HIV, komabe anapeza kuti 77% mwa iwo akuyenera kuchipatala.
• Gawani zolemba zamankhwala zamagetsi pakati pa mabungwe ovomerezeka omwe akuvomerezedwa kuti athandizire "kugwiritsa ntchito zipangizo zamagetsi" kwa iwo amene amatha kukhala otsatira kapena akusowa chithandizo. Pakati pa 2009 ndi 2011, a Department of Health a Louisiana adatha kuzindikira ndi kuchenjeza odwala omwe ali ndi kachilombo ka HIV kudzera ku Louisiana Public Health Information Exchange (LaPHIE).
• Fufuzani zonse zomwe zilipo komanso njira zowonjezera kuti anthu azitsatira ma ARV. Izi zikuphatikizapo kukulankhulana kwa odwala ndi odwala. Kafukufuku amasonyeza kuti odwala omwe ali ndi dokotala mmodzi amawachezera pachaka ndi odwala 94% odwala kapena kufa kusiyana ndi wina ali ndi anayi. Kuwonjezeka kwa mgwirizano wa madotolo ndi odwala kumagwirizananso ndi njira zowonjezera mankhwala.

_Zotsatira:

_{Cohen, M .; Miller, W .; Mphamvu, K.; ndi Smith, M. "Mankhwala Osokoneza Bongo Akumudzi monga Kuyeza kwa Kuyezetsa HIV monga Chitetezo." Matenda Opatsirana a Lancet. May 2013; 13 (5): 459-464.}

_{Gardner, E .; McLees, M .; Steiner, J ;; et al. "Makhalidwe Okhudzidwa pa Kachilombo ka HIV ndi Kufunika Kwake Kuyesedwa-ndi-Kutenga Njira Zopewera HIV." Matenda opatsirana pogonana. March 2011; 52 (6): 793-800.}

_{Giordano, T .; Gifford, A .; White, A .; et al. "Kusungidwa M'nyamaso: Chovuta Kupulumuka ndi Matenda a HIV." Matenda opatsirana pogonana. July 4, 2007; 44 (11): 1493-1499.}

_{Herwehe, J ;; Wilbright, W .; Abrams, A .; et al. "Kukhazikitsa Buku Lopanga Zamakono Labwino, (EMR) ndi Public Health Information Exchange kwa HIV / AIDS." Journal of American Medical Information Association. May-June 2012; 19 (3): 448-452.}

_{Project Inform. "TLC +: Makhalidwe Abwino Othandizira Kuwongolera Kuyezetsa Kachilombo ka HIV, Kuyanjanitsa, Kuphatikizidwa Kwambiri (TLC-Plus) Njira Zomwe Zidzakhalira M'madera Anai a US." San Francisco, California; August 2011.}

_{Udeagu, C ;; Webster, T .; Bocour, A .; et al. "Otaika Kapena Osangotsatira Zomwe Akuyesa: Ntchito Yachipatala Yowonjezera Kubwereza Anthu Omwe Ali ndi kachilombo ka HIV Osowa Kutsata HIV." AIDS. September 10, 2013; 27 (14): 2271-2279.}

_{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.}