Amadolophu ase-US anamaxabiso aphezulu kunye neeNtsholongwane ezisezantsi
Imiba yengozi ye-HIV yimiba ebeka umntu kumngcipheko omkhulu okanye omncinci wokufumana (okanye ukudlula) i- HIV . Ngokuqhelekileyo sithatha oko kuthetha enye yezinto ezine:
- Ubuhlanga bomntu
- Ukwaziswa ngezesondo
- Izenzo zesondo (umz
- Ezinye iziphatho ezinokunyusa okanye ukunciphisa amathuba okusuleleka (umz- ikhondom , ukusetyenziswa kweziyobisi , unyango lwe-antiretroviral )
Izinto ezinobungozi be-HIV azenzelwe ukuqikelela ukuba umntu uya ku suleleka; Kunoko bajolise ekugqibeleni ukukhuseleka komntu kwi-HIV ukuze athathe amanyathelo okunciphisa umngcipheko. Kwaye nangona iimeko ezithile zingatshintshi-njengentambo okanye ukuxhatshazwa ngokwesini-kunokusinceda senze isigwebo esinolwazi esisekelwe kwindlela intsholongwane isasazeka ngayo kubemi okanye iqela elithile.
Enye yemingcipheko esingaqhelanga ukuyixoxa ngayo, ubuncinci kwisiseko somntu, yindlela ohlala ngayo inempembelelo ngqo kwiingcipheko ze-HIV, kokubili ngqo nangendlela engathanga ngqo.
INTSHOLONGWANE KAGAWULAYO Ngokuqinisekileyo i-Urban Disease
Intsholongwane kaGawulayo igcina, ngokubanzi, isifo sezidolophini. Ngokuqhelekileyo kugxininiswe kwizixeko ezinabantu abanabantu abangaphezu kwama-500 000 kwaye ngokuyinhloko kuluntu olungenakusuleleka kwi-HIV kuphela kodwa nakwezinye izifo ezithintekayo.
Nangona iinguqu zentsholongwane zingahluka ukusuka kummandla ukuya kummandla, izifo zengculaza zidla ngokubakho ngenxa yentlupheko, ukungabikho kwezibonelelo ezithile ze-HIV kunye nokusingqongqo kwempilo karhulumente kwisifo sengingqi.
E-US, izinga eliphezulu lokusuleleka koGawulayo olutsha eNingizimu, apho i-18.5 yabantu abayi-100,000 isulelekile. Oku kulandelwa kufuphi neNyakatho-ntshona (14.2) kunye neNtshona (11.2).
Okuxhalabisayo ngakumbi, ezithoba zithi zibandakanya i-South nayo i-akhawunti ye-40 ekhulwini yazo zonke izifo ezithintekayo nangona zimelele kuphela i-28 ekhulwini labantu base-US.
Ngokutsho kwamaziko okuLawula nokuLawula (i-CDC), izithili zephondo ezinkulu ezineziganeko eziphezulu ze- HIV (okt, inani lamatyala e-HIV amatsha):
- EBat Rou Rouge, eLouisana
- Miami-Fort Lauderdale-West Palm Beach, eFlorida
- ENew Orleans, eLouisana
- Jackson, Mississippi
- Orlando, Florida
- Memphis, eTennessee
- Atlanta, Georgia
- Columbus, eMzantsi Carolina
- Jacksonville, eFlorida
- Baltimore, Maryland
- Houston, Texas
- ESan Juan, ePuerto Rico
- Tampa-St. EPerersburg, eFlorida
- Isixeko saseNew York-iNewark-Jersey City, eNew York-eNew Jersey
- Little Rock, Arkansas
- I-Washington-Arlington-Alexandria, DC-Maryland-West Virginia
- I-Dallas-Fort Worth, eTexas
- Charleston, South Carolina
- Las Vegas, Nevada
- ELos Angeles, eCalifornia
Umfanekiso uguquka ngokukhawuleza xa ukhangela ukwanda kwe-HIV kumadolophu ase-US. Ngokungafani nesantya sobungozi, lo mfanekiso usixelela ukuba bangaphi abantu abangama-100,000 abanesifo kwi-metropolitan region.
