Chifukwa chiyani chisankho chachipatala cha ku Texas chingakhale ndi tanthauzo lalikulu pakutha kwa chisamaliro – The Hill

Nkhani mwachidule


  • Pansi pa 2010 Affordable Care Act, olemba anzawo ntchito akuyenera kupereka chithandizo chokwanira pazithandizo zina zodzitetezera.

  • Komabe, chigamulo chatsopano cha ku Texas chapeza kuti kuperekedwa kwa mautumiki ena, monga pre-exposure prophylaxis (PrEP), kumaphwanya ufulu wa olemba ntchito pansi pa Religious Freedom Restoration Act.

  • Ngati atatsatiridwa, akatswiri akuti zitha kulepheretsa zoyesayesa zopewera matenda ndi mikhalidwe yambiri, kuphatikiza kachilombo ka HIV.

Chisamaliro chotsika mtengo ku United States chimatsalira kwambiri kumayiko ena otukuka ndipo sichipezeka kwa anthu amitundu yaing’ono komanso anthu omwe amapeza ndalama zochepa ku America. Chigamulo chatsopano cha Texas chingapangitse zinthu kuipiraipira.

Woweruza wa Federal Reed O’Connor Lachitatu adachotsa gawo lalikulu la Affordable Care Act (ACA) lomwe likufuna inshuwaransi yothandizidwa ndi olemba anzawo ntchito kuti ikwaniritse ntchito zina zodzitetezera – kuphatikiza pre-exposure prophylaxis (PrEP), mankhwala omwe amachepetsa kwambiri mwayi wopezeka. kutenga kachirombo ka HIV — Kuwonetsetsa kuti odwala salipira ndalama zotuluka m’thumba.

Woweruzayo anagamula kuti lamuloli likuphwanya lamulo la Religious Freedom Restoration Act polamula kuti anthu azipereka nkhani zosemphana ndi zimene amakhulupirira kapena zimene amakhulupirira. Lingaliro, lomwe likuyembekezeka kutsutsidwa, likuyika pachiwopsezo zisankho zaumoyo za anthu opitilira 13 miliyoni a Texans ndi 150 miliyoni aku America onse omwe ali ndi inshuwaransi yazaumoyo yothandizidwa ndi owalemba ntchito.

apamwamba Anawonjezera ndalama ndi zopinga kwa odwala

Ngakhale chisankho cha Lachitatu chisanachitike, anthu ambiri aku America omwe ali pachiwopsezo chotenga kachilombo ka HIV adagwiritsa ntchito PrEP pamitengo yotsika kwambiri. Ponseponse, 25 peresenti ya anthu 1.2 miliyoni omwe akulimbikitsidwa ndi PrEP adalembedwa PrEP mu 2020 – kuchokera pa 3 peresenti mu 2015. Ndipo kufalitsa sikuli kofanana, malinga ndi Centers for Disease Control and Prevention (CDC).

Azungu aku America amapanga 66 peresenti ya chithandizo cha PrEP, Achimereka akuda amapanga 6 peresenti ya kufalitsa ndipo anthu a ku Puerto Rico amawerengera 16 peresenti ya kufalitsa. Izi zili choncho ngakhale kuti anthu akuda ndi a ku Latino a ku America adatenga 42 ndi 27 peresenti ya matenda atsopano a kachilombo ka HIV mu 2021. Azungu a ku America amapanga 26 peresenti ya matenda atsopano a HIV.

Gay, bisexual, ndi amuna ena omwe amagonana ndi amuna amatha kutenga kachilombo ka HIV, ndipo izi ndi zoona makamaka m’madera akuda ndi a Latino. Kachilombo ka HIV kamakhudzanso kwambiri amayi akuda, amayi apakati, komanso anthu omwe amabaya jekeseni.

