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首页> 外文期刊>International Journal of Environmental Research and Public Health >Immediate Antiretroviral Therapy: The Need for a Health Equity Approach
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Immediate Antiretroviral Therapy: The Need for a Health Equity Approach

机译：立即抗逆转录病毒治疗：需要健康股权方法

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Immediate antiretroviral therapy (iART), defined as same-day initiation of ART or as soon as possible after diagnosis, has recently been recommended by global and national clinical care guidelines for patients newly diagnosed with human immunodeficiency virus (HIV). Based on San Francisco’s Rapid ART Program Initiative for HIV Diagnoses (RAPID) model, most iART programs in the US condense ART initiation, insurance acquisition, housing assessment, and mental health and substance use evaluation into an initial visit. However, the RAPID model does not explicitly address structural racism and homophobia, HIV-related stigma, medical mistrust, and other important factors at the time of diagnosis experienced more poignantly by African American, Latinx, men who have sex with men (MSM), and transgender patient populations. These factors negatively impact initial and subsequent HIV care engagement and exacerbate significant health disparities along the HIV care continuum. While iART has improved time to viral suppression and linkage to care rates, its association with retention in care and viral suppression, particularly in vulnerable populations, remains controversial. Considering that in the US the HIV epidemic is sharply defined by healthcare disparities, we argue that incorporating an explicit health equity approach into the RAPID model is vital to ensure those who disproportionately bear the burden of HIV are not left behind.
机译：立即抗逆转录病毒治疗（IART）定义为艺术的同日发起或在诊断后尽快，最近被全球和国家临床护理指南推荐用于新诊断的人类免疫缺陷病毒（HIV）的患者。基于旧金山的艾滋病毒诊断的快速艺术计划倡议（急流）模型，美国浓缩艺术启动，保险收购，住房评估和精神卫生和物质使用评估初步访问。然而，快速模式没有明确地解决结构种族主义和同性恋者，艾滋病毒相关的耻辱，医学不信任等诊断时的其他重要因素由非洲裔美国人，拉丁蛋白，与男人（MSM）发生性关系的人更加尖锐和变性患者患者。这些因素会对艾滋病毒护理连续统一体产生负面影响和随后的艾滋病毒护理婚姻和加剧重大的健康差异。虽然IART改善了病毒抑制和关联时间以进行护理率，但其与护理和病毒抑制的保留相关性，特别是在弱势群体中，仍然存在争议。考虑到在美国，艾滋病病毒疫情被医疗保健差异急剧明确，我们认为将明确的健康股权方法纳入快速模型至关重要，以确保那些不成比例地承受艾滋病毒的负担的人不会留下。

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