Iidolophu zase-US ezine-HIV eziphezulu kakhulu (inani lamatyala ngabantu aba-100,000) zi:
- Miami (1,046)
- ISan Francisco (1,032)
- Fort Lauderdale (925.8)
- Philadelphia (881.9)
- Isixeko saseNew York (859.7)
- Baltimore (678.5)
- ENew Orleans (673.3)
- IWashington, DC (622.8)
- ENewark (605.7)
- UJackson, Mississippi (589.7)
- ESan Juan, ePuerto Rico (583.2)
- IWest Palm Beach (579.4)
- IBat Rou Rouge (560)
- Memphis (543.5)
- Columbus, South Carolina (509.1)
- Atlanta (506.6)
- Los Angeles (465.2)
- Orlando (460.7)
- Jacksonville (451.4)
- Detroit (410.7)
Indlela iMpendulo yeSixeko inokunyusa ngayo, ukunciphisa amaxabiso e-HIV
Kubalulekile ukuba uqaphele ukuba ukusukela kwintsholongwane kaGawulayo akuguquleli ukuba kubekho inani eliphezulu lokusuleleka. Kwanamadolophu anezinye iindawo eziphezulu zokutheleleka nge-HIV, impendulo yempembelelo yezempilo yomphakathi inokunciphisa kakhulu umngcipheko wokusasazwa kwangaphambili.
Ngokomzekelo, thabatha iSan Francisco, isixeko esiphendule esi sibhubeni ngokuba ngowokuqala ukubiza ukuhlolwa kwendalo kunye nonyango ngo-2010.
Ngaphandle kokuba nesibini ephezulu kwi-HIV kwi-US, impendulo yezobukrakra yeso sixeko yabangela ukuba kubekho ukuphazamiseka okukhulu kwiintsholongwane ezintsha, ukubetha ixesha elide elide kuphela lamatyala amatsha angama-302 kuphela ngo-2015. Kukholelwa ukuba ukusetyenziswa okubanzi kwe- HIV PrEP (ngaphambili -exposure prophylaxis) kunokunciphisa amaxabiso ngaphezulu.
Ngokwahlukileyo, ukungabikho komphendulwano oluhambelanayo kungabangela ukugqabhuka nakwiindawo ezincinci, ezingezizo ezisemadolobheni. Sibone lokhu ngo-2015 edolophini yase-Austin, e-Indiana (abantu abangama-4,295), apho iimeko ezingaphezu kwe-100 ze-HIV zaxelwa phakathi kwabasebenzisi abasebenzisa iziyobisi abaye babelana ngezilingo ngelixa bathabatha i-oxymorphone yeziyobisi. Ukuqhambuka kwabiwe kwinqanaba elikhulu ukuvalwa kombuso kwinkqubo yokutshintshwa kweenaliti (NEPs) eyenzelwe ukukhusela ezo zifo.
Akumangalisi ukuba i-HIV kunye neenxalenye eziphezulu kakhulu ze-HIV nazo ziye zavuna ii-NEP (kuquka i-Alabama, Arkansas, Mississippi, South Carolina, eTexas), kwaye nangona ubuncwane bobungqina benzululwazi obonisa i-NEP ukuphumelela ekukhuseleni izifo ezithwala igazi ukuhanjiswa.
Ngokufanayo, amazwe angazange amkele ukwandiswa kweMedicaid, eyenzelwe ukunika ukunakekelwa kwempilo emininzi kwabahlali abanomvuzo ongezantsi, baphakathi kwalabo abaneengxaki ze-HIV (Alabama, Florida, Georgia, Mississippi, South Carolina, eTexas).
