Ubuthathaka kunye noorhulumente abangasebenziyo
Ukungafani kohlanga lwe- HIV e-United States kuye kwafikelela kumanqanaba amancinci. Oku akubonakali ngaphezu kwe-Afrika yaseMelika, nangona ibingama-12 kuphela ekhulwini labantu base-United States, i-akhawunti engama-48 ekhulwini kuwo onke amatsha.
Izizathu ezi zinto ziyinkimbinkimbi kwaye kaninzi ziqondwa kakuhle. Nangona abanye bebakhombisa ukuba inkcubeko kunye nokuziphatha ngokwesondo kuphela kubeka ityala ngale nto, iphoso lixhomekeke ngakumbi ekungalinganisweni kwezenhlalakahle nakwezoqoqosho ezingakwazi ukuphazamiseka kwezifo ezithintekayo.
Ubumpofu, ukungabi nabulungisa kwezenhlalakahle, kunye nokungabikho kompendulo osebenzayo karhulumente kunye kunye nokwandisa kwezifo kwimimandla engenazo izixhobo zokulwa nayo.
Ngeendlela ezininzi, ingqungquthela ye-HIV yinto engumzekelo wokungafani kokukhula kwinkonzo yempilo eyenza abantu abaninzi base-Afrika baseMelika bengengozini enkulu yokungagcini nje nge-HIV kuphela, kodwa ezinye izifo ezikhuselweyo kunye nezifo.
Izibalo zamanje ze-US
Ukuthi kukho ukungabikho kwintlupheko yolwahlulo lwe-HIV kwi-US yinto engaphantsi kwayo. Okwangoku, abantu base-Afrika baseMelika baphantse ukuba banokusuleleka ku-HIV kwaye banokuphindwa kabini njengeLatinos. Abafazi base-Afrika baseMerika baxhatshazwa kakhulu kwiintsholongwane ezintsha, ziqhuba ngexesha eliphindwe kuma-16 izinga elibonwa ngabafazi abamhlophe.
Ngaphandle kwindoda enobungozi kakhulu abalala ngesini kunye namadoda (MSM) , ukuba ngumlingani kunye nomAfrika waseMelika ubeka umntu kwi- 50% engozi yokufumana i-HIV ngexesha lokuphila (xa kuthelekiswa neepesenti ezili-9 kuphela phakathi kwamadoda amhlophe angama-gay).
Ezi zibalo kuphela zihlola ubuso beengxaki ezihlala ziphazamisekile kwaye ziphikisana. Ngelixa abantu abaninzi baya kubeka ngokusobala ukuziphatha kwabo bakholelwa ukuba bazalwa kwiinkcubeko, ezi ntlobo zempendulo zisebenzela ukuqhubekisela phambili izinto ezimbi ezikhuthaza ukunyaniseka, ukucalulwa, kunye nokungabikho komphakathi.
Uninzi lweziganeko eziqhelekileyo ("abantu abamnyama abalalayo" okanye "ukusetyenziswa kweziyobisi zixhaphake kubantu abantsundu") bavele bangqina into engeyinyani kumxholo we-HIV. Umzekelo:
- Amantombazana aseMerika aseMelika akakwazi ukusuleleka ukuba ayenesifo ngenxa yezilwanyana ezifayo kunabamhlophe abamhlophe. Abafazi base-Afrika baseMerika baxhomekeke ngokutsha ngesondo ngokulalana ngesondo, nangona abafazi abamhlophe banesifo esinegalelo ngokuhlanganyela .
- Akunamadoda angama-Amerika aseMerika namabhinqa anamazinga aphezulu okuziphatha kwengozi yezocansi kunanoma yiphina iqela lobuhlanga.
- I-MSM emnyama, eqinisweni, ingxelo ngamaqabane angaphantsi kwezesondo, ubuncinci obungaphantsi kwe- anal anal , kunye nokusetyenziswa kweziyobisi ezingaphantsi kwe-MSM emhlophe.
- Ngakolunye uhlangothi, abantu base-Afrika baseMerika, banokuthi bavavanyelwe i-HIV kunabamhlophe (iipesenti ezingama-75 kunye nama-14 ekhulwini).
- Ama-American aseMelika afaneleke afune kwaye ahlale eqhubekayo, unyango oluthile lwezonyango lwe-HIV njengamhlophe (ama-54 ekhulwini kuya kuma-58 ekhulwini).
- Isantya sosulelo olungabonakaliyo luyafana nangaphezulu kwi-Afrika yaseMerika njengabantu abamhlophe (iipesenti ezili-11 kunye nama-13 ekhulwini). Kuzo zonke iintlanga, ama-Asiya, ngokwenene, ayengabonwa ngabanye (iipesenti ezingama-21).
