ormagi stigma

ormagi gamowveva

fsiqikuri janmrTeloba da aiv / Sidsi centralur da aRmosavleT evropasa da axladSeqmnil damoukidebel saxelmwifoebSi

aiv-iT dainficirebulTa da SidsiT daavadebulTa uflebebis dasacavad mimarTuli sainformacio dokumenti

saqarTveloSi proeqts `fsiqikuri janmrTeloba da aiv/Sidsi centralur da aRmosavleT evropasa da axladSeqmnil damoukidebel saxelmwifoebSi~

axorcieleben organizaciebi:globaluri iniciativa fsiqiatriaSi sazogadoebrivi gaerTianeba bemoni

asociacia `Tanadgoma~

globaluri iniciativa fsiqiatriaSi`globaluri iniciativa fsiqiatriaSi~ miznad isaxavs xeli Seuwyos fsi-qikuri janmrTelobis dacvis humanur, eTikur da efeqtur politikas mTels msoflioSi. is gansakuTrebiT aqtiuria centralur da aRmosavleT evropasa da axladSeqmnil damoukidebel saxelmwifoebSi, sadac fsiqikur janmrTelobaze zrunva, umeteswilad, jer kidev ar Seesa-bameba sayovelTaod aRiarebul standartebs da aRniSnuli samsaxurebis momxmarebelTa uflebebi isev xSirad irRveva. amasTan erTad, `global-uri iniciativa fsiqiatriaSi~ axorcielebs kampanias fsiqiatriis poli-

tikuri mizniT gamoyenebis winaaRmdeg yvelgan, sadac es xdeba.

madlobawinamdebare dokumentis SemuSavebaSi mravalma adamianma Seitana wvlili. wamyvani avtorebi - anJela birni da jeni petraki, redaqtori - jein selveji. sayuradRebo komentarebi gamoigzavna saqarTvelos, yirgizeTis da moldovas fsiqikuri janmrTelobisa da aiv/Sidsis centrebidan; do-kumentis SedgenaSi monawileoba miiRes globaluri iniciativis Tanam-Sromlebma: anemik Sadem, rob Suurmanma, simon surgulaZem da katenka de vrim. madloba vuxdiT proeqtis donorebs: Temebze orientirebul Tanad-afinansebis programas, niderlandebis sagareo saqmeTa saministros, Ria

sazogadoebis institutis fonds (Zug).

nebarTva mocemuli dokumenti gamoqveynda MAIDS -is proeqtis farglebSi, romel-sac axorcielebs `globaluri iniciativa fsiqiatriaSi~, s/y 1282, 1200 hilversami, niderlandebi, www.gip-global.org. dokumentis sruli versiis an misi nebismieri nawilis aslis gadaRebaze an Targmnaze nebarTvis mis-

aRebad daukavSirdiT `globalur iniciativas fsiqiatriaSi~.

© globaluri iniciativa fsiqiatriaSi 2006

4. janmrTelobis msoflio organizaciis wina sityvaoba6. Sesavali8. kavSiri fsiqikur janmrTelobasa da aiv/Sidss Soris10. regionaluri konteqsti16. fsiqikuri janmrTelobis problemebi da aiv-infeqcia: identifikacia, mkurnaloba, prevencia20. daskvnebi politikisa da praqtikisaTvis24. ramdenime nabiji win26. daskvna26. gamoyenebuli literatura da sxva resursebi

sarCevi

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janmrTelobis msoflio organizaciis Tanaxmad (janmrTelobis msoflio organizacia, 2005a), fsiqikuri janmrTeloba warmoadgens centralur aspeqts janmrTeli, inkluziuri da produqtiuli sazogadoebis Camoya-libebaSi. magram janmrTelobis msoflio organizacia jandacvisa da socialuri sferos erT-erT yvelaze aqtualur problemad ukanaskvneli 25 wlis manZilze miiCnevs aiv/Sidss (janmrTelobis msoflio organiza-cia, 2005b). SesaZlebelia es gasakviric iyos, magram sazogadoebriobis, umaRlesi politikuri wreebis warmomadgenlebis da jandacvis sferos profesionalTa cnobierebaSi am or problemas iSviaTad akavSireben erT-maneTTan da fsiqikuri janmrTelobaze zrunvas xSirad ar eqceva jerovani yuradReba aiv-is prevenciisa da mkurnalobis programebSi. da mainc, fsi-qikuri aSliloba mWidrod aris dakavSirebuli aiv/SidsTan: is SeiZleba iyos rogorc mizezi, aseve - Sedegi. aiv/SidsiT daavadebulTa mxardaWera da fsiqikuri aSlilobebis mkurnaloba warmoadgens mTavar faqtors maTi cxovrebis xarisxis gaumjobesebisa da infeqciis Semdgomi gavrceleb-is prevenciis TvalsazrisiT.

aiv infeqciasTan asocirebuli fsiqikuri janmrTelobis problemebi doku-menturadac dasturdeba. fsiqikuri daavadeba da narkomania aZliereben mowyvladobas aiv infeqciis mimarT, xolo aiv/Sidsis diagnozma SesaZlebe-lia Zlieri gavlena moaxdinos fsiqikur janmrTelobaze rogorc stigmisa da diskriminaciis gamo, aseve TviT daavadebis progresirebis Se-degad. aiv/SidsiT daavadebul adamianTa daaxloebiT sam meoTxeds Tavisi cxovrebis manZilze erTi fsiqikuri aSliloba mainc hqonia (baingana da sxvebi, 2005w). mZime ekonomikuri da socialuri pirobebi, rac xels uwyobs aiv infeqciis swrafad gavrcelebas, aseve xels uwyobs fsiqikuri janmrTe-lobis problemebis swraf ganviTarebas.

aiv/SidsTan brZola aTaswleulis ganviTarebis im mizans warmoadgens, romelsac iwonebs da mxars uWers gaerTianebuli erebis organizacia da janmrTelobis msoflio organizacia. aiv inficirebulTa konsultirebis, testirebis, mkurnalobis da maTze zrunvis xelmisawvdomoba warmoadgens janmrTelobis msoflio organizaciis ZiriTad iniciativas. am inicia-tivis Sedegad izrdeba im adamianTa ricxvi, vinc mimarTavs testirebas. Sesabamisad, meti adamiani igebs sakuTar aiv-statuss.

amgvari raodenobrivi zrda gamoiwvevs fsiqikur janmrTelobaze zrunvisa da mkurnalobis Sesabamis zrdas, rac moiTxovs gacilebiT ufro mWidro TanamSromlobas jandacvisa da socialuri daxmarebis sxvadasxva seqtorebs Soris. dReisaTvis arsebobs Sesabamisi saxelmZRvaneloe-bis mzardi raodenoba da dagrovili gamocdileba (magaliTebisaTvis ix. cxrili 1), maT Soris saganmanaTleblo xasiaTis bukletebis mTeli kompleqti, romelic janmrTelobis msoflio organizaciis farglebSi ganxorcielebuli erToblivi muSaobis Sedegad gamosces fsiqikuri janmrTelobis, fsiqoaqtiuri nivTierebebis moxmarebisa da Sidsis gan-yofilebebma (janmrTelobis msoflio organizacia, 2005 c). 2005 wels helsinkSi 52 wevri qveynis mier miRebul iqna janmrTelobis msoflio or-ganizaciisa da evrokavSiris erToblivi deklaracia da samoqmedo gegma fsiqikuri janmrTelobis sakiTxebze evropis regionSi da masSi asaxulia ZiriTadi mimarTulebebi (janmrTelobis msoflio organizacia, 2005 d).

zemoTxsenebuli problema did SeSfoTebas iwvevs centralur da aR-mosavleT evropaSi da axladSeqmnil damoukidebel saxelmwifoebSi, sadac Sidsis epidemia swrafad vrceldeba, amave dros izrdeba fsiqikur daavadebaTa sixSire. rogorc aiv/Sidsis, aseve fsiqikuri aSlilobebis mkurnalobisaTvis xelmisawvdomi resursebis moZieba da momsaxureba Cvens winaSe rTul amocanas ayenebs. mocemuli dokumenti mimarTulia aiv inficirebulTa da SidsiT daavadebulTa uflebebisa da interesebis dasacavad, uzrunvelgvyofs faseuli informaciiTa da ideebiT, raTa daexmaros zemoTxsenebul regions arsebuli problemebis mogvarebaSi. janmrTelobis msoflio organizacia kmayofilebas gamoTqvams global-ur iniciativasa da niderlandebis xelisuflebasTan TanamSromlobis SesaZleblobiT, miesalmeba maT Zalisxmevas, daaCqaron am mimarTulebiT gansaxorcielebeli gaumjobesebani axali mTavari proeqtis meSveobiT da iwonebs am sakiTxisadmi qvemoT aRweril midgomas. Cven, Cveni riskis fasad, ugulvebelvyofT aiv-iT daavadebis safrTxis qveS myofi da ukve dainficirebuli adamianebis fsiqikuri janmrTelobis saWiroebebs am re-gionSi. Tu es saWiroebebi ar iqna dakmayofilebuli, epidemia gaagrZelebs Tavis swrafad mzard zemoqmedebas, rac SesaZlebelia sicocxlis fasad daujdes rogorc calkeul adamianebs, aseve mTel sazogadoebebsa da qveynebsac ki.

janmrTelobis msoflio organizaciis winasityvaoba

cxrili 1: fsiqikur janmrTelobasTan da aiv/SidsTan dakavSirebuli zogierTi saerTaSoriso standarti da SeTanxmeba

* gaeros aTaswleulis ganviTarebis miznebi, gan sakuTrebiT nomeri 6, `brZola aiv/Sid-sTan, malariasa da sxva daavadebebTan~* aiv/SidsTan dakavSirebul valdebulebaTa gaeros deklaracia, 2001 * janmrTelobis msoflio organizaciis Sexed-ulebaTa sistema fsiqikuri janmrTelobis, ada-mianis uflebebisa da kanonmdeblobis Sesaxeb, 2005* janmrTelobis msoflio organizaciis fsi-qikuri janmrTelobis politika da samsaxure-bis saxelmZRvanelo paketi, 2005 * fsiqikuri janmrTeloba: rTuli problemebis winaSe, gadawyvetilebebis SemuSaveba.

janmrTelobis msoflio organizaciisa da evrokavSiris deklaracia da samoqmedo gegma fsiqikur janmrTelobasTan dakavSirebiT, ev-ropis ministrTa konferencia, helsinki, 2005.

