A Amurka, an dade daɗewa cewa, ko da a lokacin da aka shawarci amfani da maganin rigakafin antiretroviral (ART) , yawancin marasa lafiya marasa cancantar magani zasu juya shi. A gaskiya, bisa ga Cibiyar Kula da Cututtuka da Cututtuka ta Amurka (CDC) , daga cikin mutanen Amurka 902,000 da aka gano da kwayar cutar HIV, kawai 363,000 ne ke aiki a kan ART a shekarar 2012.
An yi la'akari da cewa rashin haƙuri da fahimta na haƙuri ya kasance a zuciyar wannan lissafin. Duk da haka, binciken da Cibiyar Jami'ar Asibitin Zurich ta gudanar a shekara ta 2013 ya nuna cewa rashin jin daɗin gabatar da shirin ART ba ƙãra wa marasa lafiya kawai ba, amma ga likitocinsu.
Binciken, wanda aka gudanar a wurare 34 a fadin Turai da Australia, wadanda suka kamu da kwayar cutar da suka kamu da kwayar cutar HIV kuma suna karkashin kulawar likita kimanin kwanaki 180. Daga cikin marasa lafiya a cikin ƙungiyar, 67% aka bincikar da su daga shekara daya zuwa hudu da suka wuce, yayin da aka gano kashi 28 cikin dari biyar ko fiye da shekaru.
Daga cikin likitocin da aka yi binciken, 78% na da shekaru biyar ko fiye da kwarewar maganin cutar HIV, yayin da 90% na da fiye da 50 marasa lafiya HIV a kula da su.
Shirye-shiryen da ke faruwa a baya na HIV
Sakamakon binciken da aka yi a baya ya gano cewa babban mawuyacin farfadowa tsakanin marasa lafiya shine babban nauyin kwayar cutar kwayar cutar da kuma halayen mawuyacin kwayoyi.
Kwararren likita, a halin yanzu, yawancin abubuwa sun shawo kan su kamar yadda yake canza ka'idojin kulawa da kuma sababbin ra'ayoyin masana akan "daidai" lokaci don fara ART.
Tare da samfurori na yau da kullum suna alfahari da nauyin nau'i na kwayar cutar da ƙananan sakamako na gefen - da kuma motsi ga maganin cutar HIV a CD4 kimanin 500 / mL da sama - wadanda aka gaza an cire su da yawa.
Maimakon haka, marasa lafiya a yau suna da rashin sanin masaniyar farfadowa, yayin da likitoci sun ji cewa yawancin marasa lafiya basu da shirye shiryen magani, suna jinkirta ART don, ba watanni ba, amma shekaru a lokaci daya. Bisa ga binciken:
- 47% na marasa lafiya kawai "basu so suyi tunanin HIV."
- 50% na wadanda suka cancanci farfadowa sun ce ba su "shirye" ba, yayin da 33% ke jin "ambivalent".
Babban dalilai da aka ambata sune "rashin alamun bayyanar" ko kuma dabi'ar "Ina dogara ga jiki don gaya mani lokacin da zan fara."
Ya bambanta, likitoci suna jinkirta dakatar da ART ko dai saboda sun "ba da sanin mai haƙuri ba" kuma sun ji cewa mai haƙuri "ya damu sosai" don farawa. Bugu da ƙari:
- 93% na likitocin da aka yi bincike sunyi imanin cewa shawarwarin maganin yanzu sun dace ga marasa lafiya.
- Duk da haka, a cikin rayuwa na ainihi, kawai 51% fara ART don marasa lafiya da CD4 ƙidaya a kasa 500 sel / ML, yayin da kawai 16% yi imani da cewa ya dace ga marasa lafiya da CD4 ƙidaya fiye da 500 Kwayoyin / ML.
Rashin daidaituwa a cikin waɗannan siffofin yana nuna alamar rashin daidaituwa tsakanin masu aiki. Za su iya, a gaskiya, su nuna rashin shakka a tsakanin waɗanda suka ga manufofi sun motsa a daya hanya a baya, sai dai su koma baya bayan 'yan shekarun baya bayan bayyanar da ba a sani ba.
Bugu da ƙari, nuna rashin tabbas don cin nasara akan shingen da aka ba da shawara ya nuna cewa tattaunawar gargajiya game da shirye-shiryen haƙuri bai riga ya samo asali don nuna bambancin "HIV exceptionalism" na shekarun da suka gabata ba, inda yawancin halayen mutum zai iya kula da kulawa da haƙuri. Idan wannan shine lamarin, yana iya zama batun batun "wasa ne kawai" yayin da masu sa ido na siyasa suke kokarin magance rata tsakanin shaida na asibiti da kuma aikin asibiti.
Da gwajin kwayar cutar HIV yanzu an ba da shawara ga dukan jama'ar Amirka shekaru 15-65 - maimakon wadanda ke cikin kungiyoyi "masu hadarin gaske" - ana sa zuciya cewa lalata da kuskuren da ke tattare da HIV tare da karuwa sosai.
Sources:
Cibiyoyin Kula da Cututtuka da Cututtuka na Amurka (CDC). "CDC Fact Sheet | HIV a Amurka: Sashen Kulawa." Atlanta, Jojiya; aka buga Yuli 2012.
Fehr, J; Nicca, D .; Goffard, J .; et al. "Dalilai don Ba a fara Harkokin Kwararrun Kwayoyin Halitta ba: Cibiyar Nazarin Hidima a tsakanin marasa lafiya da likitansu." Turai AIDS AIDS Clinics Society (EACS) taron; Brussels, Belgium; Oktoba 16-19, 2013; Abubuwa na PS11 / 1.