Enye yeenkcazo zokuqala ukuba isiguli asiyi kukwazi ukufumana impendulo efanelekileyo kwi- antiretroviral therapy (i-ART) xa umntu echongwa ngokuthi "ugqirha wezokwelapha" -kubeka nje, umntu o tyelela iiklinikhi ezininzi okanye oogqirha kwikhosi leminyaka, inyanga, okanye iiveki.
Kukho naziphi na izizathu zokuba kutheni isigulane sikhetha ukwenza njalo.
Ngezinye izihlandlo, mhlawumbi ukuba isigulane ayithandi ugqirha othile okanye ikliniki, okanye idinga unyango oluneemeko ezihambelanayo, njenge- hepatitis C (HCV) , ukusetyenziswa kakubi kweziyobisi okanye impilo yengqondo.
Kodwa, ngokuphindaphindiweyo, kungekhona nje ukuba isigulane asifuni ukuvuma okanye ukujamelana nomba othile ophathelene nokuxilongwa , ukuphathwa okanye unyango lwe-HIV . Imizekelo ibandakanya:
- Ukulahlwa, okanye ukwesaba ukuchazwa kunye nokucwasa .
- Izigulane eziye zafumana ukungaphumeleli kokonyango ngenxa yokunyanzeliswa kweziyobisi kunye nokunyanzeliswa kwezidakamizwa kwaye kunokunyuka ukuya kwelinye ugqirha kunokuba zivume (okanye zijongane) iingcambu zabo ezingabambeleli.
- Izigulane ezingenalo ukuvuma okanye ezingenakukwazi ukujamelana nokuxilongwa okucetyiswayo, ngubani na oza kugqirha ugqirha ugqirha unethemba lokuba umphumo othile.
- Ukungakwazi ukuwamkela iimfuno zokunyanzeliswa kweziyobisi zansuku zonke okanye iinkqubo zesondo ezikhuselekileyo .
Ubuninzi kunye neProfayili yeDokotela
Uphononongo luka-2013 oluvela kwisikolo sePerelman of Medicine kwiYunivesithi yasePennsylvania lihlola ubungakanani kunye nesiphumo sokugqithisa ugqirha ngaphezu kweminyaka emibili ukususela ngo-2008 ukuya ku-2010.
Kuphando lwabo, abaphandi bafumana ukuhamba kweekliniki, imbali ye-ART, kunye nomthwalo wegciwane lesandulela ngculazi kwizigulane ezingama-13,000 kwiikliniki zikawonke-wonke ezixhaswa ngemali zikaRyan White . Kuloo manani, phantse abantu abayi-1 000 bachongwa njengevakhenkethi kwiiklinikhi ezininzi.
Uphando aluqinisekisi nje kuphela ukuba izigulane ezininzi zeeklinikhi zazingenakukwazi ukuphumeza ukunyanzeliswa kwe-viral kunezihlobo zabo zekliniki (68% ngokubhekiselele kuma-78%), bekuninzi kakhulu ukuba bathathe i-ART xa kufuneka (i-69% ngokumalunga no-83%) .
Ukongezelela koko, ngelixa uninzi lwagqirha luye lwaba ngunyaka wokuqala wokunyamekela, i-20% yaqhubeka kulo lonke ixesha.
Ugqirha ogqithisileyo kulolu cwaningo bekuninzi bachazwa ukuba bancinci, ama-Afrika aseMerika, amabhinqa, kungekho ninshuwalense okanye kwinshuwalense yezempilo kawonkewonke.
Iziphumo zeDktr Hopping
Iziphumo zogqirha zogqirha zihlala ziphawuleka kuba ezinye zezi gulane zihluleka ukutyhila imbali yangaphambili kunye nodokotela wabo omtsha. Oku kunokubangela ukucacisa iimpazamo kunye nokungaxhamlisani kwezidakamizwa-iziyobisi, ukubonakalisa umntu ukuba abe nempembelelo engafanelekanga kunye / okanye ukuphuhliswa kokukhawuleza kwe- HIV .