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Sesavali

centraluri da aRmosavleTi evropis qveynebi da axladSeqmnili da-moukidebeli saxelmwifoebi (caeq/ads) ganicdian msoflios yvelaze swra-fad mzardi aiv/Sidsis epidemiis gavlenas. gamoTvlilia, rom 1.6 milioni adamiani aRniSnul regionSi aiv infeqciis mtarebelia. es katastrofuli cifria, romelic gviCvenebs daavadebis TiTqmis 20-jer zrdas aTwleulze nakleb droSi (UNAIDS 2005). dainficirebulad cnobilni warmoadgenen regionis 410 mln. mosaxleobis SedarebiT mcire nawils - 0,4%-s; inficire-bulTa realuri raodenoba SesaZlebelia gacilebiT meti iyos.

aiv/Sidsi Seexeba rogorc Tems da sazogadoebis mTels struqturas, aseve calkeul individebs da maT axloblebs - partniorebsa da ojaxis wevrebs. regionSi arsebuli mZime socialuri da ekonomikuri pirobebi: masobrivi umuSevroba, SromiTi migracia, ekonomikuri arastabiluroba da agreTve, samedicino momsaxurebis naklebad xelmisawvdomoba metad xelsayrel pirobebs qmnis infeqciis gavrcelebisaTvis. arsebobs fsiqikuri janmrTe-lobis problemebis maRali maCveneblebi. maT Sorisaa TviTmkvleloba, narkomania, alkoholozmi da depresia. samwuxarod, miuxedavad imisa, rom fsiqikuri janmrTeloba institucionalizebulia, is araadeqvaturia da mwiri resursebi aqvs imisaTvis, rom daakmayofilos fsiqikuri jan-mrTelobis problemebis mqone adamianTa moTxovnebi. aucilebelia, rom seriozuli yuradReba mieqces mocemul regionSi rogorc aiv infeqciis, aseve fsiqikuri janmrTelobis problemebis gadaWras. mTeli Zalisxmeva unda mivmarToT am sakiTxebis erTobliv mogvarebaze, radgan isini Zlier zegavlenas axdenen erTmaneTze.

centralur da aRmosavleT evropis qveynebSi da axladSeqmnil da-moukidebel saxelmwifoebSi fsiqikuri janmrTelobisa da aiv/Sidsis problemaTa es mokle mimoxilva SemuSavda globaluri iniciativis mier rogorc nawili im proeqtisa, romelsac organizacia axorcielebs nider-landebis sagareo saqmeTa saministros mxardaWeriT (2005 - 2008). proeqti miznad isaxavs fsiqikuri janmrTelobis problemebis mqone aiv/SidsiT daa-vadebul adamianTa, maTi partniorebis, mzrunvelebisa da ojaxis wevrebis tanjvis Semsubuqebasa da cxovrebis xarisxis gaumjobesebas samxreT-aR-mosavleT evropaSi, kavkasiasa da centralur aziaSi. organizaciis `glo-baluri iniciativa fsiqiatriaSi~ iniciativiT regionSi iqmneba fsiqikuri janmrTelobisa da aiv/Sidsis 9 axali saeqsperto centri,

romlebic Seagroveben da gaavrceleben informacias; ganaxorcieleben saganmanaTleblo da saswavlo programebs aiv inficirebuli da SidsiT daavadebuli adamianebisaTvis (PLHA) , maTi ojaxebisaTvis, mzrunvelebisa-Tvis da mosaxleobis farTo fenebisaTvis; SeimuSaveben efeqtur saSuale-bebs aiv/SidsTan dakavSirebuli fsiqikuri janmrTelobis problemebTan gasamklaveblad; da imoqmedeben rogorc resurs-centrebi da samoqmedo centrebi.

mocemul sabaziso dokumentSi gadmocemulia ZiriTadi faqtebi, rom-lebic Seexeba fsiqikuri daavadebebisa da aiv/Sidsis urTierTzemoqmede-bas da mis gavlenas calkeul adamianebsa da sazogadoebaze aRniSnul regionSi. pirvel rigSi, is mowodebulia, gvibiZgos moqmedebisaken, miznad isaxavs, gavaTviTcnobieroT, Tu raoden didi mniSvneloba eniWeba fsi-qikuri janmrTelobis problemebis mogvarebas aiv/SidsiT daavadebis dros. amasTan aRniSnuli dokumenti mxars uWers fsiqikuri janmrTelo-bis problemebis mimarT gazrdil yuradRebas aiv infeqciis prevenciis, mkurnalobisa da movlis yvela etapze. is ikvlevs da aanalizebs Sedegebs jandacvis politikisa da praqtikisaTvis da rekomendaciebs gvaZlevs imasTan dakavSirebiT, Tu rogor gavuwioT Tanadgoma da daxmareba aiv inficirebulebs, raTa maT moikribon Zala sakuTari uflebebisa da interesebis dasacavad. masSi miTiTebulia problemasTan TviTgamklave-bisa da socialuri/sazogadoebrivi mxardaWeris mopovebis gzebic. do-kumentSi gamoyenebulia ukve arsebuli monacemebi da is ar warmoadgens axal gamokvlevas. ufro zustad, is ajamebs mocemuli momentisaTvis xelT arsebul informacias da gadmogvcems am monacemebs yvelasaTvis gasagebi formiT. amJamad dokumenti adaptirdeba, reziumirdeba da iTargmneba sx-vadasxva enebze adgilobrivi sargeblobisaTvis. misi ZiriTadi miznobrivi mkiTxvelebi arin adamianebi, romlebic Cabmulni arian jandacvis sfe-roSi, socialur-politikuri kursis SemuSavebis procesSi da aqtivistur moRvaweobaSi centaluri da aRmosavleTi evropis da yofili sabWoTa kavSiris teritoriaze, kerZod, qveynebSi, romlebic CarTulni arian Cvens proeqtSi. eseni arian: politikuri moRvaweebi, umaRlesi politikuri wreebis warmomadgenlebi da adamianebi, romlebic mniSvnelovan gavlenas axdenen qveyanaSi sazogadoebrivi azris Camoyalibebaze; pirebi, romlebic pasuxismgebelni arian jandacvisa da socialuri samsaxurebis dagegmvasa da marTvaze; ganaTlebis sistemis xelmZRvanelebi; jandacvisa da socia-luri momsaxurebis sistemaSi dasaqmebul profesionalTa organizaciebi; donorebi; organizaciebi, romlebic warmoadgenen PLHA-sa da fsiqikuri janmrTelobis samsaxurebis momxmareblebi.

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kavSirebi fsiqikur janmrTelobasa da aiv/Sidss Soris

Sidsis ganviTareba an, ubralod, aiv/pozitiuri statusi mniSvnelovan gavlenas axdens adamianis fsiqikur janmrTelobaze. yvela qronikul, sicocxlisaTvis saSiS mdgomareobas axlavs specifikuri stresorebi, rogoricaa - xangrZlivi diskomforti, fizikuri mdgomareobis gauare-seba, fizikuri da finansuri damokidebuleba da naadrevi sikvdilis perspeqtiva. damatebiTi problemebia diskriminacia, socialuri uaryofa, stigma, izolacia, Caketiloba, dainficirebis SiSi, mravali sikvdilisa da danakargis gancda. yvela am stresoris kumulaciuri moqmedeba niSnavs imas, rom aiv/Sidss Zlieri fsiqologiuri da socialuri gavlena aqvs. fsiqikuri janmrTelobis problemebi SesaZlebelia gamovlindes aiv in-feqciis nebismier stadiaze: testirebis periodSi, daavadebis progresire-bis, avadmyofobisa da sikvdilis dros. yvela es problema ukavSirdeba uamrav fsiqikur, fizikur da sulier cvlilebas da danakargs. isini, visac uviTardeba infeqcia, xSir SemTxvevaSi, im jgufebis warmomadgenlebi ar-ian, romelTac ukve gamocdili aqvT socialuri uaryofa, cxovrebis mZime pirobebi da janmrTelobis problemebi. rogorc ganviTarebul, aseve gan-viTarebad qveynebSi dadasturebulia kavSiri aiv-sa da siRaribes Soris, romelsac mivyavarT daRmavali spiraliT janmrTelobis mdgomareobis gauaresebisa da samedicino daxmarebis miRebis miuwvdomlobisken.

fsiqikuri janmrTelobis problemebma, narkotikebisa da alkoholis moxmarebam da daswavlis sirTuleebma SesaZlebelia ise Secvalos adami-anis qceva, rom gaizardos aiv-iT dainficirebis safrTxe. dainficirebis gansakuTrebuli riskis qveS myof populaciebSi, ineqciuri narkotikebis momxmareblebis, komerciuli seqs-muSakebis, ltolvilebis, migrantebisa da patimrebis CaTvliT, isedac aris fsiqikuri daavadebebis ufro ma-Rali maCvenebeli. fsiqikur daavadebaTa arasrulfasovanma mkurnalobam SeiZleba gamoiwvios sicocxlis xangrZlivobis Semcireba, cxovrebis xarisxis gauareseba, aiv-infeqciis mkurnalobis Seferxeba da am mkur-nalobis reJimis darRveva. mkurnalobisa da mzrunvelobis naklebobam SeiZleba daaqveiTos adamianis unari, ganaxorcielos janmrTelobisTvis saWiro qceva da moimatos qcevam, romelic aiv infeqciis gavrcelebas gana-pirobebs. isini, vinc cdiloben uzrunvelyon aiv-inficirebulTa janmrTe-lobis dacva da maTi socialuri mxardaWera, xSirad ganicdian demoral-izacias, stress da `gadawvas~.

meore mxriv, fsiqikuri janmrTelobis problemebis mkurnalobas bevri sargebloba moaqvs calkeuli adamianebisaTvis, TemisaTvis da mTlianad sazogadoebisaTvis. es aris aiv/SidsiT daavadebulebis, maTi ojaxis wevre-bis, partniorebisa da mTeli sazogadoebis cxovrebis gaumjobesebuli xarisxi; gaumjobesebuli janmrTeloba da mkurnalobis efeqturoba; aiv infeqciasTan, sxva daavadebebTan da fsiqoaqtiuri nivTierebebis moxmare-basTan dakavSirebuli avadobis Semcireba; gazrdili produqtiuloba, romelsac sargebloba moaqvs mTeli sazogadoebisaTvis; jandacvis sam-saxurebis ufro efeqturad gamoyeneba. amas garda, ar unda iqnas igno-rirebuli is mniSvnelovani roli, romelic SeiZleba iTamaSos fsiqikuri janmrTelobis dacvam aiv infeqciis prevenciis saqmeSi.

