O'Neill J F, Marconi K, Surapruik A, Blum N
HIV/AIDS Bureau, Health Resources and Services Administration, Rockville, MD 20857, USA.
J Urban Health. 2000 Jun;77(2):244-54. doi: 10.1007/BF02390535.
There has been a dramatic shift of the human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS) epidemic into poor, marginalized, and minority communities in the US. At the same time, the availability of new highly active antiretroviral treatments has made it possible for a large number of individuals to live for a much longer time with their disease. A net result is that the US is faced with an increasing number of people who are living with HIV/AIDS and are dependent on publicly supported health care services. In this paper, we review the palliative care efforts of the federal agency, the Health Resources and Services Administration (HRSA), responsible for providing Ryan White CARE Act HIV/AIDS care to medically underserved populations. In addition to supporting traditional hospice care, HRSA's HIV/AIDS Bureau has begun a series of initiatives that apply a broader concept of palliative care to its HIV programs in hospital- and community-based settings. Our interest is not to substitute palliation for access to new HIV therapies, such as highly active antiretroviral treatments, but to ensure that our health delivery systems attend to the alleviation of symptoms and suffering along with the provision of antiretroviral and other necessary treatments. HRSA's HIV/AIDS Bureau is organizing a broader provision of palliative care for its clients and actively contributing to improving care for the disenfranchised internationally.
在美国，人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）疫情已急剧转向贫困、边缘化和少数族裔社区。与此同时，新型高效抗逆转录病毒疗法的出现使大量患者能够带病生存更长时间。最终结果是，美国面临着越来越多感染HIV/AIDS且依赖公共医疗服务的人群。在本文中，我们回顾了联邦机构——卫生资源与服务管理局（HRSA）的姑息治疗工作，该机构负责为医疗服务不足人群提供《瑞安·怀特关怀法案》规定的HIV/AIDS护理。除了支持传统的临终关怀服务外，HRSA的HIV/AIDS局还启动了一系列举措，将更广泛的姑息治疗理念应用于其在医院和社区环境中的HIV项目。我们的目的不是用姑息治疗取代获得新型HIV疗法（如高效抗逆转录病毒疗法）的机会，而是确保我们的医疗服务系统在提供抗逆转录病毒和其他必要治疗的同时，关注症状缓解和痛苦减轻。HRSA的HIV/AIDS局正在为其客户组织更广泛的姑息治疗服务，并积极为改善全球弱势群体的护理做出贡献。
