Chimwe chezvinyorwa zvekutanga izvo murwere achange asingakwanisi kuwana zvakakwana kugadziriswa kweraretroviral therapy (ART) apo munhu anozivikanwa seanonzi "chiremba hopper" -kungoisa, mumwe munhu anoshanyira makiriniki akawanda kana vanachiremba pamusoro pechikoro yemakore, mwedzi, kana vhiki.
Panogona kuva nhamba ipi zvayo yezvikonzero nei murwere akasarudza kuita kudaro.
Pane dzimwe nguva, zvingave kuti murwere haadi dhipii kana kliniki, kana kuti inoda kurapwa kwechiitiko chinosanganiswa, chakadai sehepatitis C (HCV) , kushandisa zvinodhaka, kana utano hwepfungwa.
Asi, kakawanda kupfuura kwete, zvinongova kuti murwere haadi kugamuchira kana kutarisana nedambudziko rakabatana nehutano, hutungamiri, kana kurapwa kweHIV . Mienzaniso inosanganisira:
- Kurega, kana kutya kwekuzivisa nekunyadzisa .
- Varwere vakambosangana nekurapa kwekurapa nekuda kwekuzvidzivirira kwechirwere chechirwere uye vanozoenda kune imwe chiremba pane kubvuma (kana kuti kutarisana) midzi yekusagamuchirwa kwavo.
- Varwere vasingadi kugamuchira kana kusakwanisa kurarisana nechirongwa chekufungidzirwa, avo vanobva vauya kuchiremba vachienda kunechiremba vachitarisira kuti pane zvakasiyana.
- Kuvhiringidza kugamuchira zvido zvekuchengetedza mishonga zuva nezuva kana maitiro ehutano akachengeteka .
Kuwandisa uye Nhoroondo yeChirwere Hoppers
Chidzidzo che2013 kubva kuPerelman School of Medicine paYunivhesiti yePennsylvania yakaongorora huwandu uye chigumisiro chechiremba-hopping kupfuura makore maviri kubva muna 2008 kusvika muna 2010.
Mukutsvakurudza kwavo, vatsvakurudzi vakaona kliniki yekuenda, nhoroondo yeART, uye hutachiwana hweHIV mune vane 13 000 varwere mumakiriniki ehurumende yeRyan White-funded 26 . Pamusoro pevanhu ivavo, vanenge vanenge 1 000 vakaonekwa sevakashanyira makiriniki akawanda.
Kutsvakurudza hakusi kungosimbisa chete kuti varwere-makiriniki akawanda havana mikana yekuwana chirwere chepachirwere kupfuura avo varo-makiriniki (68% kusvika 78%), ivo vakanga vasingakwanisi kutora ART kana zvichidiwa (69% ne 83%) .
Uyezve, nepo vazhinji vechiremba vachiita chiitiko mukati megore rokutanga rekutarisira, 20% yakaenderera mberi panguva yose.
Chiremba hoppers munyaya ino yakazivikanwa zvikuru kuti iri muduku, African American, vakadzi, vasina inishuwarenzi kana yehutano inshuwarhu yehutano.
Migumisiro yechiremba Hopping
Migumisiro yechiremba hopping inogona kuva yakakosha sezvo vazhinji vevarwere ava vanokundikana kuzarura nhoroondo yekare nechiremba wavo mutsva. Izvi zvinogona kuguma mukurondedzera zvikanganiso uye kusanzwisiswa kwekushandisa kwezvinodhaka-zvinodhaka, kujekesa munhu kuti zvimwe zvinodzivirirwa nemigumisiro uye / kana kukura kusati kwatanga kwehutachiona hweHIV .
Uyezve, unhu, huwandu, uye kusagadzikana kwevarwere-mutaurirano-apo murwere anochengeterwa kutarisirwa mune imwe kliniki kana pamwe chete nachiremba-anozivikanwa kuti awedzere kugadzirisa zvipatara. Tsvakurudzo inobva kuVanderbilt University School of Medicine yakaratidza kuti kutarisira kwakakwana munguva yakatanga gore rokutanga kurapwa kunogona kudarika kaviri kungozi yekufa kune varwere vane HIV, vane 2.3 kufa pamakore zana nemarwere zvichienderana nevakafa 1,0 chete pa100- munhu-makore kune avo vasina kugadzikana, vasina-single-clinic.
Kubva pane maonero ehutano hwehutano, chiremba hopping inogona kunge yakanyanyisa, zvichiita kuti kuwedzerwa zvisina kufanira kwebasa uye kuparadzwa kwezvinhu zvinowedzera zvizere zvehutano hwekutarisira.
Kuziva zvikonzero zvinokonzera izvi zvingava danho rinokosha rinotevera kana vakuru vehutano vehutano vese veUnited States vachitarisira kuwana kuderedzwa kwakasimba mune zvekutapukirwa kweHIV maererano nehutachiwana hwekuedza nekurapa mazano .
Nhasi mazano anosanganisira:
- Kurambidza murwere kubata nekugadzirisa kuongororwa, kubatanidzwa kune kutarisirwa, uye kurapwa kweHIV mune imwe nzvimbo yakabatanidzwa, nzira yakakurumbira inozivikanwa se "TLC-Plus."
- Kugovana kwemarekodhi emagetsi emagetsi pakati pemagariro ehutano ane kodzero yekujekesa varwere vangave chiremba hopping kana kuti vane nhoroondo yezvakangoita kurapwa kweutano.
- Kupa ruzivo rwakanyanya rwekuchengetedzwa kwehutachiona hweHIV, kunyanya kune mharaunda yakasarudzwa. Kuwedzera kwekuenda kuMedicaid uye yehutano inshuwalhu yehutano pasi peAne Affordable Care Act inogona kubatsira kuderedza kusagadzikana kwehutano hwevanhu vanobatwa.
Sources:
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Gardner, E ;; McLees, M .; Steiner, J .; et al. "The Spectrum of Engagement muHIV Kuchengetedza uye Kukosha Kwayo Kuongororwa-uye-Kutora Nzira dzekudzivirira hutachiwana hweHIV." Clinical Infectious Diseases. March 2011; 52 (6): 793-800.
Herwehe, J .; Wilbright, W .; Abrams, A .; et al. "Kubudirira kwehutano hutsva, hubatanidzwa hwemagetsi ehurumende (EMR) uye ruzivo rwehutano rwehutano huchishandurudza HIV / AIDS." Nyaya yeAmerican Medical Information Association. May-June 2012; 19 (3): 448-452.
Mugavero, M .; Lin, H ;; Willig, J .; et al. "Kusashanyira kushanyira nekufa pakati pevarwere vachigadzira kurapwa kwekutanga kweAIDS." Clinical Infectious Diseases . January 15, 2009; 48 (2): 248-256.