SemTxveva 1: giorgi

giorgi, 26 wlis, ineqciuri narkotikebis aqtiuri mom-xmarebelia. is 18 wlis iyo, rodesac ineqciuri narko-tikebis moxmareba daiwyo axlo megobrebis wreSi. erTi Tvis win mis erT-erT megobars sisxlis gadasxma dasWir-da gadaudebeli qirurgiuli operaciisTvis da giorgi mas saavadmyofoSi donorad gahyva. testirebis Sedegad gamovlinda, rom is infeqcirebulia aiv-iT da C hepa-titis virusiT. giorgi SeZrwunebuli iyo - is arafer amdagvars ar moeloda. cxovrebam misTvis erT wamSi dakarga mniSvneloba. man ar icoda, sad wasuliyo an visTvis miemarTa. saavad-myofos TanamSromlebma Seatyobines Sidsis erovnuli centris Sesaxeb, sadac SeiZleboda analizis Sedegebis gadamowmeba da konsultaciis miReba, magram mas eSi-noda centrSi misvlis. is Tvlida, rom Sidsi ganuku-rnebelia da mas veravin ver daexmareboda. is iyo daTrgunuli, CamoSorda megobrebs da fiqrobda TviT-mkvleleobaze. erTxel, rodesac radios usmenda, Seityo aiv/Sidsis mqone adamianebisaTvis TviTdaxmarebis centris ar-sebobis Sesaxeb, romelic am problemebis mqone adami-anebs mouwodebda, dakavSirebodnen mas. ramdenime dRis fiqris Semdeg man dareka centrSi da SeuTanxmda Sexve-draze. centris TanamSromlebma mniSvnelovani dax-mareba aRmouCines - gauwies konsultacia da miiyvanes Sidsis erovnul centrSi Semdgomi testirebisaTvis. agreTve, gaagzavnes narkologiis institutSi Canacv-lebiTi Terapiis programaSi monawileobis misaRe-bad. dResdReobiT giorgi gadis antiretrovirusuli Terapiis kurss da yoveldRiurad iRebs metadons. is fiqrobs, Tavi daanebos narkotikebis moxmarebas da gacilebiT optimisturad aris ganwyobili sakuTari momavlis mimarT. es SemTxveva emyareba saqarTveloSi momxdar namdvil ambavs, magram saxelebi da zogierTi detalebi Secvlilia.

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regionaluri konteqsti

swraf ekonomikur da socialur cvlilebebs centralur da aRmosavleT evropasa da axladSeqmnil damoukidebel qveynebSi Tan mohyva sagrZnobi daRmasvla fsiqikuri janmrTelobis sferoSi, narkotikuli nivTierebebi-sa da alkoholis moxmarebasTan dakavSirebuli fsiqikuri aSlilobebis, Zaladobis, depresiisa da TviTmkvlelobebis maCveneblis zrda (cxrili 2). TviTmkvlelobebis maCvenebeli regionSi Zalian maRalia, gansakuTrebiT mamakacebs Soris. es maCvenebeli samjer aRemateba dasavleT evropis analogiur maCvenebels (janmrTelobis msoflio organizacia, 2001 w). amgvarma pirobebma nayofieri niadagi Seqmna aiv infeqciis gavrcelebisa-Tvis (cxrili 3), rogorc amas hamersi da dounsi aRniSnaven (2003 w): `Rrma socialurma da ekonomikurma gadatrialebebma yofil sabWoTa kavSirSi 1990-ian wlebSi gamoiwvia narkomaniis, alkoholizmis, prostituciis, aiv-isa da sqesobrivi gziT gadamdebi sxva infeqciebis mkveTri zrda... socialur-ekonomikuri pirobebis mkveTri gauareseba da usamarTlobis zrda iwvevs sasowarkveTilebisa da usasoobis grZnobas, rac warmoad-gens nayofier niadags aiv infeqciis gavrcelebisaTvis prostituciasa da narkotikuli nivTierebebis moxmarebasTan dakavSirebuli sarisko qceve-bis gziT. moSlili ekonomika gulisxmobs daavadebaTa profilaqtikisa da avadmyofebis movlisaTvis saWiro resursebis Semcirebas.~

am uimedo suraTis miuxedavad, gadaudebelma da swrafma moqmedebam SeiZleba ZirSive aRmofxvras epidemia. aiv/Sidsis gavrcelebis done jer kidev dabalia. oficialuri monacemebi meryeobs, magaliTad, 0,1%-dan bulgareTsa da litvaSi 1%-mde ruseTis federaciaSi, 1,1%-mde estoneTSi da 1,4%-mde ukrainaSi. da mainc, zogierT am qveyanas aiv/Sidsis yvelaze swrafad mzardi maCvenebeli aqvs msoflioSi. 2005 wels aiv/SidsiT daa-vadebul adamianTa ricxvma miaRwia daaxloebiT 1,6 milions - es aris TiTqmis 20 jeradi zrda 10 welze nakleb periodSi (UNAIDS 2005 w). gamoan-gariSebulia, rom mxolod 2005 wels daaxloebiT 270 000 adamiani dain-ficirda da savaraudod, 62 000 mozrdili da bavSvi daiRupa aiv infeqciis gamo. yvelaze metad axalgazrdoba ziandeba: regionSi aiv inficirebulTa 80% 30 wlamde asakis axalgazrdebi arian. dasavleT evropaSi ki, piriqiT, registrirebuliSemTxvevebis mxolod 30% aris am asakobrivi jgufSi (UNAIDS 2004a).

regionSi aiv infeqciis swrafi gavrceleba mWidrodaa dakavSirebuli ineqciuri narkotikebis moxmarebis sagangaSo zrdasTan, romelic mohyva ssrk-s rRvevas ekonomikuri krizisis, swrafi socialuri cvlilebebis, gazrdili siRaribisa da umuSevrobis, prostituciis zrdis viTarebaSi. ineqciuri narkotikebis moxmareba regionis yvela qveynisaTvis daavade-bis gavrcelebis ZiriTad gzad rCeba. gamoTvlilia, magaliTisaTvis, rom yirgizeTSi zrdasruli mosaxleobis 2% mainc narkotikuli nivTierebebis momxmarebelia (UNAIDS 2004a), rac seriozul safrTxes qmnis aiv infeqciis swrafi da intensiuri gavrcelebisaTvis. saqarTveloSi registrire-bul aiv inficirebulTa 70% ineqciuri narkotikebis momxmarebelia da safiqrebelia, rom narkotikebis momxmarebelTa realuri raodenoba gacilebiT didia, vidre amas oficialuri statistika gvTavazobs.

aRsaniSnavia, rom ramdenime qveyanaSi epidemiis struqtura icvleba sqesobrivi gziT aiv infeqciis gavrcelebis SemTxvevebis gamo, rac axali diagnozebis sul ufro mzardi wilis mizezi xdeba. moldovas respubli-kaSi, magaliTad, 2004 wels aiv infeqciis yvela axali registrirebuli SemTxvevis 45% miaweres daucvel seqss (Euro HIV 2005 w). maSin, roca in-ficirebulTa umravlesobas regionSi amJamad mamakacebi warmoadgenen, avaddeba ufro da ufro meti qalic - bevri maTgani partniori mamaka-cisagan, romelic Tavis mxriv, dainficirda narkotikuli nivTierebebis moxmarebis dros. ufro meti inficirebuli bavSvi ibadeba aiv inficire-buli dedebisagan, rac dedidan Svilze infeqciis gadacemis prevenciis problemis prioritetulobaze metyvelebs. (UNAIDS 2004d). rogorc Cans, bavSvebis sul ufro meti raodenoba dakargavs mSoblebs maTi sikvdilis an maT mier Svilebis mitovebis gamo; bevri moxvdeba specializebul dawe-sebulebebSi aiv/SidsTan dakavSirebuli fsiqologiuri da socialuri stresorebis zemoqmedebis qveS. safuZvels ar aris moklebuli, agreTve, SeSfoTeba im mamakacebs Soris faruli infeqciis afeTqebis arsebobis Sesaxeb, romlebsac sqesobrivi kavSiri aqvT mamakacebTan. homoseqsualiz-mis mimarT Zlierma stigmam SesaZlebelia mraval maTgans SeuSalos xeli, mimarTos daxmarebis, testirebisa da mkurnalobisaTvis. arsebobs myari monacemebi mocemul regionSi am kategoriis mamakacebs Soris daucveli sqesobrivi kavSirebis Sesaxeb da, aseve, raodenobrivi Tanafardobis sa-yuradRebo monacemebi maTi sqesobrivi kavSirebis Sesaxeb qalebTan (janmrTelobis msoflio organizacia, 2004).

cxrili 2: fsiqikuri janmrTelobis problemebi centralur da aRmosavleT evropasa da axladSeqmnil damoukidebel qveynebSi

* fsiqikuri daavadebebis maRali procentuli maCvenebeli * mamakacebs Soris TviTmkvlelobis yvelaze maRali maCvenebeli msoflioSi * stigma da socialuri gariyva * codnis moZvelebuli baza * mkurnalobis didi deficiti, araadeqvaturi samsaxurebi * pirveladi daxmarebis arasrulfasovneba * fsiqiatriuli TavSesafrebi (moZvelebuli tipis fsiqiatriuli saavadmyofoebi) * sazogadoebaze orientirebuli samsaxurebis arasakmarisi raodenoba * adamianuri resursebisa da wamlebis deficiti * inteleqtualur uunarobaze fokusirebis ararseboba * adamianis uflebebaTa yoveldRiuri darRveva * zogierTi qveyana xarjavs jandacvis biujetis <2% fsiqikur janmrTelobaze

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cxrili 3: aiv/Sidsi centralur da aRmosavleT evropis qveynebSi da axladSeqmnil damoukidebel saxelmwifoebSi

