Phindu ndi kupweteka kwa mapiritsi opewa HIV
Zingadabwe zochepa kuti kuchuluka kwa kachilombo ka HIV pakati pa anthu akuluakulu oposa zaka 50 ndi kofunika komanso kukulira. Masiku ano pafupifupi 21 peresenti ya onse omwe ali ndi kachilombo ka HIV ali pakati pa akulu akulu, omwe gawo limodzi mwa magawo atatu a awa ali pakati pa akuluakulu a zaka 60 ndi kupitirira.
Ngakhale wina angaganize kuti kutchuka kwa mankhwala osokoneza bongo erectile monga Viagra kapena Cialis akuwombera kuchuluka kwa chiwerengero cha anthu otchuka, kuti, monga anthu, timakonda kuganiza kuti anthu oposa 60 ndi 70 alibe thanzi labwino , ngakhalenso miyoyo yamphamvu, yogonana.
Ndipo izi si zoona.
Choncho, madokotala samalephera kukambirana zachipatala mosatetezeka ndi okalamba awo kapena amawafunsa mafunso awo okhudzana ndi kugonana. Wopereka zosokoneza pamodzi ndi maganizo olakwika pankhani ya chiopsezo cha HIV pakati pa achikulire ena amatha kuthawa kwambiri.
Zaka zaposachedwapa, kupezeka kwa HIV pre-exposure prophylaxis (PrEP) kwapangitsa anthu omwe ali pangozi njira zodzizitetezera ku matenda. Povomerezedwa ndi bungwe la US Food and Drug Administration mu 2012, njira ya piritsi ya patsiku yasonyezedwa kuti kuchepetsa chiopsezo cha kachirombo ka HIV pafupifupi 96 peresenti kwa anthu ena omwe ali pangozi.
Malinga ndi izi, kutsogolera kwamakono kuchokera ku US Public Health Services (USPHS) kumalimbikitsa kuti munthu aliyense "ali ndi chiopsezo chachikulu chotenga kachilombo ka HIV" athandizidwe PrEP ngati gawo limodzi la njira yothetsera HIV. Ndipo zimenezi zimaphatikizapo achikulire, kaya amuna kapena akazi okhaokha, amuna kapena akazi okhaokha, kapena amuna kapena akazi okhaokha.
Komabe ngakhale kuti boma likuyesetsa kuwonjezera kuchulukitsidwa kwa prEP, akuluakulu ambiri sakhala otsimikiza kuti ndibwino kwa iwo, nthawi zambiri amanena kuti mankhwala amawonongedwa kapena kulemedwa kwa kusamalidwa kwa mankhwala tsiku ndi tsiku monga zolepheretsa. Ena, pakadali pano, amakhulupirira kuti amatetezedwa mokondwera ndi makondomu kapena pogonana zomwe zimawoneka kuti ndizochepa.
Kwa ena adakalipo, PrEP ndi njira yomwe amakhulupirira kuti iyenera kuyeza moyenera komanso payekha, kuyesa phindu lomwe lingakhalepo potsata zotsatira zake.
Wopereka HIV Mafunso Powonjezera Gwiritsani Ntchito Okalamba
Mu nyuzipepala mu May 2016, Woimira Advocate , Stuart Sokol, yemwe ali ndi zaka 71, yemwe alibe kachilombo ka HIV yemwe adatumikira monga woyang'anira National AIDS Hotline komanso Los Angeles County Commission pa HIV Health Services, anapereka maganizo ake kuti kaya akulu ndi PrEP anali oyenerera kusakaniza monga momwe akuluakulu ena azaumoyo akuwonetsera.
