E-US, sekuyisikhathi eside saziwa ukuthi, ngisho nangabe selulekwa ngezinzuzo zokulashwa kwe-antiretroviral yokuqala (i-ART) , ingxenye enkulu yeziguli ezifanelekele ukwelashwa izoyishintsha. Eqinisweni, ngokusho kwama- US Centers for Disease Control and Prevention (CDC) , kulaba bantu abangu-902,000 baseMelika abatholwa ukuthi banesandulela ngculaza, kuphela abangu-363,000 ababenesibindi kwi-ART ngo-2012.
Kwacatshangwa kakhulu ukuthi ukungabi nesimo sokubekezela kanye / noma ukuqonda kwakukhona enhliziyweni yalesi sibalo. Kodwa-ke, ucwaningo oluqhutshwa ngo-2013 yi-University Hospital Zurich lubonise ukuthi ukungafuni ukuqala i-ART akudlulisi kuphela kwiziguli kodwa nakudokotela babo.
Ucwaningo oluqhutshwa ezindaweni ezingu-34 eYurophu nase-Australia, lwahlola iziguli ezaye zatholakala ukuthi zinesandulela ngculaza futhi zingaphansi kokunakekelwa udokotela okungenani izinsuku ezingu-180. Kulezi ziguli eziseqenjini, ama-67% atholakale avela eyodwa kuya eminyakeni emine eyedlule, kuyilapho u-28% uthola ukuthi eminyakeni emihlanu noma ngaphezulu edlule.
Phakathi kwabahlengikazi abahlolisisiwe, u-78% waba neminyaka emihlanu noma ngaphezulu yokwaziswa okwelapha i-HIV, kuyilapho 90% eneziguli ezingaphezu kuka-50 ezithathelwana ne-HIV ekunakekeleni kwazo.
Izithiyo zangaphambili zokutheleleka nge-HIV
Ucwaningo lwangaphambili lwaluqaphele ukuthi izivimbela eziyinhloko zokwelashwa phakathi kweziguli kwakuwumthwalo ophezulu wephilisi kanye nokukwazi ukuphakama kwemiphumela emibi ehlobene nezidakamizwa.
Ngesikhathi esifanayo, uDktctor udlwenguliwe, wathonywa kakhulu yizici ezifana nokuguqula imihlahlandlela yokwelapha njalo kanye nombono ophikisanayo mayelana nesikhathi "sokulungisa" sokuqala i-ART.
Njengoba izidakamizwa zezizukulwane zamanje zizikhukhumeza imithwalo ephansi yamaphilisi nomphumela omncane we-side effects-kanye nokunyakaza ekubhekaneni ne-HIV kuma- CD4 amanani ka-500 / mL nangaphezulu-lezo zithiyo kubonakala zisuswe kakhulu.
Esikhundleni salokho, iziguli namuhla zibonakala zingaboni kangako izinzuzo zokwelapha okuqala, kuyilapho odokotela bezwa ukuthi iziguli eziningi zivele zingakulungele ukuzinikela ekwelapheni, ngokuvamile ziphuza i-ART, hhayi izinyanga, kodwa iminyaka ngezinye izikhathi. Ngokwenhlolovo:
- Iziguli ezingama-47% "azifuni ukucabanga nge-HIV."
- Amaphesenti angu-50 alabo abaqeqeshelwe ukwelashwa athi "ayengakulungeli," kuyilapho ama-33% ezwa "angaboni kahle."
Izizathu eziyinhloko ezikhonjiwe ukuthi "ukungabi nampawu" noma isimo sengqondo esithi "Ngiyethemba emzimbeni wami ukungitshela ukuthi ngizoqala nini."
Ngokuphambene nalokho, odokotela bavame ukuphuza i-ART ngoba "babengazi kahle isiguli isikhathi eside" noma bezwa ukuthi isiguli "sasicindezelekile kakhulu" ukuqala. Ukwengeza:
- Odokotela abangu-93% abahlola babecabanga ukuthi izincomo zamanje zokwelashwa zifanele iziguli zabo.
- Kodwa-ke, empilweni yangempela yokuphila, kuphela u-51% owaqala i-ART ngeziguli ezinezibalo ze-CD4 ngezansi kwamaseli angu-500 / mL, kuyilapho kuphela abantu abangu-16% bakholelwa ukuthi kufanelekile iziguli ezinezibalo ze-CD4 ezingaphezu kwamangqamuzana angu-500 / mL.
Ukungafani kulezi zibalo kubonisa okungaphezu nje kokungabaza okuvamile phakathi kwabahlinzeki. Empeleni, bangabonisa ukungabaza okuqhubekayo phakathi kwalabo abaye babona iziqondiso zihamba ngendlela eyodwa esikhathini esedlule, kuphela ukubuyela emuva eminyakeni embalwa kamuva lapho kubonakala imiphumela engalindelekile.
Ngaphezu kwalokho, ukubonakala okungahambi kahle ekunqobeni izithiyo zokuziphatha kubonisa ukuthi inkhulumomphendvulwano yendabuko mayelana nokulungeleka kwesiguli ayikaze iguquke ukuze kubonakale ukudilizwa kwamanje kwe-"exceptionalism" ye-HIV emashumini eminyaka adlule, lapho ukuzimela kwesiguli kuvame ukunqotshwa ukunakekelwa kweziguli ezinolwazi. Uma kunjalo, kungase kuvele kube yinkinga yokudlala "njengabadlali" bezama ukunciphisa igebe phakathi kobufakazi bemitholampilo nokusebenza komtholampilo.
Ngokuhlolwa kwe-HIV manje kunconywa kubo bonke abantu baseMelika abaneminyaka yobudala engama-15-65-kunokuba nje labo "abasengozini enkulu" -lindeleke ukuthi inhlamba nokungaqondisi kahle kuhlotshaniswe ne-HIV ngokuphakanyiswa kakhulu.
Imithombo:
Amasevisi aseMelika okuLawula nokuvimbela izifo (CDC). "I-CDC Fact Sheets | I-HIV e-United States: Izinyathelo Zokunakekela." I-Atlanta, Georgia; eshicilelwe ngoJulayi 2012.
Fehr, J .; I-Nicca, i-D .; Goffard, J .; et al. "Izizathu Zokungaqali Ukwelashwa Kwe-Antiretroviral: Ucwaningo Lwezwe Lonke Phakathi Kwabagulayo Nabahlengikazi Babo." Ingqungquthela ye-European AIDS Clinicians Society (EACS); EBrussels, eBelgium; Okthoba 16-19, 2013; Abstract PS11 / 1.