* yvelaze swrafad mzardi epidemia msoflioSi, gansakuTrebiT baltiis qveynebSi, ruseTsa da ukrainaSi * daaxloebiT 410 milioni adamiani regionSi, romelTa Soris, sul cota, 0,4% inficirebulia * aiv/SidsiT daavadebuli 1,6 mln adamiani 2005 wels: 62,000 sikvdili, 270,000 axali infeqcia * mocemuli cifrebi, albaT, Zalze Semcirebulia * angariSebis Tanaxmad, 2000 - 2004 w.w. axali infeqciis SemTxvevaTa 75% 30 wlamde asakis axalgazrdebi arian, umeteswilad mamakacebi; axalgazrdebi amJamad yvelaze mowyvlad fenas warmoadgenen * infeqciis gavrcelebis ZiriTadi gza ineqciuri narkotikebis moxmarebaa * prostitucia infeqciis gavrcelebis wyaroa * heteroseqsualuri da vertikaluri gavrcelebis zrda * faruli epidemia im mamakacebs Soris, romelTac sqesobrivi kavSiri aqvT mamakacebTan * xSirad minimaluri prevencia, mkurnaloba, mzrunveloba da mxardaWera

gansazRvreba imisa, Tu romeli saxelmwifoebi Seadgenen centralu-ri da aRmosavleTi evropis qveynebs da axladSeqmnil damoukidebel saxelmwifoebs, icvleba, magram mocemul dokumentSi zemoTxsene-buli regioni moicavs Semdeg 27 qveyanas: albaneTs, somxeTs, azerbai-jans, belorusias, bosnias da hercegovinas, bulgareTs, xorvatias, CexeTis respublikas, estoneTs, saqarTvelos, ungreTs, yazaxeTs, yirgizeTs, latvias, litvas, poloneTs, moldovas republikas, ru-mineTs, ruseTis federacias, serbeTs da Cernogorias, slovakeTs, slovenias, tajikeTs, makedoniis iugoslaviis yofil respublikas, TurqmeneTs, ukrainasa da uzbekeTs.

regionSi aiv infeqciis 70% ruseTis federaciaSia, Tumca epidemiis gaCenis potenciali sxva qveynebSic aseve did SeSfoTebas iwvevs. registrirebuli infeqciebis raodenobis zrda grZeldeba da arian aiv infeqciis ZiriTadi gadamtanebi. magaliTad, moldovaSi aiv-inficirebulTa TiTqmis 5% quCis komerciuli seqs-muSakebi arian; yoveli meaTe ineqciur narkotikebsac moixmars (UNAIDS 2004a). dedaqalaq kiSiniovSi mamakacebTan sqesobrivi kav-Siris mqone mamakacebis sentineluri kvlevis Sedegad, maTi TiTqmis 2% aiv inficirebuli aRmoCnda (janmrTelobis msoflio organizacia, 2005 b).

zusti monacemebis miRebis sirTule - ZiriTadi problemaa. daavadebis ga-vrcelebis zemoT warmodgenili monacemebi asaxaven situacias mxolod im adamianebze dayrdnobiT, visac raime Sexeba aqvT testirebis programebT-an da es monacemebi namdvilad Semcirebulia. cota ram aris cnobili im-aTze, vinc ar ukavSirdeba aiv-testirebis ganmaxorcielebel samsaxurebs an mkurnalobs janmrTelobis sxva samsaxurebSi. efeqturi referaluri sistemebis uqonloba an TanamSromlobis ararseboba sxvadasxva samsaxu-rebs Soris, romelTa momxmareblebic arian gamovlenili an aradiagnos-tirebuli aiv inficirebulebi, aseve warmoadgens efeqturi da swrafi mkurnalobisTvis xelisSemSlel mniSvnelovan faqtors. es samsaxurebia: fsiqikuri janmrTelobis, pirveladi daxmarebis, reproduqciuli, dedaTa dacvis (samSobiaro) da infeqciur daavadebaTa samsaxurebi, seqsualuri janmrTelobis klinikebi da narkologiuri centrebi. maSin, rodesac aiv infeqciis mkurnalobisa da prevenciis programebi gafarTovda, im adami-anTa raodenoba, romelic antiretrovirusuli mkurnalobis kurss gadis, didad CamorCeba im adamianebis raodenobas, romelTaTvisac mkurnalo-bis es kursi aucilebelia (UNAIDS 2005).

SemTxveva 2: elena

elena, 51 wlis, martoxela dedaa, romelsac 13 wlis vaJi-Svili hyavs. 4 wlis win saavadmyofoSi mkurnalobis dros mas sisxlis analizi gaukeTes da aiv inficirebuli aRmoC-nda. misi pirveli reaqcia iyo azri TviTmkvlelobis Sesaxeb - cxovrebam azri dakarga. amas daemata SiSi Svilis momavlis gamo. mas ar hyavda naTesavebi, romlebic daexmarebodnen mas an mis vaJiSvils. sanam sakuTari aiv statuss Seityobda, elena alkoholze damokidebuli iyo, rasac xnida depresiis gamudmebuli gancdiT: ar hqonda sicocxlis survili da energia, arc nebisyofa, samsaxuric dakarga. mas ara aqvs survili, imkurnalos Sidsis centrSi, radgan centrSi pirve-lad misvlisas profesionali, romelsac is Sexvda, arafriT daexmara da uyuradRebod moeCvena. mas aRar ucdia, miemar-Ta Sidsis sxva profesionalebisaTvis, radganac igive saxis reaqciis miRebisa eSinoda da arc sjeroda, rom vinmes misi daxmareba SeeZlo. bolos, im eqimis daxmarebiTa da mxardaWeriT, romelic mas mkurnalobda alkoholi-zmis gamo, mimarTa saavadmyofos, romelic axorcielebs antiretrovirusul mkurnalobas. amJamad is elodeba Tera-piis kurss, romelsac, imedi aqvs, male daiwyebs.

es SemTxveva emyareba yirgizeTSi momxdar namdvil ambavs, magram saxelebi da zogierTi detalebi Secvlilia.

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raime saxis mkurnaloba aiv pozitiuri ineqciuri narkotikebis momxmare-blebisaTvis iSviaTia an ar arsebobs. es did SeSfoTebas iwvevs, radgan virusis ukiduresad swrafi gavrceleba narkotikebis momxmarebelTa Soris da maTgan mosaxleobis farTo fenebSi warmoadgens aiv epidemiis mniSvnelovan maxasiaTebels ineqciuri narkotikebis momxmarebelTa Soris. faqtobrivi monacemebi zogierTi qalaqebidan, maT Soris odesi-dan, bangkokidan da niu iorkidan gviCvenebs, rom rogorc ki aiv infeqciis gavrcelebis maCvenebeli 10%-s aRwevs, man advilad SeiZleba gadaaWarbos 40-50%-s erTidan oTx wlamde periodSi (zianis Semcirebis centri, 2003). amasTan, rodesac ineqciuri narkotikebis momxmarebelTa didi raode-nobaa komerciul seqs-muSakebsa da patimrebs Soris, arsebobs infeqciis swrafi gavrcelebis ufro didi potenciali saziaro nemsisa da daucveli seqsis gziT. yvelaze swrafad aiv infeqcia vrceldeba, rodesac bevri ada-miani iyenebs saziaro saineqcio aRWurvilobas, magram infeqcia aseve Sei-Zleba gavrceldes dabinZurebuli narkotikiT da saerTo konteineridan ineqciis SemTxvevaSic. es yvelaferi qmnis idealur pirobebs aiv infeqciisa da sxva sisxliT gadamdebi virusebis, magaliTad, B da C hepatitis ga-vrcelebisaTvis. gamokvleulia, rom aiv inficirebul ineqciuri narko-tikis momxmareblebis 60-90%-s aqvs C hepatitic, da masTan dakavSirebuli RviZlis dazianeba aiv inficirebulTa sikvdilianobis ZiriTad mizezs warmoadgens (patriki da sxvebi, 2001). aiv pozitiuri ineqciuri narkotike-bis momxmareblebi gansakuTrebiT mgrZnobiareni arian, agreTve, tuberku-lozisa da baqteriuli pnevmoniis mimarT.

SemTxveva 3: deni

denis paranoiduli Sizofreniis pirveli niSnebi gamouvlinda 19 wlis asakSi. daavadebis gamwvavebis gamovlineba iyo quCa-quCa wanwali, uari saWmlis miRebaze, mowamvlis SiSi da azri, rom sakuTar saxlSi misTvis adgili ar aris. 22 wlis asakSi is meoTxed moaTavses fsiqiatriul saavadmyofoSi. is wamoiyvanes adgilidan, sadac cxovrobda narko-tikebis sxva momxmareblebTan erTad. denis Cau-tares testireba aiv-infeqciis dasadgenad misi Tanxmobis gareSe, radgan maRali riskis jgufebis warmomadgenlebs testireba iZulebiT utardeboda. deni aiv inficirebuli aRmoCnda. misi deda muSaob-da saavadmyofoSi meddad da roca Seityo misi aiv statusis Sesaxeb, uari Tqva Svilze. mezoblebi da kolegebic aseve moiqcnen. axla is martoa da cxov-robs quCaSi. deni daxmarebas iRebs mxolod fsi-qikuri janmrTelobis sazogadoebrivi centridan, romelic Camoayaliba arasamTavrobo organiza-ciam. centris mizania, daexmaros denis, miaRwios garkveul stabilurobas cxovrebaSi da SeZlos gaumklavdes Sizofreniisa da aiv infeqciis diagnozebs.

es SemTxveva emyareba moldovas respublikaSi momxdar namdvil ambavs, magram saxelebi da zogierTi detalebi Secvlilia.

fsiqoaqtiuri nivTierebebis mavned gamoyeneba xSirad gvxvdeba fsiqikuri janmrTelobis problemebis paralelurad, rogoricaa guneb-ganwyobis aSlilobebi, magaliTad, SfoTva da depresia, aseve, Sizofrenia da bipo-larul aSliloba, romelsac fsiqozamde mivhyavarT (rejieri da sxvebi, 1990). aiv inficirebul ineqciuri narkotikebis momxmareblebSi ufro maRalia kognituri daqveiTebis, guneba-ganwyobis aSlilobebis, TviTmkvlelobis mcdelobebisa da ganxorcielebuli TviTmkvlelobebis maCveneblebi, vidre im inficirebulebSi, romlebic ar arian ineqciuri narkotikebis momxmareblebi (kaliSmani, 1995). adamianebi, romelTac amgvari Tanaarsebuli problemebi aqvT, awydebian sxvadasxva saxis stigmas, romelic dakavSirebulia maT aiv statusTan, fsiqikur daavade-basTan da fsiqoaqtiuri nivTierebebis moxmarebasTan. maT SesaZlebelia hqondeT sirTuleebi mkurnalobisa da mzrunvelobis miRebis TvalsazrisiT.

