Chimodzi mwa zizindikiro zoyamba zomwe wodwalayo sangakwanitse kupeza njira yeniyeni yothetsera kachilombo ka HIV (ARV) ndi pamene munthuyo amadziwika kuti ndi "dokotala wodziteteza" -kungowika, munthu yemwe amayendera zipatala zambiri kapena madokotala pa maphunzirowo zaka, miyezi, kapena masabata.
Pakhoza kukhala zifukwa zilizonse zomwe wodwala amasankha kuchita.
Nthaŵi zina, mwinamwake wodwalayo sakonda dokotala kapena chipatala, kapena amafuna chithandizo cha matenda omwe ali nawo, monga chiwindi cha hepatitis C (HCV) , mankhwala osokoneza bongo, kapena thanzi labwino.
Koma, mobwerezabwereza, ndiye kuti wodwalayo sakufuna kuvomereza kapena kuthana ndi vuto linalake lokhudzana ndi matenda , matenda , kapena chithandizo cha HIV . Zitsanzo zikuphatikizapo:
- Kutaya, kapena kuopa kufotokoza ndi kunyalanyaza .
- Odwala omwe akudwala matendawa chifukwa chotsatira mankhwala osokoneza bongo ndipo amatha kusamukira kwa dokotala wina kusiyana ndi kuvomereza (kapena kugonjetsa) mizu yawo yosagonjera.
- Odwala omwe sakufuna kuvomereza kapena osakhoza kupirira matenda omwe akugwiritsidwa ntchito, ndiye ndani adzalumphira kuchokera kuchipatala ndikukayembekezera zosiyana.
- Kulephera kuvomereza zofuna za mankhwala tsiku ndi tsiku kapena zachiwerewere .
Kukula ndi Mbiri ya Dokotala Woponya
Phunziro la 2013 kuchokera ku Perelman School of Medicine ku Yunivesite ya Pennsylvania anafufuza kuchuluka kwa zotsatira za dokotala-hopping pa zaka ziwiri kuchokera 2008 mpaka 2010.
Pafukufuku wawo, ofufuzawo anapeza kupita ku chipatala, mbiri yakale ya ART, ndi matenda omwe ali ndi kachilombo ka HIV mwa odwala 13,000 m'mabungwe 26 a Ryan White omwe amapereka ndalama zambiri. Mwa chiwerengero chimenecho, pafupifupi anthu 1,000 anadziwika ngati kuti anapita ku zipatala zambiri.
Kafukufukuwo sanatsimikizire kuti odwala am'chipatala ambiri sangafike poti angapitirize kulandira kachilombo kusiyana ndi anzawo omwe ali ndi kachipatala (68% peresenti ya 78%), komanso amalephera kutenga ART ngati pakufunikira (69% poyerekezera ndi 83%) .
Kuwonjezera apo, pamene adokotala ambiri ankadumpha chaka choyamba cha chisamaliro, 20 peresenti inapitilira nthawi yonseyi.
Maphunziro a adokotala mu phunziroli adadziwika kuti ali aang'ono, African American, akazi, opanda inshuwaransi kapena inshuwalansi ya umoyo.
Zotsatira za Dokotala Akuyembekezera
Zotsatira za dokotala kudula zingakhale zofunikira chifukwa ambiri mwa odwalawa alephera kufotokoza mbiri yakale ndi dokotala wawo watsopano. Izi zingachititse kulongosola zolakwika ndi kusagwirizana kwa mankhwala osokoneza bongo, kuwonetsa munthuyo kuti asatengere zotsatira zake komanso / kapena kukonzekera msanga kwa mankhwala osokoneza bongo .
Komanso, khalidwe, mafupipafupi, ndi kugwirizana kwa mgwirizano wothandizira odwala-omwe wodwalayo amasungidwira ku chipatala chomwecho kapena ndi dokotala yemweyo-amadziwika kuti azitha kusintha zotsatira. Kafukufuku wochokera ku Vanderbilt University School of Medicine wasonyeza kuti chisamaliro cholakwika mwamsanga chaka choyamba cha chithandizo chikhoza kupitirira kawiri chiopsezo cha imfa kwa odwala omwe ali ndi kachilombo koyambitsa matenda a Edzi, omwe ali ndi ana awiri omwe ali ndi zaka 100 pa odwala 100, munthu-zaka kwa omwe ali ndi chisamaliro chosasinthasintha, chokhalera.
Kuchokera pamaganizo a anthu, thanzi la dokotala lingakhale lopambanitsa, motero kuwonjezereka kosafunikira kwa mautumiki ndi kuwonongeka kwazinthu zomwe zimapereka ndalama zonse zothandizira.
Kuzindikira zifukwa zomwe zimayambitsa izi ndizomwe zingakhale zofunikira ngati akuluakulu a zaumoyo a US akuyembekeza kukwaniritsa kuchepetsa kupatsirana kwa kachilombo ka HIV motsatira ndondomeko yoyesedwa yoyezetsa magazi ndi mankhwala .
Zotsatira zamakono zikuphatikizapo:
- Kuchulukitsa odwala pogwiritsa ntchito mgwirizano, kulumikizana ndi chisamaliro, ndi chithandizo cha HIV mu malo ogwirizana, njira yotchuka yotchedwa "TLC-Plus."
- Kugawana mapepala a zamankhwala pakati pa akuluakulu a zaumoyo ovomerezeka kuti azindikire bwino odwala omwe ali dokotala akudula kapena kukhala ndi mbiri ya chisamaliro cholakwika cha mankhwala.
- Kupereka mwayi wochuluka wa chisamaliro chapadera cha kachirombo ka HIV, makamaka kwa anthu osamalidwa. Kupititsa patsogolo ku Medicaid ndi inshuwalansi ya umoyo payekha pansi pa Care Affordable Care Act kungathandize kuchepetsa kusiyana kwa thanzi la anthu omwe akukhudzidwa.
Zotsatira:
Yehia, B ;; Schranz, A .; Momplaisir, F .; et al. AIDS ndi khalidwe. "Zotsatira za Odwala omwe ali ndi kachilombo ka HIV akupeza chisamaliro pazipatala zambiri." September 28, 2013; e-yofalitsidwa patsogolo pa kusindikiza; PMID: 2407731.
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.
Herwehe, J ;; Wilbright, W .; Abrams, A .; et al. "Kukhazikitsidwa kwa chidziwitso chatsopano cha zachipatala (EMR) ndi mauthenga a zachipatala kusinthana kwa HIV / AIDS." Journal of American Medical Information Association. May-June 2012; 19 (3): 448-452.
Mugavero, M.; Lin, H ;; Willig, J ;; et al. "Odwala omwe akuyambitsa matenda opatsirana kachilombo koyambitsa matenda opatsirana pogonana akusowa alendo." Matenda opatsirana pogonana . January 15, 2009; 48 (2): 248-256.