Sokol anati, "Ngakhale kuti panopa ndikuchita chithandizo kuti athe kuchipatala," adatero Sokol, "tikudziwa kuti pamafunika zaka zambiri kuchokera pachiyambi cha HIV mpaka zizindikiro zoyamba zidzidziwitse. Izi zingakhale kuyambira zaka zisanu ndi zitatu mpaka 12, kapena ngakhale 15. "
"Masiku amenewo angandipatse ine zaka 80," adatero Sokol, ndipo ananenanso kuti, "Mwamtheradi, ngati ndinali ndi zaka 20, 30, 40, 50s kapena 60s, ndimadumpha pa mwayi, koma m'ma 70s, sindiri zedi. "
Sokol adafunsanso ngati anthu a msinkhu wake, omwe mwina akudwala matenda omwe amafunika kufufuza nthawi zonse ndi kuyesa ma labata, angakhale okonzeka kupereka mayeso owonjezera a magazi kuti ayang'ane momwe aliri ndi kachilombo ka HIV komanso zotsatira zake za mankhwala.
Ndipo pamene Medicaid ndi inshuwalansi zambiri za inshuwalansi zikhoza kuphimba PREP mu mankhwala awo okhudzana ndi mankhwala osokoneza bongo, ndalama zothandizira ndi zopatsa ndalama zokha zimakhala zosayenera kwa ena.
Sokol adanenanso kuti alibe nzeru pakati pa madokotala ngati mavuto omwe akukumana nawo ambiri omwe akufunikira kudziwa zambiri za zopindulitsa za PREP ndi zovuta.
"Palibe dokotala wanga wamkulu wa chisamaliro kapena wodwala umoyo wanga amene anali ndi maganizo awo (ponena za PrEP)," anatero Sokol. "Iwo amachenjeza za zotsatirapo kapena amauza chipatala cha HIV."
Kafukufuku amathandiza kutsimikiza kwa Sokol. Mu 2015, Centers for Disease Control and Prevention (CDC) inanena kuti 34 peresenti ya osamalira chithandizo chapamwamba ku US anali asanamvepo za PrEP.
Mwa iwo omwe adatero, ambiri adalankhula ndi odwala opaleshoni ngakhale kuti kuyesetsa kwa CDC ndi USPHS kuonetsetsa madokotala kuti PrEP chisamalire-ndipo ayenera kuchitidwa panthawi ya chisamaliro chapadera.
Ngakhale pakati pa machitidwe ena omwe ali ndi kachilombo ka HIV, pakadalibebe ntchito yowonjezera PEPEP kwa odwala, ndipo ndi 17 peresenti yokha yomwe inanenapo kuti adayitanitsa mankhwalawa.
(Kawirikawiri, ogula ntchito ku US amakhalabe odzichepetsa, ndipo kafukufuku wina akusonyeza kuti pakati pa 22,000 ndi 25,000 Achimereka mwina angakhale PrEP.)
Mikangano Yothandizira PrEP Kwa Okalamba
Ngakhale kuti ziwerengero zowonongeka, kugwiritsa ntchito PrEP kunali pafupifupi 4 peresenti pakati pa anthu omwe ali pakati pa zaka makumi anayi ndi makumi anayi kusiyana ndi awo omwe ali ndi zaka za m'ma 20, posonyeza kuti okalamba (kuphatikizapo ndalama, malingaliro, komanso kuzindikira zambiri zokhudza thanzi labwino) zochepa zolepheretsa kuchipatala.
Othandizira mfundo zowonongeka za PrEP zomwe zingathe kuika anthu ambiri okalamba pa chiopsezo chachikulu cha matenda. Zina mwazinthu izi:
- Kafukufuku amasonyeza kuti ambiri mwa anthu akuluakulu oposa 100 aliwonse ali ndi zaka zoposa makumi asanu ndi awiri (50) omwe amaika nawo chiopsezo chachikulu chotenga kachilombo ka HIV.
- Kondomu imayamba kuchepa pamene munthu akukula, kuyambira 24 peresenti kwa anthu a zaka zapakati pa 50 mpaka 59 mpaka pafupifupi 17% mwa anthu a zaka 60 mpaka 69.
- Amayi okwanira 62 peresenti ndi amayi 78 pa 100 aliwonse sanalankhulepo ndi adokotala zachipatala kuyambira zaka 50.
- Kafukufuku wambiri wasonyeza kuti amuna achikulire nthawi zambiri sagwiritsa ntchito makondomu chifukwa cholephera kusunga erection.