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fsiqikuri janmrTelobis problemebi da aiv/Sidsi: identifikacia, mkurnaloba da prevencia

aiv-inficirebulTa Soris fsiqikuri janmrTelobis problemebis ga-vrcelebis maRali maCvenebeli dafiqsirda mTel rig qveynebSi (UNAIDS 2004b). fsiqikuri janmrTelobis problemebi SeiZleba win uZRvodes aiv infeqciis diagnozs da gaamwvavos infeqciasTan dakavSirebulma stresore-bma, maT Soris aiv-is sawinaaRmdego zogierTma samkurnalo preparatmac. aiv infeqciis mqone adamianebs mravalgvari problemebi awuxebT, rom-lebic sxvadasxva dros SeiZleba gamovlindes daavadebis msvlelobisas. es aris farTo speqtris fsiqologiuri da fsiqosocialuri problemebi mocemul daavadebasTan Tanaarsebobis da masTan Seguebis procesSi. sir-Tuleebi SeiZleba aRmocendes infeqciis nebismier stadiaze: aiv testire-bis periodSi; simptomTa ganviTarebisas; Sidsis diagnozis dasmisas; aiv sawinaaRmdego medikamentozuri mkurnalobis dawyebisas; da terminalur stadiazec. amdenad, aiv/SidsiT daavadebulTaTvis sasicocxlod mni-Svnelovania, miiRon daxmareba fsiqikuri janmrTelobis problemebis mo-sagvareblad, rogorc maT sakeTildReod, aseve aiv infeqciis gavrcelebis kontrolis mizniT (cxrili 4).

aiv/Sidsis mqone yvela adamians ar uviTardeba fsiqikuri janmrTelobis qronikuli problemebi, magram zogierTi faqtori xels uwyobs mowy-vladobis zrdas. es faqtorebia siRaribe, humanitaruli krizisi, gen-derul uTanasworoba, seqsualuri Zaladoba bavSvebsa da mozrdilebze, fsiqikuri janmrTelobis arsebuli problemebi, fsiqoaqtiuri nivTie-rebebis moxmareba, inteleqtualur uunaroba, stigma da diskrimina-cia. identificirebuli iqna zogierTi is stresuli movlena, romlebic fsiqologiur zegavlenas axdens, maT Soris, aiv statusis gamJRavneba, mkurnalobis Sesaxeb gadawyvetilebis miReba, mZime danaklisi, reprodu-qciuli sakiTxebi, ojaxuri da urTierTobis problemebi. yvela es faqtori gavlenas axdens aiv infeqciis Tanamdevi fsiqologiuri problemebis xan-grZlivobaze da bunebaze. agreTve, SesaZlebelia adgili hqondes Seguebis (adaptaciis) reaqciebs, SfoTvas da depresias, suicidur azrebs da qcevas, urTierTobisa da seqsualur sirTuleebs, fsiqoaqtiuri nivTierebebis borotad gamoyenebasa da gadawyvetilebis miRebasTan dakavSirebul sxvadasxva saxis dilemebs. amas garda, aiv infeqciasTan dakavSirebulma tvinis dazianebebma SesaZlebelia gamoiwvios rogorc zomieri, aseve mZime fsiqologiuri efeqtebi, romlebic, Tavis mxriv, problemebs uqmnis rogorc calkeul adamianebs, aseve maT axloblebs.

TiToeuli am problemaTagani qvemoT ufro detaluradaa ganxiluli (ufro amomwuravi mimoxilva am sakiTxebTan dakavSirebiT ixileT av-torebTan - katalani da sxvebi, 1995).

Seguebis (adaptaciis) reaqciebiaiv/SidsiT daavadebuli adamianebi awydebian stresorTa mTel rigs, ga-dawyvetilebis miRebasTan dakavSirebul dilemebs, danakargs da cvlilebebs, romelTac Sedegad mohyveba emociuri Seguebis xanmokle an qronikuli reaqciebi. aiv testirebaze dadebiTi Sedegis Setyobineba Cveulebriv iwvevs Seguebis xanmokle reaqcias, romelic SeiZleba ga-moixatos sasowarkveTilebaSi, Sokur reaqciaSi, uaryofaSi, usasoebis SegrZnebaSi, uimedobaSi, mwuxarebaSi, danaSaulis gancdaSi, Rirsebis grZnobis dakargvaSi, SfoTvasa da depresiaSi. zemoTCamoTvlili reaqcie-bi, rogorc wesi, klebulobs diagnozis dasmidan ramdenime Tvis Semdeg, ma-gram zogjer SesaZlebelia gagrZeldes, radgan aiv infeqcia gansakuTrebu-lad stigmatizebulia - adamianebma SeiZleba daumalon Tavisi diagnozi partniorebs, ojaxis wevrebs, megobrebs, an, Tu maTi aiv statusi cnobili gaxdeba, waawydnen uaryofas da muqarasac ki. regionSi Zalze maRalia stigmatizacia jandacvis sistemaSi dasaqmebuli adamianebisagan; maT um-ravlesobas, visi aiv/ Sidsis statusic cnobilia, ar iReben samkurnalod janmrTelobis dacvis zogadi profilis samsaxurebSi, radgan jandacvis muSakebs eSiniaT dainficirebisa. amgvari damokidebuleba xels uwyobs Seguebis ufro mZime reaqciebis ganviTarebas.

SfoTvaSfoTvas adamiani xSirad ganicdis. is vlindeba rogorc xanmokle reaqcia qvemoT CamoTvlil faqtorebidan nebismierze: avadmyofobis progresire-ba, defeqtis ganviTarebis saSiSroeba, tkivili, sxvaze damokidebulebis saSiSroeba, samedicino mkurnalobis Sesaxeb gadawyvetilebis miReba, sakuTari daavadebis gamxela, uaryofis SiSi, sxvebis dainficirebis SiSi, izolacia da SidsiT daavadebuli megobrebis sikvdili. SfoTvis done meryeobs zomieridan ukiduresamde, magram zogierTi adaminisaTvis is SeiZleba gaxdes qronikulic. aseve, SfoTvas aZlierebs sikvdilis perspe-qtivasTan dakavSirebuli SiSi, romelic matulobs daavadebis progre-sirebasTan erTad. SfoTva SeiZleba iyos daniSnuli medikamentozuri mkurnalobis garTulebac da garkveuli wamlebis moxsnis Sedegic.

cxrili 4: ratom sWirdebaT aiv/Sidsis mqone adamianebs daxmareba fsiqikuri janmrTelobis problemebTan dakavSirebiT * aranamkurnalebi fsiqikuri daavadeba da wamaldamokidebuleba > sarisko qceva > aiv infeqciis gavrceleba * aranamkurnalebi fsiqikuri daavadeba da wamaldamokidebuleba > araTanmimdevruli antiretrovirusulii Terapia(arT) > aiv infeqciis gavrceleba > uaresi prognozi * arT > fsiqikuri janmrTelobisaTvis saziano gverdiTi efeqtebi * Sidsi > tvinis dazianebebi da sxva zemoqmedeba fsiqikur aqtivobaze * aranamkurnalebi fsiqikuri daavadeba da wamaldamokidebuleba > cxovrebis xarisxis gauareseba aiv/ Sidsis mqone adamianebisaTvis * aranamkurnalebi fsiqikuri daavadeba da wamaldamokidebuleba > ufro didi stresi mzrunvelebisa da ojaxisaTvis * socialuri da sazogadoebrivi mxardaWeris nakleboba > socialuri gariyva > meti daavadebebi, siRaribe, sasowarkveTileba

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SfoTvaSfoTvas adamiani xSirad ganicdis. is vlindeba rogorc xanmokle reaqcia qvemoT CamoTvlil faqtorebidan nebismierze: avadmyofobis progresire-ba, defeqtis ganviTarebis saSiSroeba, tkivili, sxvaze damokidebulebis saSiSroeba, samedicino mkurnalobis Sesaxeb gadawyvetilebis miReba, sakuTari daavadebis gamxela, uaryofis SiSi, sxvebis dainficirebis SiSi, izolacia da SidsiT daavadebuli megobrebis sikvdili. SfoTvis done meryeobs zomieridan ukiduresamde, magram zogierTi adaminisaTvis is SeiZleba gaxdes qronikulic. aseve, SfoTvas aZlierebs sikvdilis per-speqtivasTan dakavSirebuli SiSi, romelic matulobs daavadebis pro-gresirebasTan erTad. SfoTva SeiZleba iyos daniSnuli medikamento-zuri mkurnalobis garTulebac da garkveuli wamlebis moxsnis Sedegic.

depresiaaiv infeqciasTan dakavSirebulma bevrma fsiqologiurma da socialurma stresorma SeiZleba gamoiwvios depresia, romelic aiv/SidsiT daavade-bulTa fsiqikuri janmrTelobis yvelaze gavrcelebul problemas war-moadgens. misTvis damaxasiaTebelia gamudmebuli sevdiani ganwyobileba, sicarielis gancda, uimedoba, suiciduri azrebi, danaSaulis grZnoba da zizRi sakuTari Tavis mimarT, siamovnebisa da interesis dakargva, energi-is nakleboba, gadaRla, koncentraciis unaris daqveiTeba, Zilis darRveva, madis da wonis mkveTri kleba, mousvenroba da gaRizianebadoba. depresia ufro gavrcelebulia aiv infeqciis adreul stadiaze da aiv-Tan dakav-Sirebuli daavadebebis simptomebis gamomJRavnebis periodSi. adamianebi ufro eqvemdebarebian daavadebas, Tuki maT aqvT fsiqiatriuli winais-toria, arasakmarisi socialuri mxardaWera, araadeqvaturi socialuri infrastruqtura an Tuki isini ganicdian danaSaulis grZnobas sakuTari seqsualurobisa da cxovrebis stilis miuReblobis gamo.

suiciduri azrebi da qcevebidepresia zrdis suiciduri azrebisa da qcevebis albaTobas. aiv infe-qciasTan dakavSirebulma socialurma da fsiqologiurma mowyvladobam SeiZleba gazardos TviTmkvlelobis riski, romelic gansakuTrebiT matu-lobs maSin, rodesac adamians uviTardeba aiv infeqciasTan dakavSirebu-li daavadebebi. suicidis riski izrdeba daavadebis winmswrebi fsiqikuri janmrTelobis problemebisa da TviTmkvlelobis mcdelobebis arsebobis, narkotikuli nivTierebebis moxmarebis, alkoholis borotad gamoyenebis, arasakmarisi socialuri mxardaWeris, martoobisa da mZime ekonomikuri mdgomareobis SemTxvevaSi.

seqsualuri da urTierTobebis sirTuleebiseqsualuri sirTuleebi sakmaod gavrcelebulia aiv infeqciis dros da isini xSirad Cndeba fsiqosocialuri da organuli faqtorebis kom-pleqsuri kombinaciis Sedegad. isini SeiZleba moicavdnen: ereqciis dis-funcias, eakulaciis gaZnelebas, interesis dakargvas, libidos dakargvas, seqsualur zizRs, seqsualur fobiebs da rogorc wesi, urTierTobis gaZnelebas. sxva problemebi SeiZleba moicavdes seqsualuri partniore-bis dainficirebis SiSs, usafrTxo seqsis Sesaxeb SeTanxmebisa da usa-frTxoebis dacvis sirTuleebs, sakuTari Tavis mimarT pativiscemis dakargvas, rac dakavSirebulia daavadebiT gamowveul fizikur cvlile-bebTan.

