Hurumende Inotonga Kusagadzikana Kunotsvaga Obama-Era Chinangwa
Pakati pemarudzi masere eEurope uye anokwidziridza zvikuru akabatanidzwa mukugadzirisa mazano ehutachiona hwehutachiona hwehutachiona hwehutachiona hwehutachiona hwehutachiona hwehutachiona hwehutachiona hwehutachiona hweHIV, hurumende yeUnited States yakauya pakupedzisira pakugadzirisa zvinangwa zvehutachiwana hweHIV , kurapa, uye kutungamirirwa Sezvakataurwa kune 2014 International Congress pamusoro peDrug Therapy muHIV Infection muGlasgow, Georgia chete-sangano duku, rakabatana muEastern Europe umo 34 muzana yevanhu vanogara pasi peurombo-yakawedzera.
Maererano nekudzidza, ma 25% chete evaAmerica vane HIV vane zvirwere zve antiretroviral therapy (ART) vanogona kuwana nekuchengetedza chinangwa chemukoko wehutachiona hwehutachiona husingaoneki (hunotsanangurwa se pasi pemakopi 50 / mL). Uyezve, kubva kumazana makumi matanhatu nemazana matanhatu kubva pamakumi mashanu ekushingaira akabatanidzwa nekutarisira, 33 chete muzana ndeyeVAR asi pasinei nemitemo yenyika inoda kurapwa painoongorora .
Kuongorora kwehutachiona hwehutachiona hweHIV huri kuongororwa kwete chete muzana yevanhu vakaongororwa neHIV munyika imwe neimwe asi chiyero chakanga chichibatanidzwa nehanya, chinopiwa kurapwa uye chinogona kuzadza zvakakwana uye zvakachengetedzwa kushandiswa kwehutachiona . Kusarudzwa kwemasere masere kwaive kwakagadzirwa nehuwandu hwehuwandu hwemashoko kubva muna 2010 kusvika muna 2012, hwakabviswa kubva mukubatanidzwa kwemashumo ehurumende yeHIV, database yeUNAIDS , nenyaya dzakadzokororwa, uye mamwe mamiriro.
Utachiona hweHIV hunoitika muEuropean Eight uye High-Inyika Nyika
| Nyika | Vanhu vane HIV (ndiyo.) | Kuwandisa kweHIV (%) | Anozivikanwa neHIV (%) | Kunobatanidza Nekutarisirwa (%) | Pamusoro peART (%) | Undetectable Viral Load (%) |
| Ositireriya | 33,000 | 0.2 | 75 | - | 35 | 32 |
| British Columbia | 11 700 | - | 71 | 67 | 51 | 35 |
| Dhenimaki | 6,500 | 0.2 | 85 | 81 | 62 | 59 |
| Furanzi | 149,900 | 0.4 | 81 | > 74 | > 60 | 52 |
| Jojiya | 4,900 | 0.2 | 52 | 44 | 26 | 20 |
| Netharenzi | 25,000 | 0.2 | - | 73 | 59 | 53 |
| United Kingdom | 98,400 | 0.3 | - | 79 | 67 | 58 |
| nyika dzakabatana | 1,148,200 | 0.6 | 82 | 66 | 33 | 25 |
Chinokosha pakati pezvikonzero zvekuratidzira kwevarombo veUnited States yaiva yepamusoro yehutachiwana hwehutachiona hweHIV -asi, iyo yakakwirira kupfuura dzimwe nyika masere, uye vane 15.3 vane utachiona hwe100 000 (kana vanenge 50 000 mishonga inotarisana neHIV gore negore). Nokuenzanisa, chiitiko chemukati chemukati chaive pasi pehafu yenhamba iyo, kana kuti inenge 6.3 kutengesa kwe100 000.
Pakati pemarudzi masere akabatanidzwa mukudzokororwa, vazhinji vakaratidza kuti HIV inotaridzika yakaenzana ye 71% uye 85 muzana (kunze kweGeorgia, nyika yega isiri yepamusoro). Kunyange zvazvo chikamu chakabatanidzwa nekuchengetwa munyika dzakapfuma zvikuru chaive chakaenzana (neIndaneti neBritish Columbia chete inowira pasi pe70 percent threshold), kukanganiswa kukuru kwakaratidzwa apo ART inobvunzwa, uye US neAustralia vanotaura kuti 33% chete uye 35 kubva muzana yehutachiwana hweHIV, pamwe chete, vairapa.