Xa ukungafani, ngoko-ke, akuninzi kwimpendulo yoluntu kwi-HIV kodwa ezinye izinto ezinzima kunzima ukuzenza phantsi.
Namhlanje, i-HIV ihlala isisithandathu sokubangela ukufa kwabantu base-Afrika baseMerika kunye neyesine ebangela ukuba bafa kubomama base-Afrika baseMerika phakathi kweminyaka engama-35 no-44. Ngokwahlukileyo, i-HIV ayisabonakaliswa njengobangela obangela ukufa ngenxa nayiphi na enye uhlanga.
Ukuxhatshazwa kwamanani amaninzi kuGawulayo
I-HIV ayichaphazeli lonke uluntu ngendlela efanayo. Nangona u-Afrika waseMerika, umhlophe, okanye iLatinino ingayitshintshi indlela umntu asabela ngayo esi sifo, kukho ukukhuseleka okunokubeka umntu wohlanga olulodwa kwingozi enkulu yokusuleleka kunye nokugula kunomnye.
Siyabona oku, umzekelo, ngeempendulo ezahlukeneyo kwiinkatho ze-HIV.
Nangona ama-70 ekhulwini kuma-whites akwazi ukufezekisa umthwalo wentsholongwane engabonakaliyo xa unyango, abangaphantsi kwama-50 ekhulwini labase-Afrika baseMerika banako ukwenza okufanayo.
Ngaloo ndlela, inkcubeko okanye ukuziphatha ngokwesondo akunakucacisa nakubakho ukuhlukana. Kunoko, imbambano ibonakala inzulu kakhulu kunye neziko, echaphazelekayo ngezinto ezinje:
- Intlupheko
- Stigma
- Ukungabikho kokufikelela kwiinkonzo zempilo
- Ukungaphumeleli karhulumente, intlalo, amapolisa kunye neenkonzo zomthetho
- Amanani athatywayo okubanjwa nokuboshwa
- Abemi basezidolophini eziphezulu
Ezi zingalingani zidlala enye elandelayo kwiindlela ezidala umjikelo wokungcipheko okusoloko kunzima ukuwaphula.
Siye sabona oku, mhlawumbi kuninzi kakhulu, nge-African American MSM ene-HIV. Uphononongo olwenziwa ngo-2014 oluqhutywa yiSikolo seRollins lweMpilo kaRhulumente kwi-University yase-Emory lugqiba ukuba, nangona kunemiba emngciphekweni yesondo kunabo abalingani bamhlophe, la manani a madoda ayenokuba yincinci, ayinayo imfundo encinane, ayisebenzi, ayinama-STD angaphantsi. , kwaye kungabi ncinane ukuba uxoxe ngeHIV kunye nomlingani wesini.
Ezi zinto zidibeneyo zenza into emfutshane ngesiqhwithi esipheleleyo sosulelo.
IiNtlupheko zoTyhulo
Phantse omnye kumntu omnye wase-Afrika waseMerika uhlala entlupheko, ngaphezu kwezinga eliphindwe kabini kumhlophe. Ngokwabo, intlupheko ibangela ubungozi ngokuthintela abahlwempuzekileyo ukuba bafumane iinkonzo ezinokuthi zithintele okanye zithathe unyango.
Oku akubandakanyi kuphela ukufikelela kwiinkonzo zempilo kodwa kufikelela kwezinye iindawo zoluntu, ngokunjalo. Phakathi kwabo:
- Ukungabikho kwamapolisa kunye nokukhuselwa ngokomthetho kwiindawo ezihluphekileyo kubandakanya abasetyhini abasetyhini, abantwana kunye nabanye abasengozini yokusetyenziswa gadalala.
- Iinkonzo zentlalo ze-intanethi kunye neengxowa-mali ezingabikho phantsi kwezimali zonakalise abaninzi ukuba bafune uncedo nakweyiphi na ngaphandle kwezinye iimfuno zabo.
- Ukungabikho kweenkqubo zokusetyenziswa kakubi kweziyobisi kwenza ukuba ukusasazeka kwabangasetyenziswanga kuphela kubasebenzisi kodwa kunye nabalingani babo besini, ngokunjalo.
- Ixabiso eliphantsi le-inshorensi yonyango, ngokukodwa kumazwe avumele ukunyuswa kweMedicaid , ngokukhawuleza ihambelana namazinga aphezulu okusuleleka ngoGawulayo.
Ngokuhamba kwexesha, ukungaphumeleli kwezi ziko kubangela ukungathembeki kubo bobabini kunye negunya ngokubanzi. Ngenxa yoko, abantu baya kufikelela kwiinkonzo abazivelayo ziyimfuneko (njengoncedo lwezezimali kunye nonyango lwezonyango) kwaye ugweme abo "banokulinda" (njengempilo yokukhusela kunye nonyango).
