Okwenza Ikheli Lakho Lingabi Ngengozi Yakho Engcono kakhulu yeHIV

Amadolobha ase-US anezilinganiso eziphezulu kunazo zonke ezithathelwanayo

Izingozi ze-HIV ziyimpawu ezibeka umuntu engozini enkulu noma encane yokuthola (noma ukudlula) i- HIV . Ngokuvamile sithatha lokho kusho enye yezinto ezine:

• Ubuzwe bomuntu
• Isimo socansi
• Imikhuba yezocansi (isb., Ubulili obuyitholayo , ubulili bomlomo )
• Okunye ukuziphatha okungakwandisa noma ukunciphisa amathuba okutheleleka (isib. Amakhondomu , ukujova ukusetshenziswa kwezidakamizwa , ukwelashwa kwama-antiretroviral )

Izinto ezibangelwa yi-HIV azihloselwe ukubikezela ukuthi ngabe umuntu uzongenwa yini; kunalokho bahlose ukugqamisa ukukhathazeka komuntu ku-HIV ukuze akwazi ukuthatha izinyathelo zokunciphisa ingozi. Ngisho nalapho izici ezithile zingashintshi-njengohlanga noma ukuzocansi-zingasisiza ukuba senze isahlulelo esinolwazi ngokusekelwe endleleni esandulela ngayo igciwane ngaphakathi kwesibalo sabantu noma iqembu.

Esinye sezici eziyingozi esingazixoxisi ngaso sonke isikhathi, okungenani ngesisekelo somuntu siqu, indlela ohlala kuyo ithonya ngqo engozini yakho ye-HIV, kokubili ngokuqondile nangokungaqondile.

I-HIV Ngokuyinhloko i-Urban Disease

I-HIV igcina, ngokubanzi, isifo selidolobha. Ijwayele ukugxila emadolobheni amakhulu abantu abangaphezu kuka-500 000 futhi ngokuyinhloko emiphakathini engabhekene ne-HIV kuphela kodwa kwezinye izifo ezithathelwanayo.

Nakuba amandla okutheleleka ahlukahluka kusuka esifundeni kuya esifundeni, izifo ze-epidemics zivame ukubangelwa ubumpofu, ukungabi khona kwezinsizakalo ezithile ze-HIV, kanye nokuphendula okungenele kwezempilo emphakathini ekusabeni kwendawo.

E-US, izinga eliphakeme kakhulu lokutheleleka kwe-HIV elisha eNingizimu, lapho abantu abangu-18,5 abantu abangu-100,000 banesifo. Lokhu kulandelwa eduze nenyakatho-ntshonalanga (14.2) naseNtshonalanga (11.2).

Okunye okukhathazayo, lezi zingu-9 ezichaza ukuthi iNingizimu nayo ilandisa ngamaphesenti angu-40 azo zonke izifo ezintsha ngaphandle kokumelela amaphesenti angu-28 kuphela e-US.

Ngokwezikhungo zokuLawula nokuVimbela (i-CDC), izifundazwe ezindawo ezinezindawo eziphezulu ze- HIV (okungukuthi, inani lamasha amasha we-HIV) yilokhu:

1. Baton Rouge, Louisiana
2. I-Miami-Fort Lauderdale-West Palm Beach, eFlorida
3. ENew Orleans, eLouisana
4. Jackson, Mississippi
5. I-Orlando, eFlorida
6. Memphis, eTennessee
7. I-Atlanta, Georgia
8. Columbus, eNingizimu Carolina
9. Jacksonville, Florida
10. Baltimore, Maryland
11. Houston, eTexas
12. I-San Juan, ePuerto Rico
13. I-Tampa-St. Petersburg, eFlorida
14. I-New York City-Newark-Jersey City, eNew York-New Jersey
15. Little Rock, Arkansas
16. Washington-Arlington-Alexandria, DC-Maryland-West Virginia
17. I-Dallas-Fort Worth, eTexas
18. Charleston, eNingizimu Carolina
19. Las Vegas, Nevada
20. Los Angeles, California

Isithombe sishintsha kancane uma ubheka ukutholakala kwe-HIV emadolobheni ase-US. Ngokungafani nesilinganiso senani labantu, lesi sibalo sisitshela ukuthi bangaki abantu abangaphezu kuka-100 000 abanesifo esithile esifundeni esithile semadolobha amakhulu.