(Izvo zvidzidzo zvisingaratidze ndezvokuti USwo inewo yakaipisisa rekuchengetedza varwere mukuchengetedza, kurasikirwa nehafu yenguva yekutevera mushure mokunge vashanyira.)
Pane imwe nguva paART, nhamba dzacho dzakanyanya kukurira kuU.S., ine imwe chete-in-mana inokwanisa kuzadzikisa kukonzerwa kwehutachiona hwakakwana. Mune dzimwe nyika, nyika dzeEurope dzakaratidza huwandu hwakareba husingaoneki hweHIV kune hweNorth America neAustralia (48 muzana kusvika 27 muzana).
Kutsanangura Kusiyanisa
Kunyange zvazvo pasina tsananguro imwe chete yezviwero, vazhinji vanobvumirana kuti kusava nehutano muhutano hwekuchengetedzwa kweHIV huripo pamwoyo wezvakasiyana.
MuGeorgia, somuenzaniso-muitiro wakaipisisa pane urongwa-anofungidzirwa makumi matatu kubva muzana yehuwandu vanozvidzivirira pamishonga ekurapa pamusana pemari yepamusoro yezvokushandisa, kunyanya mari yezvinodhaka zvinodhaka .
Panguva iyi, mutemo wekugadzirisa hutano hwehutano hwehutano mumakore ekuma1991 hwakanyanya kusiyiwa nekuda kwehutano inshuwalhu yega yega, asi 80 muzana yezvipatara zvevanhu zvakatengeswa kune vega sechikamu chehutano hwehutano hwehutano hwehutano hwehupfumi.
Saizvozvowo muUnited States, kusati kwaitwa kugadziriswa kweAffordable Care Act (ACA) muna 2014, kukwanisa kutarisira vaAmerica vane HIV kwakaonekwa sevarombo, vane 17 muzana chete vanokwanise kuwana hutano hwehutano hwepachivande kusvika 54 kubva muzana yehuwandu hwevanhu . Uye, kusvika pakupera kwegore ra2013, kugadziriswa kwehurumende yeAIDS Drug Assistance Program (ADAP) kwave kwakagara kwenguva yakareba zvokuti vamwe varwere vaifanira kumirira kwemakore mashanu kuti vawane rubatsiro rwakakodzera rwekubhadhara zvinodhaka.
Kuwedzera kwehutano hwekumira kweUnited States kwaiva kusava nehutano hwakanaka hweHIV huripo, pamwe nekuedza kwakaitwa naClinton kutadza kusanganisira imwe nguva yekusangana nechinangwa chairo kana tsanangudzo yekuti mahofisi ehurumende aive ane chinangwa chezvizhinji zvezvinangwa izvi.
Kupararira kwekupararira kwenharaunda yehutachiwana hweHIV-pamwe nekuparadzana kwenyika-ne-nyika yeMedicaid kukodzera-kunowedzera kuwedzera maitiro eUnited States, zvichisiya vakawanda hurumende vane hutano vasina hurumende inobatanidza iyo inogona kubatanidza nyika inopindura.
Obama Era Inobatsira Kuderedzwa neHurump Administration
Muchiedza chekusimbisazve sangano rezvematongerwo enyika kune hutachiona, Obama hurumende yakarongedza yeNational HIV / AIDS Strategic yeUnited States (NHAS). Pasi peNHAS, hurumende yehurumende inova nechinangwa chekuzadzisa zvinangwa zvina zvinokosha muna 2020:
- Wedzera huwandu hwevanhu vanogara neHIV vanoziva serostatus yavo kusvika 90 muzana.
- Deredza nhamba yezviitiko zvitsva zvinowanikwa ne25 muzana.
- Kuderedza kuwandisa kwevechidiki vanoita zvepabonde uye varume vanoita zvepabonde avo vakapinda muhutachiona hwehutachiwana hweHIV nevanenge 10 muzana.
- Wedzera huwandu hwevanhu vachangobva kuongororwa vakabatanidzwa nehutachiona hwehutachiona hweHIV mune mwedzi umwe weHIV vachiongororwa kusvika kune 85 muzana.
