Ubumpofu kanye nohulumeni abangasebenzi abangela ukuhlupheka okuqhubekayo
Ukungalingani ngokobuhlanga kwe- HIV e-United States sekufinyelele cishe okulinganayo. Lokhu akubonakali nakakhulu kunabanye base-Afrika baseMelika, naphezu kokumelela amaphesenti angu-12 kuphela abantu base-United States, balinganiselwa ngamaphesenti angu-48 azo zonke izifo ezintsha.
Izizathu zalokhu ziyinkimbinkimbi futhi ngokuvamile aziqondi kahle. Ngenkathi abanye bengase basikisele ukuthi isiko kanye nokuziphatha ngokobulili kuphela okusola lokhu, iphutha lithinta kakhulu ukungalingani kwezenhlalakahle nezomnotho ezingasusa noma yisiphi isifo esithathelwanayo.
Ubumpofu, ukungabi nabulungisa kwezenhlalakahle, nokuntuleka kwempendulo ephumelelayo kahulumeni ndawonye kuvumela ukusakazwa kwezifo emiphakathini engenazo izinsiza zokulwa nayo.
Ngezindlela eziningi, isifo segciwane lesandulela ngculazi siyisifingqo sokungafani okukhulayo ekunakekelweni kwezempilo okubeka emiphakathini eminingi yase-Afrika engozini enkulu yokungabi negciwane lesandulela ngculazi kuphela, kodwa ezinye izifo ezivimbelayo kanye nezifo.
Izibalo zamanje ze-US
Ukuthi kukhona ukungalingani ekusabalaliseni ngokobuhlanga kwe-HIV e-US kukhona okungahambisani nalokhu. Njengamanje, abase-Afrika baseMelika cishe bangama-8 amathuba okutheleleka kunabamhlophe futhi cishe cishe kabili njengeLatinos. Abesifazane base-Afrika baseMelika basengozini ikakhulukazi kwizifo ezintsha, ezigijima izikhathi ezingaphezu kuka-16 isilinganiso esabonwa ngabesifazane abamhlophe.
Ngisho naphakathi kwabantu abengozi kakhulu abalala nabesilisa (MSM) , ukuba yi-gay kanye ne-African American babeka umuntu engxenyeni engama- 50 emangalisa yokuthola i-HIV ngesikhathi sokuphila (uma kuqhathaniswa namaphesenti ayisishiyagalolunye kuphela emadodeni abesilisa abamhlophe).
Lezi zibalo zikhomba kuphela inkinga yenkinga evame ukuhlanganiswa nokudideka nokuphikisana. Ngenkathi abantu abaningi bezobekwa icala ngokuziphatha okukholelwa ukuthi bahlala emasikweni, lezi zinhlobo zempendulo zisebenzela ukuqhubekisela phambili ukungaboni kahle, okubandlulula, nokungahlali komphakathi.
Amaningi amabizo ajwayelekile ("amadoda amnyama alala nxazonke" noma "ukusetshenziswa kwezidakamizwa zivame phakathi kwabantu abamnyama") bamane bafakazela okungelona iqiniso ngaphakathi kwesimo se-HIV. Ngokwesibonelo:
- Amantombazane aseMelika aseMelika ayengasencane kakhulu ukutheleleka ngokusebenzisa izidakamizwa zokujova kunabesifazane abamhlophe. Abesifazane base-Afrika baseMelika basuke benesandulela ngculaza ngokuhlanganyela kocansi, kanti abesifazane abamhlophe basuke benesandulela ngculazi.
- Akunamadoda ase-Afrika aseMelika nabesifazane abanamazinga aphezulu okuziphatha okungozini ngokobulili kunanoma yiliphi elinye iqembu lobuhlanga.
- I-MSM emnyama, eqinisweni, ibika abalingani bobulili abambalwa, ubulili obungalingani obuvikelekile , nokusebenzisa kabi izidakamizwa kune-MSM emhlophe.
