Naphezu komthetho Ukuvumela ukuguqulwa okwenziwe nge-HIV, ukukhubazeka kubuzwa
NgoNovemba 12, 2013, uMongameli uBarack Obama usayine umthetho umthetho we- HIV Organ Policy Equity Act (i-Hope Act) evumela umnikelo wezifo ezingenayo i- HIV (a) nomamukeli we-HIV noma (b) umuntu ohlanganyela emcwaningweni wezokwelapha ovumela ukusetshenziswa kwezitho ezinegciwane lesandulela ngculaza ngaphansi kwemigomo nemigomo yeThe Hope Act.
I-Hope Act ishintshe uMthetho Wokuguqulwa Ngokwemvelo ka-1988, owawuvimbela iminikelo enjalo ngenxa yokukhathazeka mayelana nokuphikiswa kwezidakamizwa ezidlulisiwe , ukusebenza komzimba, ukungafani nokunye okunye okungahle kunciphise izinzuzo zalolu hlobo lokufakelwa. Umthetho omusha ufika ngesikhathi lapho isidingo sokuguqula izidakamizwa singakaze sikhulu, ikakhulukazi ngokukhula kwamazinga enhliziyo , isibindi, izinso nezinye izifo ezithinta abantu asebekhulile be-HIV .
Lo Mthetho uphinde uvume ukusebenza kwe- antiretroviral therapy (ART) ekuqinisekiseni ukucindezelwa okuqhubekayo kwegciwane lesandulela ngculazi kumbili umhlinzeki womzimba nomamukeli, ukunciphisa ukukhathazeka ngaphambilini okuhlobene nokufakelwa kabusha.
Umthethosivivinywa, owahlongozwa nguSenator Barbara Boxer waseCalifornia, ubonwe njengendlela yokusiza abantu ukuthi bangenalo igciwane lesandulela ngculazi kuluhlu lokulinda ukufakelwa komzimba. Isilinganiso saholela ekumemezelweni ngoFebhuwari 2016 ukuthi uJohn Hopkins School of Medicine uzoba isikhungo sokuqala ukuqala ukuguquka komzimba kusuka komuntu oyedwa one-HIV komunye.
Okwenza I-Hope Act ibaluleke kakhulu
Ngaphandle kokunciphisa umzila wokulinda uhlu lokulinda nokubhekana nesidingo esikhulu seminikelo yombutho phakathi kwabantu abanegciwane lesandulela ngculaza, i-Hope Act ibonakala abaningi njengesiqalo sokuqala ekuqedeni ukuxhaswa kwezidakamizwa ezihlala isikhathi eside kubantu abaphila ne-AIDS. Lisho ngokucacile ukuthi, kule minyaka yobudala be-CART yesimanje, ukwesaba ukuphindaphindiwe kufana nokuqhathaniswa nenani lokufa elibangelwa ukwehluleka kwegciwane elihambisana ne-HIV.
Previous to the Hope Act, bekungekho emthethweni ngisho nokutadisha ukufakelwa komzimba wegciwane lesandulela ngculaza ngaphansi kwengcwaningo yocwaningo-ukubonakalisa isayensi embi nokwesaba okuphazamisayo okwakubangele imithetho eminingi ecatshangelwe "ukuvikela" umphakathi jikelele (kufaka phakathi namanje -ukumelana nokuhlukunyezwa kwegazi gay e-US futhi okuningi
Njengokuhlinzekwa kwegazi, ukuguquka komzimba e-US kulawulwa kakhulu. Isizukulwane samanje, ukuzwela okukhulu kwe-HIV ukuhlola ukuthi akukho muntu ongenayo i-HIV ongathola isitho kumuntu onesandulela ngculazi. Njengamanje, yonke iminikelo yesikhumba kanye nezicubu ihlolwe ngokuzenzakalela nge-HIV, i-hepatitis B (HBV) ne- hepatitis C (i-HCV) ngokusho kwezinkombandlela zika -1994 ze-US Health Health (PHS) zokuvimbela ukuhanjiswa kwe-Human Immunodeficiency Virus ngokusebenzisa ukuguqulwa.