fsiqoaqtiuri nivTierebebis mavned gamoyenebaregionSi dainficirebul adamianTa umravlesoba ineqciuri narkotikebis momxmarebelia. aiv testirebaze dadebiTma pasuxma, daavadebis progre-sirebam an sxva stresulma movlenebma SeiZleba gamoiwvios alkoholisa da narkotikebis moxmarebis momateba. iseTi faqtorebi, rogoricaa gauaresebuli janmrTeloba, tkivili, SiSi, SfoTva da mwuxareba aseve

zrdis narkotikebis moxmarebis ganaxlebisa da eskalaciis individualur risks. aiv infeqciis samedicino da fsiqologiuri aspeqtebis mosagva-reblad Zalze mniSvnelovania fsiqoaqtiuri nivTierebebis moxmarebis Sefaseba da kavSirebis damyareba im dawesebulebebTan, romlebic muSaoben narkotikuli da alkoholuri damokidebulebis problemebze.

aiv infeqciasTan dakavSirebuli tvinis dazianebebinevrologiuri darRvevebi SeiZleba Camoyalibdes aiv/Sidsis centralur nervul sistemaze pirdapiri zemoqmedebis Sedegad, an gamoiwvios aiv in-feqciasTan dakavSirebulma sxva infeqciebma. nevrologiuri darRvevebi, demenciisa da kognitur-motoruli darRvevebis CaTvliT, rogorc Cans, yalibdeba daavadebis gviandel stadiaze da iTvleba aiv infeqciis yvelaze mZime da yvelaze sagangaSo gamovlinebad. demenciis SiSi, TavisTavad, Sesa-Zlebelia iqces mniSvnelovan problemad aiv infeqciis mtarebeli adami-anebisaTvis.

urTierTobebi da socialuri problemebiaiv infeqciasTan dakavSirebuli fsiqologiuri distresi, bunebrivia, gavlenas axdens inficirebuli adamanebis axloblebze. urTierTobis sirTuleebi, magaliTad, dainficirebis SiSi, aiv infeqciis Temis daxu-ruli xasiaTi da seqsualuri problemebi iwvevs fsiqikuri janmrTelobis problemebis zrdas, xolo socialuri mxardaWera xels uwyobs fsiqolo-giuri keTildReobis gaumjobesebas, depresiisa da SfoTvis Semcirebas. Tumca, socialuri mxardaWeris miReba SeiZleba garTuldes im poten-ciuri negatiuri SedegebiT, romelic, rogorc wesi, mohyveba diagnozis gamoaSkaravebas. es garTulebebia: socialuri diskriminacia da miuRe-bloba partniorebis, ojaxisa da sazogadoebis mxridan. fsiqosocialuri mxardaWera aris mudmivmoqmedi procesi, romelic gulisxmobs aiv/SidsiT daavadebulTa da fsiqikuri janmrTelobis problemebis mqone adamanebis fizikuri, emociuri, socialuri, fsiqikuri da sulieri saWiroebebis dak-mayofilebas (REPSSI 2004).

mzrunvelTa `gadawva~aiv infeqciis mqone yovel adamians awuxebs eWvebi sakuTari janmrTelobis mdgomareobisa da momavlis Sesaxeb, magram fsiqologiuri gavlena gac-ilebiT ufro farToa. is vrceldeba sayvarel da axlobel adamianebze, ojaxze, mSoblebze, Svilebsa da axalgazrdebze, momvlel personalze da, saerTod, sazogadoebaze. mzrunveloba aiv/Sidsis diagnozis mqone ada-mianebze, romelTac fsiqikuri janmrTelobis problemebic aqvT, Zalze mZimea, rogorc janmrTelobis dacvis sferoSi momuSave adamianebisaTvis, aseve moxaliseebisaTvisac. stres-faqtorebi moicavs: dainficirebis SiSs; mwuxarebisa da danakargis simZimes; aiv/SidsTan muSaobis intensivobas; araadeqvatur unar-Cvevebsa da codnas; diskomforts, romelic dakav-Sirebulia seqsualobisa da narkotikebis moxmarebis sakiTxebTan; stig-mas, daavadebis damalvas, diskriminaciasa da eTikuri xasiaTis dilemebs; finansuri sirTuleebis tvirTs; da sakmarisi Tanadgomis uqonlobas. mzrunvelebi an partniorebi TviTon SeiZleba iyvnen aiv infeqciis matare-blebi, rac qmnis damatebiT problemas - sxvebze zrunva da, amavdroulad, sakuTar mdgomareobasTan gamklaveba.

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daskvnebi politikisadapraqtikisaTvis

cxrili 5: aiv/Sidsis mqone adamianebisaTvis fsiqikuri janmrTelobis dacvis arasakmarisi uzrunvelyofis Sedegebi * aiv infeqciis ufro swrafi gavrceleba * aiv infeqciis gavrceleba araizolirebul jgufebSi * avadobis zrda * naadrevi sikvdilianoba * siRaribe da gasaWiri * socialuri gariyva * ojaxisa da urTierTobebis moSla * Temis daSla * negatiuri gavlena ekonomikaze * SesaZlo arakontrolirebadi da katastrofuli regionaluri pandemia

aiv/SidsTan dakavSirebuli fsiqikuri problemebis es mokle mimoxilva xazs usvams maTi mogvarebis mniSvnelovnebas rogorc calkeuli individe-bisaTvis, aseve TemebisaTvis da mTlianad sazogadoebisTvisac (cxrili 5). igi, agreTve, migviTiTebs am problemebis did sirTuleze. es problemebi, Tavisi bunebidan gamomdinare, Zalian rTulad mosagvarebelia, xolo am problemis mqone adamianebi Znelad xelmisawvdomebi arian, amitomac maTi daxmareba Zalze rTulia. dResdReobiT regionSi arsebuli jandacvisa da socialuri daxmarebis sistemebi ver umklavdebian am rTulad gadasa-Wreli amocanebis uzarmazar nakrebs. ramdenime kerZo samsaxuris garda, romelTa momsaxurebiT SeiZleba isargeblon mxolod SeZlebulma ada-mianebma, isini, ZiriTadad, ar iReben sakmaris dafinansebas, mwiri aR-Wurviloba aqvT da cudad maragdebian, ganicdian Sesabamisi ganaTlebis, codnisa da gamocdilebis mqone profesionalTa naklebobas. amasTan, Tanamedrove samkurnalo saSualebebis SeZenac Zalze rTulia.

fsiqikuri janmrTelobis dacva mocemul regionSi aradamakmayofilebeli da moZvelebulia. stacionarul fsiqiatriul daxmarebas pacientebs jer kidev uweven did fsiqiatriul saavadmyofoebSi, sadac mzrunvelobis xarisxi da movla, rogorc wesi, Zalian mwiria da emyareba ZiriTadad pacientebis SezRudvas maTi palatebSi gamoketviT da intensiur medikamen-tozur mkurnalobas, da ara individualur mxardamWer Terapias saku-Tari uflebebisa da interesebis dasacavad Sesabamisi preparatebisa da reabilitaciis meSveobiT. pacientebis uflebebi regularulad irRveva. fsiqikuri janmrTelobis sazogadoebrivi samsaxurebi Zalze iSviaTia da mcirea iseTi iniciativebi, romlebic mowodebulni arian daexmaron adamianebs da maT axloblebs Sesabamisi unar-Cvevebis ganviTarebaSi, raTa maT sakuTar problemebTan efeqturi gamklavebis unari SeswevdeT. Sesa-bamisi ganaTlebis mqone fsiqikuri janmrTelobis sferoSi dasaqmebuli adamianebis raodenoba (rogorc fsiqiatrebis, aseve fsiqologebis, medde-bisa Tu socialuri muSakebis) arasakmarisia imisaTvis, raTa maT SeeZloT arsebuli moTxovnilebis dakmayofileba; maTi swavleba, Tuki is xorciel-deba, Cveulebriv, ar pasuxobs Tanamedrove standartebs da, faqtiurad, ar arsebobs uwyveti profesiuli ganaTleba.

jandacvis sistemis sxva dargis profesionalebs, Sidsis erovnuli cen-trebis CaTvliT, sadac mkurnalobas gadis aiv inficirebulTa umravle-soba, mcire gamocdileba aqvT fsiqikuri janmrTelobis sferoSi. axali da rTulad gadasaWreli amocanebi, romelic aiv/SidsiT daavadebuli adami-anebis moTxovnilebebis dakmayofilebas gulisxmobs, Seuqmnis damatebiT samuSaos fsiqikuri janmrTelobisa da pirveladi daxmarebis arsebul samsaxurebs da moiTxovs codnisa da unar-Cvevebis ufro maRal dones. is, vinc amJamad yvelaze metadaa aiv inficirebis riskis qveS - ineqciuri narkotikebis momxmareblebi da komerciuli seqs-muSakebi xSirad Znelad xelmisawvdomni arian Semdegi faqtorebis gamo: jandacvis sistemaSi da sazogadoebaSi stigmisa da diskriminaciis maRali done; am kategoriis adamianebi xSirad xvdebian cixeSi; naklebad mimarTaven daxmarebisaTvis saTanado samsaxurebs; araswori cxovrebis wesi, oficialuri pirebis mi-marT undobloba. yvelaferi es arTulebs jandacvis im samsaxurebis saqmi-anobas, romlebmac unda uzrunvelyon aiv inficirebulTa da fsiqikuri janmrTelobis problemebis mqone adamianTa saWiroebebis dakmayofileba. es ki, Tavis mxriv, moiTxovs mniSvnelovan cvlilebebs Sexedulebebsa da kulturaSi, ufro met codnas, mWidro TanamSromlobas sxvadasxva samsa-xurebs Soris, multidisciplinarul jgufur muSaobas da momxmarebelTa (iuzerTa) CarTvas - yvela es Semadgeneli nawili aucilebelia Taname-drove, eTikuri, klientebze orientirebuli jandacvis sistemis CamoyalibebisaTvis.

socialuri urTierTkavSirebis, Temebisa da ojaxebis daSla mTeli re-gionis masStabiT aseve axdens uaryofiT zegavlenas. aiv/SidsiT daavade-bulebs da maT uSualo momvlelebs SesaZlebelia hqondeT ufro naklebi Tanadgomac ki, da maTi siRaribisaken daRmasvla ar kompensirdeba erTma-neTTan mWidrod dakavSirebuli Temebis arsebobiT, romelTac maT dasa-xmareblad gaaCniaT garkveuli fsiqikuri da ekonomikuri resursebi. so-cialuri kavSirebi daasusta an gaanadgura siRaribem, samoqalaqo omebma, migraciam, korufciam da tradiciuli damokidebulebebis, praqtikisa da kulturis rRvevam, anu imis ganadgurebam, rac adamianebs sirTuleebTan gamklavebaSi exmareboda.