- Ngakolunye uhlangothi, abantu base-Afrika baseMelika bangase bahlolwe kakhulu ngegciwane lesandulela ngculaza kunabamhlophe (amaphesenti angama-75 aphakathi kwamaphesenti angu-14).
- AbaseMelika baseMelika banamathuba amaningi okufuna nokuhlala eqhubekayo, ukunakekelwa okwelashwa okuqondene ne-HIV njengabamhlophe (amaphesenti angu-54 kuya kwezingamaphesenti angu-58).
- Izinga lokutheleleka okungatholakali lingafani kakhulu nabase-Afrika baseMelika njengabamhlophe (amaphesenti angu-11 ahambisana namaphesenti angu-13). Kuzo zonke izinhlanga, ama-Asiya, empeleni, ayengabonwa (amaphesenti angu-21).
Lapho ukungaboni ngaso linye kungakhombisi kakhulu empilweni yomphakathi kwi-HIV kodwa ezinye izinto ezilukhuni kakhulu ukuzinqamula noma ukuzihlukanisa.
Namuhla, igciwane lesandulela ngculaza lihlala liyisithupha lesibangele sokufa emadodeni aseMelika aseMelika kanye necala lesine eliholela ekufeni kwabesifazane base-Afrika baseMelika phakathi kweminyaka engama-35 no-44. Ngokuphambene, i-HIV ayisasetshenziswa njengesizathu esiholela ekufeni kokunye umncintiswano.
Ukuhlukunyezwa Okuphindaphindiwe Ukutheleleka
I-HIV ayithinti yonke imiphakathi ngendlela efanayo. Nakuba u-African American, umhlophe, noma i-Latino engashintshi indlela umuntu asabela ngayo kulesi sifo, kukhona ukukhubazeka okungafaka umuntu womhlanga owodwa engozini enkulu yokutheleleka nokugula kunomunye.
Lokhu sibona lokhu, isibonelo, ngezimpendulo ezihlukile kokwelashwa kwe-HIV.
Nakuba amaphesenti angaba ngu-70 abamhlophe akwazi ukufeza umthamo wegciwane elingenakutholakali ngenkathi ekwelapheni, abangaphansi kwamaphesenti angama-50 ase-Afrika aseMelika bangakwazi ukwenza okufanayo.
Ngakho-ke, isiko noma ukuziphatha ngokocansi akukwazi neze ukuchasisa lezi zingxabano. Esikhundleni salokho, le nkinga ivela kakhulu kakhulu-inzalo kanye nezikhungo, ithinteke yizinto ezifana nalezi:
- Ubumpofu
- I-Stigma
- Ukungabi nalutho lokunakekelwa kwempilo
- Ukuhluleka kwamasevisi kahulumeni, ezenhlalakahle, emaphoyiseni nasemthethweni
- Amazinga angacacile wokuboshwa nokuboshwa
- Abantu abaningi basemadolobheni amakhulu
Lokhu kungalingani kudlala omunye olandelayo ngendlela edala umjikelezo wokungcupheni okuvame ukuwuphula.
Sikubonile lokhu, mhlawumbe ngokumangazayo, nge-African American MSM ene-HIV. Ucwaningo olwenziwa ngo-2014 oluqhutshwa yi-Rollins School of Health Public e-Emory University lugcizelela ukuthi, naphezu kokuba nezinkinga ezimbalwa ezingozini zobulili kunabalingani babo abamhlophe, lesi sizwe samadoda cishe singasemncane, sibe nemfundo encane, singasebenzi, sibe nama- STD angenasiphathiswa. , futhi angabi ncane amathuba okuxoxa nge-HIV nomlingani wezocansi.
Lezi zinto azihlanganisi nhlobo isiphepho esiphelele sokutheleleka.
Amaphesenti omfutho we-Fuel Infection
Cishe oyedwa kulabo abane base-Afrika baseMelika bahlala ebumpofu, ngaphezu kokuphindwe kabili izinga elibonwa abamhlophe. Ngokwakhe, ubumpofu budala ubungozi ngokuvimbela abampofu ukuthi bangafinyeleli izinsizakalo ezingase zivimbele noma ziphathe ukutheleleka.