- Wedzera huwandu hwevanhu vane hutachiona hunotapukirwa neHIV avo vanochengeterwa mune zvehutano hwehutano husinganzwisisiki kusvika 90 muzana.
Wedzera huwandu hwevanhu vane hutachiona hunotapukirwa neHIV avo vanochengeterwa mune zvehutano hwehutano husinganzwisisiki kusvika 90 muzana.
Wedzera huwandu hwevanhu vane hutachiwana hutachiona hweHIV avo vanowanzodzvinyirira kusvika ne80 muzana.
Kunyange zvazvo zvichifungidzirwa kuti mari yeHNAS yaizove yakadarika $ 15 mabhiriyoni pamusoro pemakore mashanu, vamwe vakaratidza kuti kuchengetedzwa kwehutano hwehutano hweUnited States-zvose maererano nekudzivirira zvirwere uye rufu-zvinogona kuva zvakakwirira se $ 18 biliyoni.
Mikana yekuita iyi yehutano yekutsvaga pasi peHurumende yeTrump inoratidzika slim inopa chinangwa cheGOP chekudzoka shure kwezvinhu zvakawanda zveAACA nekunyatsogadzirisa zvirongwa zveMedicaid zvinotarisirwa kupa hutano kuvarombo vanotambura, munharaunda yakaoma.
Muna Gumiguru 2017, Mutungamiri akaita imwe danho rinopfuurira mukudzikisa hutachiona hweHIV kuburikidza nechisayina urongwa hwehutungamiri hunoita kuti vashandi varambe kudzivirira kuberekwa sezvinorondedzerwa neAACA's Essential Benefit zvinodiwa. Urongwa hwakanga huchibva pamashoko ekuti vashandi vanofanira kubvumidzwa kuramba kuberekwa kwekuberekwa, kwete nekuda kwezvikonzero zvezvemari, kunze kwekunamata chete kana "tsika" dzezvikonzero.
Icho chinonyangadza kuita sangano reRepublican Party mumakore ekuma1990 ekurambidza mari kune veAfrica vane hutachiwana hutachiwana hweHIV vakatsigira chero rudzi rwekuronga mhuri, kusanganisira kudzora kana kubvisa pamuviri. Yaiva (uye yakasara) ibwe rekona remagariro asina kururama asi-akadzokorora kuzvidzivirira-based GOP dzidziso iyo inowedzera kuwedzera kwehutachiwana hwehutachiona uye zvimwe zvirwere zvepabonde.
Izvo zvinoratidza kusafarira kweTrump maitirwo akave zvichiratidzwa zvakare nekuti NHAS zvinangwa zvakadzingiswa zvachose kubva pahutachiona hweHIV.gov website.
Inoramba ichinyatsojeka chii, kana chimwe chinhu, cheTrump inotarisira ichaita kuti igadzire kana kubvuma kugadzikana kwemazuva ano mumatambudziko akaoma eAfrica nemasangano emadzimai. Mukuongorora kweDestern Health Organisation yeHIV / AIDS, US yakasvika muvakafa pakupedzisira nekusava nehuwandu huwandu hweHIV huri huwandu hwenyika dzakakwirira-zhinji muNorth America neEurope asiwo yechipiri chekuwedzera kweHIV-yakapfuura neLatvia chete 0.7 muzana.
> Sources:
> Centers for Disease Control and Prevention (CDC). "CDC Fact Sheet | HIV muUnited States: Matanho Ekutarisira." Atlanta, Georgia; yakabudiswa muna July 2012.
> Raymond, A .; Hill, A .; uye Pozniak, A. "Kusiyana kukuru kwehutachiona hweHIV kunoputika pakati penyika yeEurope neyepamusoro-zhinji - kuongorora kwe > breakpoints >." International Congress paDrug Therapy muHIV Infection; Glasgow, Scotland; November 2-6, 2014; abstract O237.
> World Health Organization (WHO). "Kuwandisa kweHIV pakati pevanhu vakuru kusvika kune makumi mana nemakumi mashanu nemakumi mana nemana makumi mashanu (49 kusvika ku49)." Data nedzimwe nyika. "Geneva, Switzerland; yakarongedzwa musi waNovember 6, 2014.
> Yahia, B. naFrank, I. "Kurwisana neAIDS muAmerica: Kuongororwa kweNyika yeHIV neAIDS." American Journal of Public Health. Svondo 2011; 101 (9): e4-e8.