Amadolobha ase-US anesandulela-ngculaza esiphakeme kakhulu (inani lamacala abahlali abangu-100,000) yilo:

1. I-Miami (1,046)
2. I-San Francisco (i-1,032)
3. I-Fort Lauderdale (925.8)
4. I-Philadelphia (881.9)
5. I-New York City (859.7)
6. I-Baltimore (678.5)
7. I-New Orleans (673.3)
8. Washington, DC (622.8)
9. I-Newark (605.7)
10. UJackson, Mississippi (589.7)
11. I-San Juan, ePuerto Rico (583.2)

1. I-West Palm Beach (579.4)
2. I-Baton Rouge (560)
3. Memphis (543.5)
4. I-Columbus, eNingizimu Carolina (509.1)
5. I-Atlanta (506.6)
6. I-Los Angeles (465.2)
7. I-Orlando (460.7)
8. I-Jacksonville (451.4)
9. I-Detroit (410.7)

Ukuthi Ukuphendula Komuzi Kungakwandisa Kanjani, Nciphisa Izindleko Zama-HIV

Kubalulekile ukuqaphela ukuthi ukusakazeka kwegciwane lesandulela ngculazi akusho ukuthi lihumushe kwinani eliphakeme lokutheleleka okusha. Ngisho nasemadolobheni anezinye izindawo eziphezulu kakhulu zokutheleleka ngegciwane lesandulela ngculaza, impendulo ephumelelayo yezempilo yomphakathi inganciphisa kakhulu ingozi yokudluliselwa phambili.

Thatha iSan Francisco, isibonelo, idolobha elibhekene nalesi sifo ngokuba yilokuqala lokubiza ukuhlola jikelele kanye nokwelashwa ngo-2010.

Naphezu kokusakazeka kwesandulela-ngculaza okwedlula zonke e-US, ukusabela komuzi okwedlulele kwaholela ekwehleni okuphawulekayo kwezifo ezintsha, ukushaya isikhathi esiphezulu samacala amasha angu-302 kuphela ngo-2015. Kukholelwa ukuthi ukusetshenziswa okubanzi kwe- HIV PrEP (ngaphambi -exposure prophylaxis) inganciphisa amazinga ngisho nangaphezulu.

Ngokuphambene nalokho, ukungabi nokuphendula okuhlangene kungabangela ukuqubuka ngisho nasemiphakathini encane, engekho emadolobheni. Sibone lokhu ngo-2015 edolobheni lase-Austin, e-Indiana (inani labantu abangu-4,295), lapho kunezigameko ezingaphezu kuka-100 zegciwane lesandulela ngculaza ezabikwa phakathi kwabasebenzisi abasebenzisa izidakamizwa ababelane ngezilonda ngenkathi bethatha i-oxymorphone yezidakamizwa. Ukuvuthwa kwabikwa ngokuthi ingxenye enkulu ekuvinjweni kukahulumeni ohlelweni lokushintshanisa izinaliti (NEPs) olwenzelwe ukuvimbela izifo ezinjalo.

Akumangalisi ukuthi ama-rates amaningi kakhulu e-HIV nawo abuye avimbele ama-NEP (kufaka phakathi i-Alabama, i-Arkansas, i-Mississippi, i-South Carolina, iTexas), nalokhu naphezu kobuciko bobuchwepheshe besayensi obonisa ukuthi i-NEP iyasebenza ekuvimbeleni izifo ezithwala igazi ukudluliselwa.

Ngokufanayo, izifunda ezingazange zamukele ukwandiswa kweMedicaid, ezenzelwe ukuhlinzeka ukunakekelwa kwempilo enkulu kwabakhileyo abahola imali encane, ziphakathi kwalabo abanezinkinga ze-HIV (Alabama, Florida, Georgia, Mississippi, South Carolina, Texas).