Lokhu akubandakanyi nje ukufinyelela kokunakekelwa kwezempilo kepha kufinyelele kwezinye izingxenye zomphakathi, futhi. Phakathi kwazo:
- Ukuntuleka kwamaphoyisa nokuvikelwa ngokomthetho emiphakathini empofu kubeka abesifazane abasengozini, izingane kanye nabanye abasengozini yokuhlukunyezwa.
- Izinsizakalo zezenhlalakahle ze-Overtaxed nezikhokhelwa imali ezingenayo imali zikhuthaza abantu abaningi ukuba bafune usizo nganoma yini ngaphandle kwezinye izidingo zabo ngokushesha.
- Ukungabikho kwezinhlelo zokusebenzisa izidakamizwa kwenza ukusabalala kokutheleleka kungekhona phakathi kwabasebenzisi kuphela kodwa nabalingani babo bobulili.
- Izindleko eziphansi zomshuwalense wezokwelapha, ikakhulukazi ezichaseni ukunwetshwa kwe-Medicaid , ngokuqondile zihambisana namazinga aphezulu okutheleleka nge-HIV.
Ngokuhamba kwesikhathi, ukuhluleka kwalezi zikhungo kubangela ukungathembeki kokubili kuhulumeni kanye negunya ngokujwayelekile. Ngenxa yalokho, abantu bazovame ukufinyelela izinsizakalo abazizwa zidingekile (njengokusiza kwezezimali kanye nokwelashwa okuphuthumayo) futhi ugweme labo "abangalinda" (njengempilo yokuvimbela kanye nokwelapha).
Lokhu kubangelwa ukuthi kungani amaphesenti angu-22 ase-Afrika aseMelika aphuza ukuhlolwa kwegciwane lesandulela ngculaza kuze kube yilapho esebucayi, futhi ngezinye izikhathi, ngokugula, ngokugula.
Kodwa akuzona nje ukuhlolwa okudlulile odokotela abakhathazekile ngakho. Izifo ezithathelwana ngocansi ezifana ne-gonorrhea, ezigcwele emiphakathini empofu, zingandisa ingozi ye-HIV ngama-700%. Ngaphezu kwalokho, ukunakekelwa kwezempilo okungavumelani kwenza umuntu angabi naso amathuba okuthola izinzuzo ze-HIV zokwelapha futhi kungenzeka kakhulu ukuthuthukisa ukumelana nezidakamizwa .
Ekugcineni, ubumpofu buphazamisa ukutheleleka ngokunciphisa kanye / noma ukuthonya izinqumo umuntu angenza. Lapho enye, imiphakathi ecebile inendlela yokunqoba eziningi zalezi zithiyo, imiphakathi ehlwempu yase-Afrika yaseMelika ayifuni. Ukusabalala kwe-HIV kule miphakathi, ngenxa yalokho, kwenzeka ngenxa yokuthi akukho lutho olungaluyeka.
I-HIV Stigma Phakathi kwama-Afrika ase-Afrika
Naphezu kokushintsha okukhulu esimweni sengqondo somphakathi, ukucwaswa kwabantu abaphila negciwane lesandulela ngculaza kuqhubeka. Umthelela wokuhlambalaza ungabetha umphakathi wase-Afrika ikakhulukazi kanzima, kokubili ezimweni lapho kubonakala khona (uzizwa) futhi wenziwe (wangempela).
Imiphumela yokucwasa ingaba yinto ejulile. Izikhathi eziningi, abantu bayomelana nokuveza isimo sabo se-HIV ngenxa yokwesaba ukubuzwa mayelana nokuziphatha kwabo ngokobulili noma ukubizwa ngokuthi "ukuziphatha okubi," "ukungcola," noma "ukungathembeki."