Oku kubangelwa ukuba kutheni iipesenti ezingama-22 zama-Afrika aseMerika zilibazise ukuvavanya i-HIV kude kube nzima, kwaye ngezinye izihlandlo zigula, zigula.
Kodwa akusikho nje uvavanyo olugqithiseleyo oogqirha abakhathazekile ngalo. Izifo ezithintekayo ngokwesondo ezifana ne-gonorrhea, ezixhaphakileyo kwiindawo ezihlwempuzekileyo, zinokwandisa umngcipheko we-HIV ngama-700 ekhulwini. Ngaphezu koko, ukunakekelwa kwonyango okungahambelaniyo kwenza umntu angabi nako ukufumana izibonelelo zonyango lwe-HIV kwaye kunokwenzeka kakhulu ukuba akwazi ukunyanzelisa iziyobisi .
Ekugqibeleni, intlupheko yentsholongwane yokhuseleko ngokukhupha kunye / okanye ukuchaphazela ukhetho umntu angakwenza. Apho, ezinye iindawo ezicebileyo zineendlela zokunqoba ezininzi zee miqobo, abantu abahluphekileyo base-Afrika baseMerika abayithandi. Ukusasazeka kwe-HIV kule mimandla, ngoko, kwenzeka kuphela kuba akukho nto yokuyima.
I-HIV Stigma Phakathi kwama-Afrika aseMerika
Nangona kukho utshintsho olukhulu kwisimo sengqondo sikawonkewonke, ukunyanzelwa kwabantu abaphila ne-HIV kuqhubeka. Impembelelo yehlazo ingabetha abantu base-Afrika baseMelika ikakhulukazi nzima, zombini kwiimeko apho kuqondwa khona (ukuvakalelwa) kunye nokumiselwa (okwenene).
Imiphumo yehlazo ingaba yinto enzulu. Amaxesha amaninzi, abantu baya kunqanda ukuchaza isimo sabo se-HIV ngenxa yokwesaba ukubuza imibuzo malunga nesondo sabo okanye ukubizwa ngokuthi "ukuziphatha kakubi," "ukungcola," okanye "ukungathembeki."
Oku kubonakala kunyanisekileyo kwimimandla apho imfundiso yenkonzo inokuthi ifune ukuxhaswa ngabantu abaphila ne-HIV ngelixa begxeka ukuziphatha njengento engabonakaliyo. Uphando olwenziwa ngo-2014 yi-Non-Income Public Religion Research Institute lwagqiba ukuba i-17 ekhulwini yabasontayo e-US bakholelwa ukuba i-HIV "isijeziso sikaThixo" ngokuziphatha okubi ngokwesondo.
Phakathi kwamaqela amaninzi angamkela ezi nkolelo zingamaProtestanti abamhlophe abamhlophe (ama-25 ekhulwini), amaKatolika ama-Hispanic (ama-21 ekhulwini) kunye namaProthestani abamnyama (ama-20 ekhulwini).
Kwiindawo zase-Afrika zaseMerika, apho amaphesenti angama-95 amabhinqa acinga ukuba unqulo luphambili ebomini babo kwaye iipesenti ezingama-50 zithandaza rhoqo okanye ziya kwicawa, ezi ngxaki zinzima ukusinda.
Ngenxa yoko, abantu base-Afrika baseMelika banako ukuthetha ukuba kukho inkcazo kunye nokucwaswa kubantu abane-HIV kunokuba ngabahlophe okanye iLatinos. Ezi mpawu zizidlala kwiindlela ezininzi ezimbi:
- Abantu abanentsholongwane kaGawulayo ababona isiglameko banako ukusela ngokugqithiseleyo okanye ukubika kakubi kweziyobisi.
- Abantu besaba i-HIV intshutshiso kunye nokudalulwa banokuthi baphephe ukuvavanya nokunyamekela unyango.
- Ukwanda kwezinga lokudakumba kudla ngokuguqulela ukwanda kwindlela yokuziphatha ephezulu.
Ukongezelela, ukujonga ubandlululo obubanjwe neempembelelo zangempela kwimpendulo karhulumente kubonakala kukuqinisa iinkolelo phakathi kwamaninzi ase-Afrika ase-Afrika ukuba i-HIV ayikhupheki nje kuphela kodwa, ngokwenene, iinjongo.
Uphando olupapashwe ngo-Apreli 2010 lwe- Journal ye-American Medical Association yabika ukuba kuma-1,351 amadoda ase-Afrika aseMerika ahlolisisiwe, ama-49 ekhulwini ayenokuthi i-HIV yenziwe yi-CIA ukubulala abantu abamnyama.
Nangona abanye befumana ezi ntlobo zeqhinga okanye ziyancipha, abaninzi abanokholo kwengqondo bakholelwa ukuba luhlobo olunzulu lokukhanyela. Esikhundleni sokujongana nesifo abayamoyikayo, abantu baya kukhangela ingozi ukuze baqikelele ukungabikho kwabo kunye nokuvakalelwa.