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samoqalaqo sazogadoebis Seqmnis iniciativa, socialuri CarTvis stimu-lireba da unarebis ganviTareba aucilebelia aiv/Sidsisa da fsiqikuri daavadebebis problemebis gadasaWrelad. daskvnebi politikisa da praq-tikisaTvis Sors cdeba jandacvis samsaxurebis tradiciul sazRvrebs. aucilebelia saswrafo gadamWreli zomebis miReba ZiriTad da momijnave sferoebSi, rogoricaa: adamianis uflebebi, stigma da diskriminacia, mocemuli samsaxurebis momxmarebelTa (iuzerTa) da maTi axloblebis CarTva aRniSnul procesebSi da efeqturi fsiqikuri jandacvis uzrunvelyofa.

adamianis uflebebi

aiv infeqcia yvelaze did dartymas ayenebs iq, sadac adamianis uflebebi naklebad aris daculi (UNAIDS 2004b), es gansakuTrebiT exeba marginalur jgufebs - komerciuli seqs-muSakebs, ineqciuri narkotikebis momxmare-blebs da mamakacebs, romlebsac sqesobrivi kavSiri aqvT mamakacebTan. ami-tom adamianis uflebebis dacva warmoadgens aiv/Sidsze efeqturi reagire-bis arsebiT nawils individualur, erovnul, regionalur da globalur doneebze. gaeros Tanaxmad, aiv/SidsTan adamianis uflebebis dacvaze orientirebuli midgoma gulisxmobs: • adamianis uflebis dacvas, misi fizikuri da fsiqikuri jan- mrTelobis maqsimalurad maRali donis misaRwevad; • erToblivi samuSao procesis uzrunvelyofas, romelic erTmaneTTan daakavSirebs samsaxurebis momxmareblebs (iuzerebs) da specialistebs, rac ufro relevanturs da misaRebs gaxdis sazogadoebrivi jandacvis strategias; • aradiskriminaciuli programebis stimulirebas, romlebic moicaven aiv infeqciis mimarT mowyvlad marginalur jgufebs; • aiv/SidsTan brZolis gasaZliereblad am problemis mqone adamianebis mxardaWera maTi uflebebis dacvis, aiv infeqciis prevenciisa da Sesabamisi samsaxurebidan momsaxurebis miRebis mizniT; • saxelmwifoTa pasuxismgeblobis gazrdas im adamianTa aqtivobis saSualebiT, romlebic eZeben jandacvis politikis negatiuri Sedegebis Tavidan acilebis gzebs. adamianis uflebaTa dacvaze orientirebuli kanonieri qmedebani, yovelTvis warmoadgenda maTi uflebebis dacvis garantias jandacvis samsaxurebidan Sesabamisi daxmarebis misaRebad, antiretrovirusuli mkurnalobis CaTvliT.

stigmasa da diskriminaciaze mimarTuli muSaoba

aiv/SidsTan da fsiqikuri janmrTelobis problemebTan asocirebuli or-magi stigma uaryofiTad moqmedebs maTi prevenciisa da daZlevisaken mima-rTul Zalisxmevaze. is qmnis iseT konteqsts, sadac adamianebi yovelgvari survilis gareSe midian testirebaze. amasTan, ormag stigmas aqvs Zlieri fsiqologiuri Sedegebi aiv infeqciis mtarebeli adamianebisaTvis, is aZlierebs maT socialur izolacias da depresias (UNAIDS 2002). stigmasa da diskriminaciasTan gamklavebisaken mimarTuli muSaoba jandacvis sis-temebSi da farTo sazogadoebriv fenebSi - aiv infeqciasTan brZolis, misi movlisa da prevenciis arsebiTi nawilia.

samsaxurebis momxmarebelTa (iuzerTa) da maTi axloblebis CarTva

aiv/SidsiT daavadebuli adamianebi CarTulebi unda iyvnen politikis formirebaSi da Sesabamisi samsaxurebis momsaxurebis klientebisTvis miwodebis procesSi. maTi CarTva gadamwyvet faqtors warmoadgens im programebis warmatebiT ganxorcielebisaTvis, romlebic ebrZvian aiv-Tan dakavSirebul stigmas, diskriminacias da adamianis uflebaTa darRvevebs. yvelaferi es xels uwyobs prevenciis, mkurnalobisa da mzrunvelobis xelmisawvdomobas. maTi Cabma fsiqikuri janmrTelobis dagegmvasa da mi-wodebaSi aseve garkveul wvlils Seitans relevanturi samsaxurebis ganvi-TarebaSi, e.w. `jgufuri~ iniciativebis CaTvliT, da, agreTve, xels Seuwyobs maT mier sakuTari uflebebisa da interesebis dacvas Rirsebisa da saku-Tari Tavis mimarT pativiscemis aRdgenis, izolaciis Semcirebis gziT da SesaZleblobas miscems, Seicvalon damokidebuleba sakuTari aiv statusis mimarT (aRar damalon sakuTari aiv-statusi). maTi CarTva uamravi

sxvadasxva gziT SeiZleba ganxorcieldes, isini SeiZleba Caebnen poli-tikis SemuSavebasa da strategiis dagegmvaSi, mxardaWeris jgufebis Camoya-libebaSi, sakonsultacio programebSi, pozitiuri cxovrebis wesis da fsiqikuri janmrTelobis profesionalebis treningebSi.

partniorebis, megobrebis, ojaxebisa da sxva axloblebis CarTva poli-tikaSi, samsaxurebis dagegmvasa da momsaxurebis miwodebaSi aseve Zalze mniSvnelovania. roca maTi Sexedulebebi da moTxovnilebebi gulwrfelad asaxaven im adamianebis Sexedulebebsa da moTxovnilebebs, romelTac isini Tanadgomas ucxadeben, maTi wvlili unda waxalisdes da dafasdes. amas garda, gasaTvaliswinebelia, rom TviTon mzrunvelebsac esaWiroebaT mxardaWera da dasveneba, raTa SeinarCunon fsiqikuri janmrTeloba.

efeqturi fsiqikuri daxmarebis uzrunvelyofa

fsiqikuri janmrTelobis problemebisadmi tradiciuli midgoma moicavs medikamentozur mkurnalobas da sxvadasxva saxis fsiqologiuri Tera-pias. bevri maTgani Zalze efeqturia depresiis, SfoTvis da mTeli rigi problemebis dros. Tumca, maTi gamoyeneba mocemul regionSi jer kidev SezRudulia. aiv konteqstSi fsiqikuri daxmarebis efeqturi da eTikuri uzrunvelyofa moiTxovs socialuri da politikuri iniciativebis mTel speqtrs. es gulisxmobs aiv/SidsiT daavadebuli im adamianebis CarTvas sakuTari uflebebisa da interesebis dacvis saqmeSi, romelTac fsiqikuri janmrTelobisa da wamaldamokidebulebis problemebi aqvT; programebis SemuSavebas, romelic stigmisa da diskriminaciis Semcirebas emsaxureba; praqtikul daxmarebas inficirebuli adamianebisa da maTi axloblebis cxovrebis xarisxis gasaumjobeseblad.

konsultaciebi, socialuri mxardaWeris jgufebi, saganmanaTleblo pro-gramebi ojaxebisTvis, Ria centrebi (Drop-in centers - mudmivad Ria centrebi, sadac yvela msurvels SeuZlia Sevides yovelgvari specialuri mipatiJeb-is gareSe) da aiv inficirebulTa da SidsiT daavadebulTa uflebebisa da interesebis dasacavad mimarTuli programebi SeiZleba daexmaron ada-mianebs maTi rTuli da kompleqsuri fsiqo-socialuri moTxovnilebebis dakmayofilebaSi. amgvari Careva Zalze efeqturia jandacvis profesio-nalebisa da moxaliseebisTvisac avadmyofebis movlasTan dakavSirebuli mZime mdgomareobis Semsubuqebisa da stresis SemcirebisaTvis. fsiqoso-cialuri intervencia SeTavsebadia fsiqiatriul mkurnalobasTan. aiv inficirebuli populaciis saWiroebaTa sirTulidan gamomdinare, xSirad aucilebelia mkurnalobis ramdenime midgomis gamoyeneba.

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ramdenimenabijiwin amJamad zogierTi organizaciebi da proeqtebi cdiloben ipovon aiv/Sidsisa da fsiqikuri janmrTelobis problemis gadaWris gzebi centra-luri da aRmosavleT evropis qveynebsa da axladSeqmnil damoukidebel saxelmwifoebSi. dRemde yuradReba gamaxvilebuli iyo, pirvel rigSi, zianis Semcirebaze da aiv/SidsiT daavadebulTa konsultirebaze. es iniciativebi, rasakvirvelia, misasalmebelia, magram isini gavlenas ver axdenen fsiqikuri janmrTelobis samsaxurebis ZiriTad mimarTulebebze, an Tundac ormagi diagnozisa da ormagi an sammagi stigmisagan gawamebuli adamianebis keTildReobaze.