Amuna ogonana amuna kapena akazi okhaokha amapanga 7 peresenti ya omwe adapezeka ndi kachilombo ka HIV, ndipo azimayi ogonana ndi amuna kapena akazi okhaokha adapanga 16 peresenti mu 2019.


America ikusintha mwachangu kuposa kale! Onjezani Changing America ku fayilo Facebook kapena Twitter Dyetsani kuti mukhale pamwamba pa nkhani.


Matenda atsopano a kachirombo ka HIV achulukanso ku South, komwe anthu aku America nthawi zambiri alibe mwayi wopeza chithandizo chamankhwala chotsika mtengo cha HIV ndi matenda opatsirana pogonana, kulera, kuchotsa mimba ndi chisamaliro chotsimikizika kuti ndi amuna kapena akazi. Ku Texas, anthu opitilira 22,000 adapatsidwa PrEP ndipo anthu opitilira 123,000 anali pachiwopsezo chotenga kachilombo ka HIV mu 2020.

Kwa mwezi umodzi dzina la mtundu wa PrEP ndi pafupifupi $2,000 popanda inshuwaransi, pomwe mtundu wa generic umawononga $30 mpaka $60 pamwezi. Maphukusi ambiri a inshuwaransi amapereka mankhwala kwaulere.

Chigamulochi chikatsatiridwa, madera omwe ali pachiwopsezo chotenga kachilombo ka HIV – ambiri omwe akukumana kale ndi tsankho komanso kusalidwa – adzapatsidwa ntchito yothana ndi vuto lina lazachuma kuti alandire chithandizo chodzitetezera, Perry N. Halketes, dean ndi pulofesa ku Rutgers School of Public Health. , adauza a Changing America.

Halkitis ndi katswiri wazamisala wa anthu onse omwe amayang’ana kwambiri ntchito yake pa matenda opatsirana, ndipo ndiye woyambitsa komanso wotsogolera Center for the Studies of Health, Identity, Behavior, and Prevention ku Rutgers University.

“Chomaliza chomwe mukufuna kuchita ndikuyika chopinga china m’malo mwake, ndipo ngati vuto lina liri lachuma tsopano, pali mwayi waukulu kuti kutengeka kutha,” adatero Halketitz.

Katundu wachuma pantchito ndichuma chamagetsi

Halkitis akuti chigamulo chatsopanochi chingapangitse kuti ndalama zachipatala zikhale zokwera mtengo kwa ogwira ntchito, owalemba ntchito komanso azachuma.

Zili choncho chifukwa kupewa kachirombo ka HIV ndikotsika mtengo kusiyana ndi kuchiza, ndipo kuwongolera matenda osakhalitsa ndikokwera mtengo kwambiri kwa olemba anzawo ntchito kuposa njira zodzitetezera. Kampaniyo idzawononga ndalama zambiri popereka chithandizo cha matenda osachiritsika ngati HIV kuposa momwe imakhudzira chisamaliro chodzitetezera – zomwe zimalimbikitsidwa osati kungochepetsa mtengo komanso kuonetsetsa thanzi la ogwira nawo ntchito.

“Mumachotsa PrEP ndiye zomwe zidzachitike ndikuti gawo laling’ono la malo anu antchito litenga kachilombo ka HIV,” adatero Halketese. “Chotero, pobwezera, mudzalipira mankhwalawo moyo wanu wonse. Zolemetsa pazachuma ndi kampaniyi ndi yaikulu kwambiri pa chithandizo cha HIV kusiyana ndi kupewa HIV ndipo iyi ndi mtsutso womveka wa PrEP, mkangano womveka bwino womwe ukanatha. limbikitsani bungweli komanso Woweruzayu kuti azitsatira PrEP.”

Lingaliro la Texas lotsegulira mabwana mwayi wokana kupereka chithandizo chilichonse chodzitetezera chomwe akuwona kuti ndi losemphana ndi zikhulupiriro zachipembedzo chawo, lingapangitsenso mwayi wopeza khansa ndi matenda a mtima, mwachitsanzo.