Urhulumente kunye neHIV
EUnited States, i-HIV ininzi isifo sezidolophini. Ngenxa yokuba aba bantu baninzi kwaye banomlinganiselo ophezulu wokubuyiswa kwemali, naluphi na ukuphazamiseka kokusasazeka kunokusasazeka ngokukhawuleza ngaphandle kokuba kuthathwa inyathelo elinobuqhetseba nguRhulumente ukuliyeka.
Ukungaphumeleli ukwenza oko kungakhokelela kwiziphumo eziphezulu ezingasamkelekiyo zentsholongwane ezibonakala eMzantsi, apho i-Arkansas, Alabama, eFlorida, eGeorgia, eLouasana, i-Mississippi, eSouth Carolina, eTennessee naseTexas, namhlanje iphendula malunga ne-40 ekhulwini sulelo olutsha.
Ngenxa yokuba ama-Afrika aseMelika athambekela ngokukhethekileyo ngokukhetha kwabo isondo (ngokuchasene nabamhlophe abasenokwenzeka ukuba bakhethe abalingani beentlanga ezahlukeneyo), amanethiwekhi ezesondo kula maninzi athambekele ukuba amancinci kwaye athabathe. Ngenxa yoko, nayiphi na intsholongwane kuluntu iya kuhlala kuluntu, ukwandisa ngamanani njengoko abaninzi abantu beza kukhangela ithuba lomsebenzi.
Kwiindawo ezininzi zasezidolophini, ukusuleleka kwi-HIV kuqhutyelwa phambili yimigaqo-karhulumente eyenza ukubandlulula abahluphekileyo. Phakathi ezininzi kweephene:
- Akuyona ingozi yokuba amazinga e-HIV aphezulu kakhulu kwiindawo eziye zalahla ukwandiswa kweMedicaid, kuquka i-Alabama, iFlorida, i-Georgia, i-Mississippi, iSouth Carolina kunye neTexas. Uphando oluvela kwi-Women's Interagency HIV Study liye lagqiba ukuba iMedicaid, njengento eyayizimeleyo, ingaphezu kokuphindaphinda kabini amathuba omntu wokufumana umthamo wentsholongwane engabonakaliyo.
- Ngokufanayo, iivumelwano ezivinjelwe iinkqubo zokutshintshwa kweenaliti nazo zikarhulumente ezifanayo kunye namazinga aphezulu okusuleleka. Ezi ziquka kwakhona i-Alabama, iFlorida, i-Georgia, i-Mississippi, iSouth Carolina kunye neTexas.
Ngenxa yezi zinto kunye nokunye ukuhluleka, ukunqoba isifo se-HIV kwiindawo zase-Afrika zaseMerika ziza kuthatha okungaphezulu nje kwonyango. Kuya kufuna utshintsho olukhulu kwisimo sengqondo esidlangalaleni kunye neendlela zokunakekelwa kwempilo kunye nezinye iinkonzo zentlalo ebalulekileyo ezihanjiswa kuluntu oluninzi oludinga.
> Umthombo:
> Bogart, L .; Galvan, F .; Wagner, G; okqhubekayo. Iingcamango zobuqhetseba malunga ne-HIV zixhomekeke kwi-Antiretroviral Treatment Ukunganaki phakathi kwamadoda ase-Afrika ase-Afrika abane-HIV. " I-Journal ye-Immune Deficiency Syndromes. Epreli 2010; 53 (5): 648-655.
> El-Bassel, M .; Caldeira, M .; Ruglass, uL. et al. "Ukubhekiselele kwiiMfuno eziZodwa zeBaMerika baseMerika kwiNtsholongwane kaGawulayo." Juni 2009; 99 (6): 996-1001.
> Friedman, S .; Cooper, S; kunye no-Osborne, H. "Ulungelelaniso lwezakhiwo kunye noluntu lweNgcembelelo kaGawulayo phakathi kwama-Afrika aseMerika." I-American Journal yeMpilo kaRhulumente. Juni 2009; 99 (6): 1002-1008.
> Fry, V .; Bonner, S; Williams, K. et al. Intetho echanekileyo: Ukukhusela i-HIV kwi-African-American Homestone Sexual Design: Uhlolo lweMfundo kaGawulayo. Oktobha 2012; 24 (5): 389-407.
> Sullivan, P .; Petersen, J .; Rosenburg, E. et al. "Ukuqonda ukuhlukana kobuNtsholongwane kaGawulayo / i-STI kubantu abaMnyama nabamhlophe abalala ngesondo: Indlela eya kwi-Multilevel." PLoS One. 2014; 9 (3): e90514.