Ngokusho kwamaCenter for Budget and Policy Priorities, ukwamukelwa kokunwetshwa kweMediicaid kunikeza abantu abaphila negciwane lesandulela ngculaza ukuthi bangafinyeleleka kakhulu ekunakekeleni ukwelashwa kuphela kodwa kungaphazanyiswa ukunakekelwa kwempilo yesikhathi eside.

Esimweni saseMassachusetts, ngokwesibonelo, ukuguqulwa kwezempilo okuphelele kunwetshe ukunakekelwa kwegciwane lesandulela ngculazi kanye nokwelapha kuma-91 amaphesenti abahlali abaphila negciwane lesandulela ngculaza, ukunciphisa izindleko zokunakekelwa kwezempilo kanye neHIV ehambisana neHIV nge $ 1.5 billion.

Ngokuphambene nalokho, isimo sase-Alabama kwadingeka sithathe isabelo-mali se- ADAP (i-AIDS Drug Assistance Program) esivela ezikhwameni zikahulumeni ngo-2011-eziningi zazo ezingahle zihanjiswe kwezinye izinhlelo zempilo zomphakathi kusukela amaphesenti angu-81 alabo ase-ADAP ayefanelekile.

Konke okukhulunywe ngakho, abangaphezu kwesigamu sabantu abangaqinisekisiwe nabangenayo imali abaphila negciwane lesandulela ngculazi bahlala ezindaweni eziye zala ukukhuliswa kweMedicaid. Iningi liyavuma ukuthi ukumelana okuqhubekayo ekwandiseni kufaka labo abadinga kakhulu-phakathi kwabo, abase-Afrika-baseMelika kanye nabesilisa abesilisa nabesilisa abesilisa nabesifazane-engozini enkulu kakhulu yokutheleleka, ukugula nokufa.

Amadolobha Anezibalo Eziphansi kakhulu ze-HIV

Ngokusho kweCDC, ukusabalala kwegciwane lesandulela ngculazi ezindaweni ezingekho emadolobheni ase-US kugijima cishe ngamaphesenti angu-112.1 ku-100,000. Emadolobheni angu-107 afakwe umbiko walo ka-2015, kuphela ayisithupha kuphela ewela ngaphansi kwalesi sikhwama:

1. UBoise, Idaho (71.7)
2. Rapid City, Michigan (100.1)
3. Fayetteville, Arkansas (108.8); Madison,
4. I-Wisconsin (110)
5. Ogden, Utah (48.6)
6. I-Provo, i-Utah (26.9)

Ngokuphambene, imizi engu-10 yase-US enezinga eliphansi kunazo zonke zokutheleleka nge-HIV yilezi:

1. I-Provo, i-Utah
2. Spokane, Washington
3. Ogden, Utah
4. Boise, Idaho
5. I-Modesto, e-California
6. Worcester, eMassachusetts
7. Fayetteville-Springdale-Rogers, Arkansas-Missouri
8. Madison, Wisconsin
9. I-Scranton-Wilkes-Barre, ePennsylvania
10. Knoxville, eTennessee

> Imithombo:

> American Medical Association. "Isimo Sezinhlelo Zokungena Izitshalo Ezepolitiki zase-US." I-JAMA. NgoMashi 2016; 18 (3): 252-257.

> Amasevisi weZabelomali kanye nokuPhambili kweNqubomgomo. "I-Medicaid izothuthukisa imiphumela, izindleko ezingezansi zabantu abane-HIV." Washington, DC; eshicilelwe ngo-Okthoba 11, 2012.

> Amasevisi Okulawula Nokuvimbela Izifo. (2015) Umbiko we-HIV Surveillance Report, 2014 (Umqulu 16). I-Atlanta, Georgia: CDC.

> Snider, J .; Juday, T .; Romley, J .; et al. "Cishe abantu abangaba ngu-60 000 abangaqinisekisiwe nabantu abaphansi abathola imali abane-HIV / AIDS abahlala emazweni angafaki ukuxilongwa." Izindaba zezeMpilo. Mashi 2014; 33 (3): 386-393.