“Kwa ine, ikunena za kufunikira kwa njira yothandizira zaumoyo m’dziko lathu,” adatero Halketitz. “Kumene zisankho zamtunduwu sizimapangidwa ndi olemba ntchito, pomwe zosankha za thanzi langa zimasankhidwa ndi ine osati munthu amene ndimamugwirira ntchito, komwe anthu omwe amafunikira ntchito amatha kupeza ntchito popanda kuopa zotsatira zomwe mabwana angawauze. kugonana, momwe amagonana, ndi zomwe amachita ndi matupi awo.”

Tsogolo la HIV ndi chisamaliro chodzitetezera

Ngakhale sizikudziwika ngati chigamulochi chidzakambidwa kunja kwa Texas kapena ngati olemba anzawo ntchito akutsutsa chigamulo cha lamulo loletsa katangale, zidzakhala ndi zotsatira zamphamvu pa chisamaliro chamtundu uliwonse.

M’chigamulo chake, O’Connor adagamula motsutsana ndi zomwe adanena kuti azigwira ntchito zina zodzitetezera monga kuwunika kwa colorectal, khansa zina, kupsinjika maganizo komanso kuthamanga kwa magazi – ponena kuti dongosolo la US Preventive Services Task Force lodziwa ntchito zomwe ziyenera kuchitidwa mokwanira silinali lovomerezeka. .

Kupitilira kukhudza ACA, chigamulo cha Texas chingakhudzenso cholinga cha dzikolo chothetsa matenda atsopano a HIV kumapeto kwa zaka khumi.

Pamlanduwo, olemba anzawo ntchito ku Texas adati kulipira mapulani azaumoyo omwe amaphimba PrEP “kutha kulimbikitsa kapena kulimbikitsa kugonana kwa amuna kapena akazi okhaokha,” ndikuwonjezera kuti sakufuna kapena kufunikira kudziphimba okha chifukwa “ali pachibwenzi ndi okwatirana” “palibe kapena kukhudzidwa ndi aliyense wa m’banja lawo m’machitidwe amafalitsa kachilombo ka HIV.”

Koma kupeza PrEP sikutsogolera ku khalidwe la kugonana kwa amuna kapena akazi okhaokha, Halkitis ananena, kufanizira mkanganowo ndi womwe unapangidwa m’ma 1990 umene unanena kuti kuika makondomu m’masukulu kumalimbikitsa kugonana kwa achinyamata.

“Lingaliro loti mwanjira inayake timapanga munthu kukhala gay chifukwa tikuwapatsa mankhwala omwe amawalepheretsa kudwala, mwina ndi njira yopusa kwambiri, yachikale, yodana ndi amuna kapena akazi okhaokha, komanso yosagwirizana ndi Mulungu poganizira kuti ndi ndani,” adatero. .

HIV imathanso kupatsirana kuchokera kwa amayi omwe ali ndi kachilombo kupita kwa ana awo komanso kudzera mu singano zogawana.

Chochititsa chidwi n’chakuti, chiyambire pamene mankhwala a PrEP ndi mankhwala ena oletsa tizilombo toyambitsa matenda a interferon, omwe amalepheretsa odwala kupatsirana kachilomboka, chiŵerengero cha matenda atsopano a kachirombo ka HIV chatsika, makamaka m’madera amene mumapezeka anthu ambiri monga New York.

Mu 2019, oyang’anira a Purezidenti wakale Trump adapereka ndondomeko yothetsa kufala kwa kachirombo ka HIV ku United States pofika 2030.

Koma ngati chigamulochi chikatsatiridwa, chikhoza kusokoneza cholingacho, pamene “cholinga chofuna kutenga kachilombo ka HIV pofika chaka cha 2030 chingakhale chosatheka,” adatero Halketitz. “Ichi ndiye chinthu chomaliza chomwe tikufunika kuti tithane ndi kachilomboka.”

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