Ukukhubazeka kwe-Hope Act Kubuzwe
NgoSeptemba 2014, abacwaningi baseYunivesithi yasePennsylvania baqhuba isifundo sokuqala emthethweni weThe Hope Act, behlola ukuthi kufaneleka abantu abangu-578 abafayo, abaneziguli ezinegciwane lesandulela ngculazi njengabaxhasi abangamalungu.
Lolu cwaningo olwenzelwe ukumelela i-pool ye-organ engase ibe khona endaweni yaseFiladelphia, yayineziguli ezineminyaka engama-53 ubudala, abangu-68% abesilisa nabangu-73% babo base-Afrika-American.
Njengoba inani le- CD4 eliphakathi kuka-319 nemithwalo engavumelekile yegciwane lengculaza , leli qembu lalibhekwa njengabaxhasi abafanelekayo, abanezifo ezimbalwa ezithandanayo (4); okumbalwa ukuguqulwa kwezidakamizwa ezingamanga (2); futhi ezimbalwa, kamuva-stage protease inhibitor izidakamizwa izidakamizwa ngesikhathi sokufa (6).
Isifundo, esethulwa kwi-54th Interscience Conference mayelana nama-Antimicrobial Agents kanye ne-Chemotherapy (i-ICAAC) eWashington, DC, saphetha ngokuthi leli qembu lingase liveze izinso eziyisikhombisa kanye ne-livers ayisishiyagalolunye kusukela ngo-2009 kuya ku-2014, kanti iningi lingabanjwanga ngaphansi kwezinga elifanele lokufakelwa komzimba . Lezi zihlanganisa:
- 260 abangekho esibhedlela ngesikhathi sokufa kwabo.
- 87 akhishwe ngokungabikho kokucutshungulwa kobuchopho.
- 75 engavunyelwe ukuba nesizathu esingaziwa sokufa.
- 70 engavunyelwe ukuba angaphansi kokunakekelwa kwezokwelapha ngesikhathi sokufa kwabo.
- 63 akhishwe ngaphandle kokungenwa umoya we-ventilation.
- 13 ngaphandle kwesifo sikashukela, umfutho wegazi ophakeme, i-HCV, i-cirrhosis, noma isifo sezinso zokuphela kwezinso.
- 3 engavunyelwe ukuba ne-malignancy.
Ngaphezu kwalokho, ukufometha kwekhompiyutha kunqume izinga lokuphumelela elilinganiselwa ku-50% ezinkampanini zezinso ezisezingeni eliphezulu lezitho ngaphakathi kwechibi lezinkokhelo ezihlongozwayo. Ngokuphambene nalokho, izinga lokusinda kwe-foft yeminyaka emithathu lalingama-more-or-less lihambisana nelomphakathi jikelele (71% kuya kwe-74%, ngokulandelana).
Ucwaningo oluqhubekayo luzocaca ukuthi ngabe amaphethini afanayo abonakala yini kwabanye abantu abane-HIV, lapho ukutholakala kwezitho ezingenayo i-HIV kungase kungabikho ukunikeza inani elinamandla labaxhasi abaphezulu.
Imithombo:
I-United States Congress. "S.330 - I-HIV Yomthetho We-Equity Act Act113 Congress (2013-2014)." Washington, DC; Novemba 21, 2013.
I-New York Times. "UJohn Hopkins Ukwenza Ukufakelwa Kwamalungu E-HIV Okuqala E-US" Kushicilelwe ngoFebhuwari 10, 2016.
Isevisi yezempilo yomphakathi yase-US (PHS). "Izinkombandlela ze-US US Health Service (PHS) zokuvikela Ukudluliswa Kwegciwane Lokungena Emzimbeni We-Human Immunodeficiency Virus ngokusebenzisa iTransplantation." Umbiko wezeMpilo yomphakathi. Julayi-Agasti 2013; Umqulu 128.
Richterman, A .; Lee, D .; Reese, P .; et al. "Ukufaneleka kwe-HIV kugciwane