Kuzindikira Zopinga za Kugwiritsa Ntchito Pulogalamu
Zasonyezedwa kuti kugwiritsa ntchito tsiku ndi tsiku kwa mankhwala ochepetsa kachilombo ka HIV, Truvada , kungachepetse kwambiri chiopsezo chotenga kachilombo ka HIV mwa anthu omwe alibe kachilombo ka HIV (mwachitsanzo, pamene wina ali ndi kachilombo ka HIV ndipo winayo alibe kachilombo ka HIV). Njirayi, yomwe imatchedwa pre-exposure prophylaxis (kapena PrEP) , yasonyezedwa kuti ichepetse chiopsezo chotenga kachilomboka pena paliponse kuyambira 62 peresenti mpaka 75 peresenti ngati imakhala yosamalidwa mosalekeza.
Kuchokera m'malingaliro, ziwerengero zimatsindika kwambiri kugwiritsa ntchito PrEP monga mbali yowononga kachilombo ka HIV. Komabe, kuchokera pakuwona moyo weniweni, chiwerengero sichingakhale chokhutiritsa, ndi mawu oti "osagwirizana" ndi "osasokonezeka" akupereka zopinga zomwe zingakhalepo kwa iwo omwe angafune.
Ndipotu, malinga ndi kafukufuku wamakampani, anthu 1,774 okha ku US anali ndi malamulo a Truvada a PrEP pakati pa January 2011 ndi March 2013. Pofika mu July 2016, chiŵerengero chimenecho chinakula kufika pa 76,000. Ichi ndi chiwerengero chodzichepetsa kwambiri chomwe chinapereka kuti 50,000 kachilombo ka HIV kameneka kakuchitika ku US chaka chilichonse.
Ziwerengerozi zimabweretsa zovuta zambiri zomwe zimapangitsa PrEP kukhala yabwino mu kafukufuku, koma osachepera pamene akuyikidwa pa nkhani ya dziko lenileni. Ndipo si nkhani yokha ya maphunziro kapena kuzindikira (ngakhale izi ndizo zifukwa zazikulu). Mwachiwonekere pali chinachake chikuchitika.
Zotsatira za Mtengo ndi Kumvera
Kafukufuku wa 2012 omwe bungwe la United States loona za matenda ndi chitetezo cha matenda a ku United States (US Centers for Disease Control and Prevention) (CDC) la United States linanena kuti oposa theka la a America omwe ali ndi kachilombo ka HIV pa matenda opatsirana pogonana (ART) satha kusunga mankhwala tsiku ndi tsiku - limalongosola molunjika kwa nthawi yaitali ndi umoyo wa moyo.
Titha kuyembekezera kuti zolepheretsa kukhala zochepa kwa anthu omwe amatenga kachilombo ka HIV osati "kupulumuka" payekha, koma kupewa HIV? Ndipotu pamene makondomu amadziwika kuti amateteza kwambiri, ziwerengero zimasonyeza kuti zimagwiritsidwa ntchito pazochitika ziwiri zokhazokha zogonana.
Kotero pamene ena angafunse kuti, "Zimakhala zovuta bwanji kutenga piritsi limodzi patsiku?", Kafukufuku ambiri amasonyeza kuti kumatira tsiku ndi tsiku kungakhale vuto lalikulu kwambiri logonjetsa. Taganizirani kuti mankhwala osapatsirana a shuga kapena matenda a mtima amafunika kuti peresenti yokwanira 70 peresenti ikhale yovomerezeka. Mosiyana ndi zimenezo, PrEP amafunsa pafupi ndi kumamatira mwangwiro kuti akwaniritse zolinga zoteteza.
Kafukufuku wamakono amatsimikizira zovuta. Mu 2013, Phunziro la VOICE-lomwe linayang'ana kugwiritsa ntchito PrEP pakati pa 5,029, omwe ali pachiopsezo cha amayi a ku Africa-linanenedwa zopanda pake pamene zinawonetsedwa kuti 30 peresenti yokha idatha kusunga mankhwala tsiku ndi tsiku. Zotsatira zofananazo zinawonetsedwa mu FEM-PrEP Study, yomwe inaletsedwanso chifukwa cha kuchepa kwa anthu omwe amatenga Truvada tsiku ndi tsiku.
Malingana ndi maphunzirowa ndi chiwerengero cha anthu omwe ali ochepa kuposa omwe akulembera olembera a PrEP, kulimbikitsidwa kwakukulu kungafunikire kuikidwa pa maphunziro omwe akuwunikira, omwe anthu omwe ali mu chiyanjano cha serodiscordant ( kuphatikizapo omwe akufuna kukhala ndi pakati ) amalangizidwa za PrEP monga banja lonse chizoloŵezi, m'malo mokhazikika pa HIV.
Oyambitsa ndondomeko angafunikirenso kuwona ngati mtengo wa PrEP, womwe umakhala wokwana madola 12,000 pachaka, ukhoza kukhala cholepheretsa kwa iwo omwe ali ndi mapulani a inshuwalansi omwe saphimba ntchito yake.
Mu kafukufuku wa 2013 wa akatswiri odwala matenda opatsirana a ku US ndi Canada, 74 peresenti anathandizira kugwiritsa ntchito PrEP ponseponse. Komabe, mwa gulu ili, 9% okha ndi amene analembera odwala.
Tikuyembekeza kuti mayankho omwe a CDC amapanga mu May 2014, akuyesa kugwiritsa ntchito PrEP m'madera omwe akuwoneka kuti ali pachiopsezo chotenga kachilombo ka HIV, zidzakulitsa kulembetsa anthu ku United States Magulu omwe ali ndi CDC ndi awa:
- Amuna omwe amagonana ndi amuna (MSM) omwe sagwiritsa ntchito makondomu ;
- Anthu omwe alibe kachilombo ka HIV omwe nthawi zonse amagonana ndi munthu amene ali ndi HIV;
- Ogwiritsa ntchito mankhwala osokoneza bongo (IDUs), ndi;
- Amuna omwe amagonana amuna kapena akazi okhaokha omwe amagonana ndi anthu omwe ali ndi chiopsezo chachikulu.
Zotsatira:
Rawlings K, Mera R, Pechonkina A, et al. "Mkhalidwe wa Truvada wa HIV pre-exposure prophylaxis (PrEP) ku United States: kusanthula koyambirira kwa mankhwala." Msonkhano wa 53 wa ICAAC Interscience Conference on Antitimicrobial Agents ndi Chemotherapy; Denver, Colorado; September 10-13, 2013; zowonongeka H-663a.
Zachigawo za US za Kuletsa ndi Kupewa Matenda (CDC). "CDC Fact Sheet | HIV ku United States : Maphunziro a Care." Atlanta, Georgia; inasindikizidwa mwezi wa July 2012.
Anderson, J. "Kugwiritsa Ntchito Kondomu ndi Vuto la HIV pakati pa Akuluakulu a ku America." Buku Lopatulika la Umoyo Wathanzi. June 2003; 93 (6): 912-914.
Microbicides Trial Network (MTN). "MTN Chigamulo Chosankha Kusiya Kugwiritsa Ntchito Mapiritsi Omwe Amamwa Tenofovir mu VOICE, Phunziro Loyamba la Kupewa Kachilombo ka Akazi." Nkhani yomasulidwa yotuluka pa September 28, 2011.
National Institute of Allergies and Infectious Diseases (NIAID). "Pulogalamu ya FEM-PrEP Yopewera HIV ndi Zotsatira Zake pa NIAID Research." Bethesda, Maryland; ndondomeko yofalitsa yomwe inatulutsidwa pa April 18, 2011.