Ngaphezu koko, umgangatho, ubukhulu, kunye nokuhambelana kokusebenzisana nesigulane-apho umguli egcinwa kunyameko kwiklinikhi efanayo okanye kunye nogqirha ofanayo-ayaziwa ngokuphucula iziphumo zeklinikhi. Uphando olusuka kwi-Vanderbilt School School of Medicine lubonise ukuba ukunakekelwa okungekho ngangoko kunyaka wokuqala wonyango kunokuphinda kabini umngcipheko wokufa kwizigulane ezine-HIV, kunye nokufa kwama-2.3 ngamnye kwiminyaka eyi-100-isigulane kunye nokufa kwe-1.0 kuphela kwi-100- umntu-iminyaka kubantu abanokunyamekela, kunye neklinikhi eyodwa.
Ukususela kwimpembelelo yempilo yoluntu, ugqirha ogqirha unokuba luncedo ngokulinganayo, obangela ukuphindaphinda okungabalulekanga kweenkonzo kunye nokuchithwa kwezixhobo ezinokwandisa iindleko zonyango jikelele.
Ukuchonga izizathu ezisisiseko salokhu kuya kuba yinyathelo elilandelayo elifanelekileyo ukuba amagosa ezempilo aseburhulumenteni ase-US anethemba lokufumana ukunciphisa ukunyuswa kwe-HIV ngokuhambelana nemigaqo-nkqubo yokuvavanya kunye neyonyango .
Iingcebiso ezikhoyo ziquka:
- Ukuhlengahlengisa isigulane ngokubambisa ukuvavanya, ukudibana nokunyamekela, kunye nokunyangwa kwe-HIV kwisibonelelo esihlangeneyo, isicwangciso esibizwa ngokuba yi "TLC-Plus."
- Ukwabelana ngeengxelo zezobugcisa zonyango phakathi kwamagunya ezempilo ogunyazisiweyo ukuba zichonge ngakumbi izigulane ezinoba ugqirha okanye ufumane imbali yokunakekelwa kwezempilo.
- Ukubonelela ngoncedo olungakumbi kwiinkathalo ezithile ze-HIV, ngokukodwa kwimimandla ebekelwe phantsi. Ukufikeleleka kokufikelela kwiMicrosoft kunye ne-yinshorensi yezempilo yangasese phantsi kwe- Care Affordable Act kunganceda ukunciphisa ukungabikho kwempilo kubantu abachaphazelekayo.
Imithombo:
Yehia, B .; Schranz, A .; Momplaisir, F .; okqhubekayo. AIDS kunye nokuziphatha. "Iziphumo zezigulane ezithathelwana nge-HIV ezifumana unyameko kwiiklinikhi ezininzi." Septemba 28, 2013; e-papashwe ngaphambi kokuprinta; PMID: 2407731.
Gardner, E .; McLees, M .; Steiner, J; okqhubekayo. "I-Spectrum of Engagement kwi-HIV Care kunye nokuBheka kwayo kwi-Test-and-Treat Treat Strategies for Prevention of HIV Infection." Izifo ezithathelwanayo zonyango. Matshi 2011; 52 (6): 793-800.
Herwehe, J .; UWilbright, W. Abrams, A .; okqhubekayo. "Ukuphunyezwa kwerekhodi yezobugcisa zedijithali (innovative), edibeneyo ye-elektroniki (EMR) kunye nolwazi lwezempilo loluntu lwe-HIV / AIDS." Umbhalo we-American Medical Information Association. NgoMeyi-Juni 2012; 19 (3): 448-452.
Mugavero, M .; Lin, H; Willig, J .; okqhubekayo. "Ukutyelelwa kunye nokufa kwabantu phakathi kwezigulane ezenza unyango lokuqala lwe-HIV." Izifo ezithathelwanayo zonyango . NgoJanuwari 15, 2009; 48 (2): 248-256.