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加拿大一名苏丹难民新诊断出的艾滋病毒管理:文献评论与综述

The Management of Newly Diagnosed HIV in a Sudanese Refugee in Canada: Commentary and Review of Literature.

作者信息

Sidhu Aven, Kakkar Rohan, Alenezi Osamah

机构信息

Vancouver Virology Centre, Vancouver, Canada.

Faculty of Science, University of British Columbia, Vancouver, Canada.

出版信息

Rev Recent Clin Trials. 2019;14(1):61-65. doi: 10.2174/1574887113666180903145323.

Abstract

BACKGROUND

Human Immunodeficiency Virus (HIV) prevalence rates in refugee camps are inconclusive in current literature, with some studies highlighting the increased risk of transmission due to poor living conditions and lower levels of education. With the increasing number of refugees from HIV endemic countries, it is important to assess the programs established to support patients upon arrival. Refugees have been reported to have a lower health literacy and face disease-related stigmatization, which must be overcome for the lifelong treatment of HIV.

CASE PRESENTATION

31-year-old female arrived in Canada as a refugee from Sudan with her 5 children in July of 2017. She was diagnosed with HIV and severe dental carries during her initial medical evaluation and referred to our centre. A lack of social support has resulted in severe psychological stress. The first being stigmatization which has led to her not disclosing the diagnosis to anyone outside her medical care team. Her level of knowledge about HIV is consistent with literature reporting that despite HIV prevention programs in refugee camps, compliance with risk reduction behaviors, especially in females, is low. Lastly, her major concern relates to the cost of living and supporting her children.

CONCLUSION

Assessment of current HIV programs is necessary to recognize and resolve gaps in the system. Focusing on programs which increase both risk reduction behaviors in refugee camps and integration of refugees in a new healthcare system can facilitate an easier transition for patients and aid in the quest for global 90-90-90 targets for HIV.

摘要

背景

当前文献中关于难民营中人类免疫缺陷病毒(HIV)流行率的结论并不明确,一些研究强调由于生活条件差和教育水平低,传播风险增加。随着来自HIV流行国家的难民数量不断增加,评估为难民抵达后提供支持的项目非常重要。据报道,难民的健康素养较低,且面临与疾病相关的污名化问题,而这对于HIV的终身治疗来说必须予以克服。

病例介绍

一名31岁女性于2017年7月作为难民从苏丹抵达加拿大,还带着她的5个孩子。她在初次医疗评估时被诊断出感染HIV并患有严重龋齿,随后被转诊至我们中心。缺乏社会支持导致了严重的心理压力。首先是污名化问题,这使得她没有向医疗团队之外的任何人透露自己的诊断情况。她对HIV的了解程度与文献报道一致,即尽管难民营中有HIV预防项目,但降低风险行为的依从性较低,尤其是在女性中。最后,她主要担心的是生活成本和抚养孩子的问题。

结论

有必要对当前的HIV项目进行评估,以发现并解决系统中的差距。关注那些既能提高难民营中降低风险行为,又能促进难民融入新医疗体系的项目,可为患者提供更轻松的过渡,并有助于实现全球HIV防治的90-90-90目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce8a/6691779/a71e964eaf99/RRCT-14-61_F1.jpg

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