Ngokutsho kwamaZiko oLwabiwo-mali kunye nokuPhambili kwePolisi, ukwandiswa kweMedicaid kwandisa abantu abaphila ne-HIV ukufikelela okukhulu ekungangeni nje kuphela unyango kodwa kungaphazamiseki, ukunakekelwa kwezempilo kwexesha elide.
Kwimeko yaseMassachusetts, ngokomzekelo, ukuguqulwa kwezempilo ngokubanzi kwandisa ukunakekelwa kwe-HIV kunye nonyango kuma-91 ekhulwini kwabemi abaphila ne-HIV, ukunciphisa iindleko zokubhedlele kunye ne-HIV ezinxulumene nokunyamekelwa kwezempilo nge-$ 1.5 billion.
Ngokwahlukileyo, urhulumente waseAlabama kufuneka athathe iipesenti ezingama-25 ze- ADAP (Inkqubo ye-AIDS ye-AIDS Drug Assistance Programme) kuhlahlo lwabiwo-mali-mali-mali-karhulumente-ngo-2011-eninzi ebenokuyithintela kwezinye iinkqubo zempilo zikawonkewonke ukususela kuma-81 ekhulwini abo kwi-ADAP babefanelekile.
Yonke into echazwe, ngaphezu kwesigamu se-noninsured and low-income people living with HIV bahlala kwiindawo eziye zaliwa ukunyuselwa kweMedicaid. Abaninzi bayavuma ukuba ukunyanzelwa kokuqhubekayo kubangelwa ukuba baninzi abasweleyo-phakathi kwabo, abase-Afrika-baseMelika nabasetyhini kunye nabesilisa abanezilwanyana zesini-kwingozi enkulu yentsholongwane, ukugula kunye nokufa.
Amadolophu anamaxabiso aphantsi kakhulu kwi-HIV
Ngokutsho kweCDC, ukusabalalisa kwe-HIV kwizithili ezingekho kwizixeko zase-US zihamba malunga nama-112.1 amacala angama-100,000. Kwizixeko ezili-107 ezibandakanyiweyo kwingxelo yayo ka-2015, zintandathu kuphela zawela phantsi kwesi sihlalo:
- Boise, Idaho (71.7)
- Rapid City, Michigan (100.1)
- Fayetteville, Arkansas (108.8); Madison,
- IWisconsin (110)
- Ogden, Utah (48.6)
- Provo, Utah (26.9)
Ngokwahlukileyo, iidolophu ezili-10 zase-US ezinezinga eliphantsi kakhulu lokungenwa kwe-HIV:
- Provo, Utah
- Spokane, Washington
- Ogden, Utah
- Boise, Idaho
- Modesto, California
- EWorcester, eMassachusetts
- Fayetteville-Springdale-Rogers, Arkansas-Missouri
- Madison, Wisconsin
- IScranton-Wilkes-Barre, ePennsylvania
- EKnoxville, eTennessee
> Imithombo:
> American Medical Association. "Isimo seSingle Exchange Programme 'kwi-Politics yase-US." JAMA. Matshi 2016; 18 (3): 252-257.
> Amacandelo ohlahlo lwabiwo-mali kunye neMigqaliselo yePolisi. "Iingcamango ziya kuphucula iziPhumo, iindleko eziphantsi kubantu abane-HIV." EWashington, DC; yapapashwa ngo-Okthobha 11, 2012.
> Amacandelo okuLawula nokuLawula izifo. (2015) Ingxelo yokuHlola i-HIV, 2014 (Umqulu 16). Atlanta, Georgia: CDC.
> Snider, J .; Juday, T; Romley, J .; okqhubekayo. "Phantse abantu abangama-60 000 abangaqinisekisiweyo kunye nabantu abaphantsi kweNtsholongwane kaGawulayo / noGawulayo abahlala kwiZizwe ezingenakwandisa iMedicaid." Imiba yezeMpilo. Matshi 2014; 33 (3): 386-393.