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В Сан-Франциско срок выдачи АРТ сократили до 6 дней

В Сан-Франциско срок выдачи АРТ сократили до 6 дней

Средняя продолжительность периода до начала терапии после установления диагноза ВИЧ-инфекции в Сан-Франциско сократился с 35 до 6 дней. За этот же период, время необходимое для снижения вирусной нагрузки до уровня, не превышающего 200 копий/мл, сократилось вдвое (со 134 до 61 дня).

В 2015 году, городские власти стали осуществлять проект «RAPID» для ускорения доступа нуждающихся к ВААРТ. Проект был частью более широкомасштабной инициативы, направленной на сокращение числа новых случаев инфекции. Проект «RAPID» направлен на сокращение времени постановки всех выявленных на учет в течение 5 последующих дней и на начало ВААРТ с использованием наиболее эффективного режима при первом же посещении специалиста, за исключением случаев с высоким риском развития синдрома восстановления иммунитета (ВСВИ). Антиретровирусные препараты, для назначения которых необходимо первоначальное лабораторное исследование (например, при назначении абакавира или ненуклеозидных ингибиторов обратной транскриптазы), в проекте не применялись.

Все нововыявленные случаи направляются в специализированные центры «навигаторами» — работниками, которые, на основании психоэмоциональной оценки и оценки социального положения «новичков» и в зависимости от их страхового статуса, помогают им определить наиболее подходящие для них центры. Наличие программ «Medicaid» для лиц с низким уровнем дохода является фундаментальным аспектом этого проекта. 39% выявленных лиц начинают терапию в обычных клиниках, в то время как 60% - в центрах, в которых принимаются лица из программ «Medicaid» или без страховки.

К 2016 году произошла нивелировка демографической разницы между лицами, принимающими и непринимающими терапию. Период с момента постановки диагноза до начала терапии значительно сократился во всех группах населения, особенно, среди бездомных лиц, а также полинезийцев и латиноамериканцев.

«Итоги наблюдения показали, что при слаженном взаимодействии различных секторов, оказывающих помощь населению, возможно сократить время, необходимое для снижения вирусной нагрузки, — сказал д-р Оливер Бейкон из Отдела Общественного Здравоохранения Сан-Франциско, — однако регулярный анализ данных и отдельных случаев пациентов остается важным аспектом работы для определения и усовершенствования слабых звеньев оказания помощи».

В Сан-Франциско срок выдачи АРТ сократили до 6 дней

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