`globaluri iniciativa fsiqiatriaSi~ wamyvani saerTaSoriso organiza-ciaa, romelic mxars uWers fsiqikuri janmrTelobis samsaxurebis refor-mas mocemul regionSi, amJamad yuradRebas amaxvilebs aiv/fsiqikur jan-mrTelobasTan dakavSirebuli problemebis mogvarebaze. is dResdReobiT axorcielebs mTavar proeqts, romlis mizania fsiqikuri janmrTelobis problemebis mqone aiv/SidsiT daavadebuli adamianebis, maTi partniore-bis, mzrunvelebisa da ojaxis wevrebis cxovrebis xarisxis gaumjobeseba samxreT-aRmosavleT evropaSi, kavkasiaSi da centralur aziaSi (cxrili 6). MAIDS-is proeqti gulisxmobs fsiqikuri janmrTelobisa da aiv/Sid-sis centrebis farTo qselis Seqmnas. amgvari centrebi ukve daarsda saqarTveloSi, yirgizeTSi da moldovaSi da ixsneba somxeTis, azerbai-janis, bulgareTis, serbiis da montenegros, yazaxeTisa da tajikeTis cen-trebi. isini moqmedeben, rogorc resurs-centrebi `cvlilebaTa agentebis~ motivirebisa da swavlebisaTvis. centrebi muSaobs destigmatizaciaze, aiv/SidsiT daavadebuli adamainebis, maTi mzrunvelebis, ojaxebis da mTlianad mosaxleobis ganaTlebisa da swavlebis programebis SemuSave-baze, mWidrod TanamSromlobs yvela seqtoris umaRlesi politikuri wreebis warmomadgenlebTan da adamianebTan, romlebic sazogadoebrivi azris CamoyalibebaSi iReben monawileobas. isini amuSaveben efeqtur me-Todebs aiv/ SidsTan dakavSirebuli fsiqikuri janmrTelobis problemebis mosagvareblad.

rekomendirebuli zomebi `globaluri iniciativa fsiqiatriaSi~-is proeqti da literatura, romelic am dokumentSia naxsenebi, miuTiTebs mTel rig aqtivobebze, romelic ormagi stigmisa da aiv/Sidsis da fsiqikuri janmrTelobis or-magi problemis mogvarebazea mimarTuli da rekomendirebulia aiv/Sid-sis mqone adamianebisaTvis, politikuri wreebis warmomadgenlebisaTvis, profesionalebisaTvis, menejerebisaTvis, uflebebis damcvelebisaTvis da aqtivistebisaTvis adgilobriv, regionalur, erovnul da saerTaSoriso doneze. es rekomendaciebia:

- ganisazRvros jandacvisa da socialuri daxmarebis im samsaxurebis (rogorc samTavrobo, aseve arasamTavrobo) aiv infeqciis Sesaxeb codna, gamocdileba da treningebis saWiroebebi, romlebic uzrunvelyofen fsiqikur jandacvas da/an aiv/ Sidsis mkurnalobas, rogorc programebis ganviTarebisa da referaluri qselis gaZlierebis safuZveli. - Cautardes pirveladi da meoradi jandacvisa da socialuri daxmarebis samsaxurebis TanamSromlebs treningebi fsiqikuri janmrTelobis problemebisa da aiv/ Sidsis amocnobis, prevenciisa da mkurnalobis sakiTxebTan dakavSirebiT. aiv/SidsiT daavadebuli adamianebi da fsiqikuri janmrTelobis samsaxurebis momxmareblebi unda iyvnen CarTulebi treningebis dagegmvasa da ganxorcielebaSi.

- identificirdes arsebuli masala treningebisaTvis, saganmanaTleblo saqmianobisTvis da TviTdaxmarebisaTvis; adaptirdes da iTargmnos adgilobriv enebze adgilobrivi moxmarebisaTvis; SemuSavdes axali masala, romelic daefuZneba saWiroebaTa Sefasebas. zemoTxsenebuli resursebi unda iyos farTod xelmisawvdomi wignebSi, JurnalebSi, veb gverdze, kompaqt-diskebze da videoze. - gaumjobesdes aiv infeqciasTan dakavSirebuli fsiqikuri jandacva, konsultaciebis, fsiqosocialuri mxardaWeris jgufebis aqtivobis, fsiqoaqtiuri nivTierebebis moxmarebis mkurnalobis, fsiqologiuri da fsiqiatriuli Sefasebis da mkurnalobis, TviTdaxmarebis resursebisa da socialuri intervenciebis gamoyenebis (magaliTad, profesiuli swavleba) gziT. - gaumjobesdes samsaxurebis mimwodebelTa unari, gascen Sesabamisi mimarTvebi, rogorc fsiqikuri daxmarebis samsaxurebSi, aseve aiv centrebSi da, rodesac es saWiroa, fsiqoaqtiuri nivTier ebebis moxmarebis samkurnalo samsaxurebSi. - amaRldes sazogadoebis gaTviTcnobiereba sxvadasxva dainteresebul mxareebTan TanamSromlobis gziT - pirveladi daxmarebis samsaxurebTan, saavadmyofoebTan, cixeebTan, sazogadoebriv jgufebTan, skolebTan, fsiqikuri jandacvis arsebuli samsaxurebis momxmarebelTa jgufebTan, masobrivi informaciis saSualebebTan da umaRlesi politikuri wreebis warmomadgenlebTan. - yuradReba mieqces muSaobas fsiqikuri janmrTelobis problemebTan da aiv infeqciasTan dakavSirebuli stigmisa da diskriminaciis sakiTxebs politikisa da praqtikis doneze, sazogadoebis ganaTlebisa da sainformacio kampaniebis CaTvliT.

cxrili 6: MAIDS-is proeqti `globaluri iniciativa fsiqiatriaSi~, fsiqikuri jan-mrTelobis sferoSi moRvawe wamyvani arasamTavrobo organizacia, dafuZnebuli niderlandebSi, uflebamosi-lad iqna cnobili niderlandebis sagareo saqmeTa samini-stros mier, ganexorcielebina mTavari proeqti 2005-2008 w.w. misi saboloo mizania fsiqikuri janmrTelobis mqone aiv/SidsiT daavadebuli adamianebis, maTi partniorebis, mzrunvelebisa da ojaxis wevrebis cxovrebis xarisxis gaumjobeseba da maTTvis tanjvis Semsubuqeba samxreT-aR-mosavleT evropaSi, kavsasiasa da centralur aziaSi.proeqtis ZiriTadi mimarTulebaa aRniSnul regionSi fsiqikuri janmrTelobisa da Sidsis saeqsperto centre-bis qselis Seqmna, romlebic mowodebulni iqnebian:* ganaxorcielon epidemiologiuri kvlevebi da moaxdinon saWiroebaTa Sefaseba; * ganaviTaron da ganaxorcielon destigmatizacia da saganmanaTleblo programebi aiv/SidsiT daavadebulTaTvis, maTi mzrunvelebis, ojaxis wevrebisaTvisa da farTo sazogadoebriobisaTvis;* ganaxorcielon aiv/Sidsis fsiqikur aspeqtebTan dakavSirebuli treningebi profesionalTa da `eqspert-klientebisaTvis~;* SeimuSavon aiv/SidsTan dakavSirebuli fsiqikuri janmrTelobis problemebis mogvarebis efeqturi gzebi;* imoqmedon rogorc relevanturi publikaciebiTa da saswavlo masaliT aRWurvilma, advilad xelmisawvdomma resurs-centrebma.mocemuli mTavari proeqtis dafinanseba xorcield-eba holandiis sagareo saqmeTa saministros Tematuri grantiT, romelic Seadgens 3.6 milion evros damatebiTi dafinansebiT - 105, 000 evro Ria sazogadoebis instituti-dan.

ufro detaluri informaciisaTvis ixileT: www.gip-global.org

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daskvna

Cven, sakuTari riskis fasad, ugulvebelvyobT im adamianebis fsiqikuri janmrTelobis saWiroebebs da uflebebs, romlebic infeqciis maRali riskis qveS imyofebian an ukve dainficirdnen aiv-iT centralur da aR-mosavleT evropasa da yofili ssrk-s teritoriis qveynebis farglebSi. Tuki am adamianebis moTxovnilebebi daukmayofilebeli darCeba, an maTi uflebebi ignorirdeba, epidemia gaagrZelebs Tavis swrafad mzard ze-moqmedebas, rac SesaZlebelia sicocxlis fasad daujdes calkeul adami-anebs, sazogadoebebsa da qveynebs, sabolood ki mTels regionsac. amJamad infeqciis gavrcelebis dabali maCveneblebi ar SeiZleba gaxdes TviTdam-Svidebisa da umoqmedebis mizezi. regionaluri epidemia SeiZleba axlave aRmoifxvras, Tuki saswrafo zomebs miviRebT.

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REPSSI (2004). About REPSSI: State of the initiative, 2003. Regional Psychosocial Sup-port Initiative. http://www.repssi.org/initiativestate.htmUNAIDS (2002). Report on the global AIDS epidemic (angariSi Sidsis globaluri epidemiis Sesaxeb). UNAIDS, Geneva, Switzerland. UNAIDS (2004a). Report on the global AIDS epidemic. UNAIDS epidemic (angariSi Sid-sis globaluri epidemiis Sesaxeb), Geneva, Switzerland.UNAIDS (2004b). The changing HIV/AIDS epidemic in Europe and Central Asia (aiv/Sid-sis epidemiis cvlilebebi evropasa da centralur aziaSi). CP 102, UNAIDS, Geneva, Switzerland. UufasoFgadmowera saitidan: www.unaids.org/en/Regions_Coun-tries/Regions/EasternEuropeAndCentralAsia/aspUNAIDS (2005). Report on the global AIDS epidemic (angariSi Sidsis globaluri epidemiis Sesaxeb), UNAIDS, Geneva, Switzerland.janmrTelobis msoflio organizacia (2001). Project Atlas: Mental health resourc-es around the world (proeqti atlasi: msoflios fsiqikuri janmrTelobis resursebi). WHO, Geneva, Switzerland. www.who.int/mental_health/evidence/enjanmrTelobis msoflio organizacia (2004). The HIV/AIDS epidemic in Europe and central Asia (aiv/Sidsis epidemis evropasa da centralur aziaSi). WHO Regional Office for Europe, Copenhagen, Denmark. www.euro.who.int/aids/20040326_1 janmrTelobis msoflio organizacia (2005a). WHO resource book on mental health, human rights and legislation (fsiqikuri janmrTelobis, adamianis uflebe-bis da kanonmdeblobis resursTa wigni). www.who.int/mental_health/policy/en/janmrTelobis msoflio organizacia (2005b). AIDS Epidemic Update (Sidsis epidemiis modernizacia), December. www.who.int/hiv/pub/epidemiology/epiup-date2005/en/index.htmljanmrTelobis msoflio organizacia (2005c). Mental health and HIV/AIDS therapy series (aiv/Sidsisa da fsiqikuri janmrTelobis Terapia) Booklets 1-5. WHO, Geneva, Switzerland. ufaso gadmowera saitidan: http://www.who.int/mental_health/resources/mh_hiv_aids/en/index.htmljanmrTelobis msoflio organizacia (2005d). Mental Health: facing the chal-lenges, building solutions (fsiqikuri janmrTeloba: rTuli amocanebis winaSe, gadawyvetilebebis miReba) Declaration and Action Plan on Mental Health, European Ministerial Conference (deklaracia da samoqmedo gegma fsiqikuri janmrTelo-bis Sesaxeb, evropis ministrTa konferecia), Helsinki 2005.

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