- Kuwonjezera apo, amayi ambiri achikulire omwe ali ndi kachilombo ka HIV amakhulupirira kuti iwo kapena omwe alibe HIV amafunikira kondomu chifukwa ndi amodzi omwe amachititsa kuti asatenge kachilombo ka HIV.
Kupewa HIV kumakhala kofunika kwambiri kwa okalamba akuluakulu omwe amapereka chithandizo chokwanira chachipatala poyerekeza ndi achinyamata. Komanso, okalamba omwe ali ndi kachilombo ka HIV amakhala ndi kachilombo kochepa ka CD4 panthawi ya matenda, komanso kukhala ndi CD4 yowonjezereka-kumayambitsa matenda ofulumira kwambiri .
Kugwiritsa ntchito kachilombo ka HIV kungakhalenso kovuta kwa okalamba monga momwe amachitira ndi matenda ena a mtima, matenda a mtima, matenda a m'mapapo, ndi shuga. Izi zikutanthawuza kuopsa koyambitsa kugwiritsira ntchito mankhwala osokoneza bongo , komanso mavuto omwe amakhudzana ndi ndondomeko yolembera ndi kugwiritsira ntchito mankhwala osokoneza bongo.
Pamodzi, zonsezi zikuthandizira kugwiritsa ntchito PrEP, ngati pokhapokha kupewa zovuta za matenda ndi chithandizo kwa akulu akulu.
Kusankha Bwino
Kaya PrEP ndi yoyenera kwa inu ndi inu ndi dokotala wanu muyenera kusankha payekha, ndikudziwitseni bwino zonse zomwe zimapindulitsa komanso kuwononga ntchito zomwe mukugwiritsa ntchito malinga ndi zochitika zanu komanso chiopsezo chanu. Chimene sizowona sizomwe zimagwirizanitsa ndi kukula kwake.
Tiyeneranso kukumbukira kuti PrEP sichiyenera kukhala chida chokha. Makondomu, kuchepetsa chiwerengero cha anthu ogonana ndi abambo, komanso kugwiritsa ntchito mankhwala opatsirana pogonana kwa munthu yemwe ali ndi kachilombo ka HIV ayenera kufufuzidwa ngati gawo la njira yothandizira.
"Ndimakonda lingaliro lakuti pali njira zomwe zingagwire ntchito," adatero Sokol. "Ndili 100 peresenti ya izo, komabe ndikufunika kulingalira ngati (PrEP) ndi yoyenera kwa ine."
Pamapeto pake, ndiyomwe mwasankha-yopangidwa ndi chidziwitso chathunthu, chosasamala-chomwe chidzatsimikizire ngati PrEP ndi yabwino kwa inu. Lankhulani ndi dokotala kapena funsani malo anu a AIDS a m'dera lanu kuti mudziwe zambiri kapena kutumiza kwa katswiri wapafupi ndi inu.
Zotsatira:
Grant, R. "Kusakaza kwa PrEP Zopangira." Msonkhano wa Mayiko 10 pa Nkhani ya Kuchiza ndi Kuteteza Kachilombo ka HIV. Paris, France; October 2015; zojambula.
US Public Health Service (PHS). "Preexposure Prophylaxis ya Kupewa Kachilombo ka HIV ku United States - 2014: Buku Lophunzitsira Ophunzira." Washington, DC; inafalitsidwa May 14, 2014;
Castel, A .; Kuthamanga, D .; Tang, W .; et al. "Kumvetsetsa maganizo okhudzana ndi kachilombo ka HIV pa Cholinga cha Kulemba PrEP." Journal of Immacular Immune Deficiency Syndrome. 2015; 70 (5): 520-528.
Pillowsky, D. ndi Wu, L. "Zizolowezi zowononga zakugonana ndi chiopsezo cha HIV pakati pa anthu a ku America zaka 50 kapena kuposerapo: ndemanga." Kusokoneza Bongo. 2015; 6: 51-60.
Guaraldi, G; Zona S, Abale, T .; Stentareli C, et al. "Kukalamba ndi kachilombo ka HIV / kachirombo ka HIV pa ukalamba: anthu osiyanasiyana okhala ndi mbiri zosiyana." PLoS One. April 2015; 10: e0118531.