Lokhu kubonakala kuyiqiniso ikakhulu emiphakathini lapho imfundiso yenkolo ingase ifune khona ukusekelwa kwabantu abaphila negciwane lesandulela ngculaza ngenkathi behlambalaza ukuziphatha njengento engavamile. Ucwaningo oluqhutshwa ngonyaka ka-2014 yi-Non-profit Public Religion Research Institute lwaphetha ngokuthi amaphesenti angu-17 abasebenza esontweni e-US akholelwa ukuthi i-HIV "isijeziso sikaNkulunkulu" ngokuziphatha okubi ngokobulili.
Phakathi kwamaqembu amaningi okuzokwamukela lezi zinkolelo ngamaProthestani abamhlophe abamhlophe (amaphesenti angu-25), ama-Hispanic Catholic (amaphesenti angu-21), namaProthestani abamnyama (amaphesenti angu-20).
Emiphakathini yase-Afrika yaseMelika, lapho amaphesenti angu-95 abesifazane abheka inkolo ephakathi kwamaphilo abo kanti amaphesenti angu-50 ayethandaza njalo noma aya esontweni, lezi zengqondo zinzima ukubalekela.
Ngenxa yalokho, abantu base-Afrika baseMelika bangase basho ukuthi kunezinhlamba eziningi nokubandlulula kubantu abane-HIV kunabamhlophe noma i-Latinos. Lezi zengqondo zithinta ngezindlela eziningi ezimbi:
- Abantu abanegciwane lesandulela ngculaza ababona inhlamba bangase baphuze ngokweqile noma babike ukuhlukumeza izidakamizwa.
- Abantu abesaba i-HIV ukuhlambalaza nokudalula kungenzeka ukuthi bagweme ukuhlolwa nokunakekelwa kwezempilo okuqhubekayo.
- Amanani okukhuphuka kokucindezeleka avame ukuhumusha ekwenzeni ukuziphatha okukhulu kakhulu.
Ngaphezu kwalokho, umbono wokucwaswa ohlangene nokwehluleka kwangempela ekuphenduleni kukahulumeni kubonakala ukuqinisa izinkolelo phakathi kwabaningi base-Afrika base-Afrika ukuthi i-HIV ayinakugwema kuphela kodwa, empeleni, ngenhloso.
Ucwaningo olwenziwe ngo-Ephreli 2010 lwe- Journal of the American Medical Association lwabika ukuthi kwabangu-1 351 amadoda ase-Afrika aseMelika ahlolisisiwe, amaphesenti angu-49 akholelwa ukuthi i-HIV yenziwe yi-CIA yokubulala abantu abamnyama.
Nakuba abanye bengase bathole lezi zinhlobo zezinhlelo ezihlekisayo noma ezicasulayo, izazi zezinqondo eziningi zikholelwa ukuthi ziyindlela ejulile yokuphika. Esikhundleni sokubhekana nesifo abesaba ngempela, abantu bazovame ukwandisa usongo ukuze baqikelele ukungabi nokusebenza kwabo nokuzizwa bangenathemba.
Ukuhlala emadolobheni kanye ne-HIV
E-United States, igciwane lesandulela ngculaza ikakhulukazi liyisigodi zasemadolobheni. Ngenxa yokuthi lezi zizwe zinabantu abanzi futhi zinezinga eliphakeme lokubuyiswa kwemali, noma yikuphi ukuhlukunyezwa okubhebhethekayo kungasakazeka ngokushesha ngaphandle kokuthi isenzo esibi sithathwe nguhulumeni ukuyiyeka.
Ukwehluleka ukwenza kanjalo kungaholela ezingeni eliphezulu ezingenakamukeleka lokutheleleka okubonakala eNingizimu, lapho kunezingxenye eziyisishiyagalolunye zase-US (Arkansas, Alabama, Florida, Georgia, Louisiana, Mississippi, South Carolina, Tennessee naseTexas) namuhla zilandisa ngamaphesenti angaphezu kwangu-40 izifo ezintsha.
Ngenxa yokuthi abantu base-Afrika baseMelika bavame ukukhetha ngokulingana ekukhethweni kwabalingani babo bobulili (ngokuphambene nabamhlophe okungenzeka bakhethe abalingani bezinhlanga ezahlukene), amanethiwekhi ezocansi kule miphakathi athambekele ekubeni yincinci futhi igxile. Ngenxa yalokho, noma yikuphi ukutheleleka emphakathini kuzohlala emphakathini, kwanda ngezinombolo njengoba abantu abaningi befika befuna amathuba okuqashwa.
Eziningi zalezi zindawo zasemadolobheni, ukutheleleka ngegciwane lesandulela ngculazi kuqhutshwa phambili yizinqubomgomo zikahulumeni ezibandlulula ngokungafanele abampofu. Phakathi kokunye okushiwo:
- Akuyona ingozi ukuthi amazinga e-HIV aphezulu kakhulu ekukhulumeni ukuthi wenqaba ukwanda kweMedicaid, kuhlanganise ne-Alabama, eFlorida, eGeorgia, eMosissippi, eSouth Carolina naseTexas. Ucwaningo oluvela kwi-Women's Interagency HIV Study lwaphetha ngokuthi i- Medicaid, njengento eyayizimele, ingaphezu kokuphindaphinda amathuba omuntu wokuthola umthamo wegciwane elingenakulinganiswa.
- Ngokufanayo, izivumelwano ezivimbela izinhlelo zokushintshanisa izinaliti nazo ziyizifunda ezifanayo namazinga aphezulu okutheleleka okusha. Lezi zihlanganisa futhi i-Alabama, iFlorida, i-Georgia, i-Mississippi, i-South Carolina neTexas.
Ngenxa yalokhu nokunye ukuhluleka, ukunqoba isifo se-HIV emiphakathini yase-Afrika yaseMelika kuyothatha okungaphezu nje kokwelashwa. Kuzodinga izinguquko ezinkulu esimweni sengqondo somphakathi kanye nezindlela zokunakekelwa kwezempilo nezinye izinsizakalo ezibalulekile zomphakathi ezihanjiswa emiphakathini inesidingo.
> Umthombo:
> Bogart, L .; Galvan, F .; Wagner, G; et al. "Izinkolelo Zenkohlakalo Nge-HIV Zihlobene Ne-Antiretroviral Treatment Ukunganaki phakathi kwama-American American Men with HIV." I-Journal ye-Immune Deficiency Deficiency Syndromes. April 2010; 53 (5): 648-655.
> El-Bassel, uM .; I-Caldeira, M .; Ruglass, L. et al. "Ukubhekana Nezimfuneko Eziyingqayizivele Abesifazane baseMelika base-Afrika ekuvimbeleni i-HIV." Juni 2009; 99 (6): 996-1001.
> Friedman, uS .; Cooper, uS .; no-Osborne, H. "Izingqinamba Zokwakhiwa Kwezenzo Nezenhlalakahle zeHIV phakathi kwama-Afrika aseMelika." I-American Journal of Health Public. Juni 2009; 99 (6): 1002-1008.
> Fry, V .; Bonner, S .; Williams, K. et al. "Ukukhuluma okuqondile: Ukuvimbela i-HIV kumuntu wase-African-American Owesifazane Owesilisa Owesifazane Owesilisa Owesifazane Owesifazane Owesifazane Owesifazane Owesifazane Owesifazane Owesifazane Owesifazane Owesifazane Owesilisa Owesilisa: Ama-Basics and Design Design I-AIDS Education Preview. Okthoba 2012; 24 (5): 389-407.
> Sullivan, P .; Petersen, J .; Rosenburg, E. et al. "Ukuqonda Ukuhlukana Kwezingculaza / I-STI Emadodeni Abomnyama nabomhlophe Abalala Ngesilisa: Indlela Ehamba Ngezindlela Eziningi." PLoS One. 2014; 9 (3): e90514.