Ndondomekoyi ikufuna kuthetsa chiwerengero cha anthu omwe ali pachiopsezo chachikulu
Kachilombo koyambitsa matenda a HIV (TasP) ndi njira yowonjezera umboni yomwe anthu omwe ali ndi kachilombo koyambitsa matendawa sagwiritsidwa ntchito kwambiri kuti apatsire kachilomboka kwa munthu yemwe alibe kachilomboka.
Ngakhale kuti TasP inayamba kuwonedwa ngati njira yochepetsera chiopsezo payekha pamene mfundoyi inayamba kufotokozedwa mu 2006, mu 2010 pokhapokha umboni wochokera ku HTPN 052 wophunzira unapereka kuti ungagwiritsidwe ntchito ngati chida chowombera anthu.
Kupita Patakafukufuku Kunayesedwa Kusintha kwa Masewera
Mlandu wa HTPN 052-womwe unaphunzira momwe mankhwala opatsirana pogonana amathandizira (ART) pa chiwopsezo chotenga kachilombo ka HIV pakati pa amuna ndi akazi okhaokha-anaimitsidwa pafupifupi zaka zinayi kumayambiriro pomwe adasonyezedwa kuti anthu omwe akuchiritsidwa anali oposa 96% omwe angapatsire anzawo kusiyana ndi omwe anali nawo. 't.
Zotsatira za mayeserowa zatsogolera anthu ambiri kuti aganizire ngati TasP ikhoza kuchepetsanso, ngati siimayima, kufalikira kwa HIV mwa kuchepetsa zomwe zimatchedwa "chiwerengero cha tizilombo toyambitsa matenda". Mwachidule, pochepetsa chiwerengero cha tizilombo toyambitsa matenda pakati pa anthu omwe ali ndi kachilombo ka HIV, kutengako kachilombo ka HIV kudzakhala kosavuta kuti tipewe mliriwu.
Umboni Pothandizira TasP
Asanayambe kulandira mankhwala osokoneza bongo atsopano, TasP inkaonedwa ngati yosadalirika chifukwa cha mankhwala oopsa a mankhwala osokoneza bongo komanso miyeso yowononga tizilombo toyambitsa matenda yomwe imakhala yokwanira pafupifupi 80 peresenti, ngakhale kwa iwo omwe amatsatira mwatcheru.
Chithunzichi chasintha kwambiri m'zaka zaposachedwa, ndikuyamba mankhwala othandiza, otsika mtengo. Ngakhale m'mayiko ovuta kwambiri monga South Africa, kupezeka kwa magetsi otsika mtengo (osachepera $ 10 pamwezi) wapangitsa kuti mfundoyi ifike pafupi.
Ngakhale kuti mfundo zonsezi zikusonyeza kuti TasP ndi mbali yofunika kwambiri ya njira yopezera chitetezo cha munthu, kodi izi zikutanthauza kuti izi zidzasintha pa chiwerengero cha anthu?
Mavuto Otsatiridwa
Kuyambira pachiyambi, zinaonekeratu kuti padzakhala mavuto ambiri omwe angagonjetse ngati TasP iyenera kuthekera:
- Zidzakhala zofunikira kwambiri pakuyezetsa magazi ndi chithandizo chamankhwala, makamaka m'madera osasamalika, m'madera ambiri. Ku US, anthu ambiri mwa anthu asanu omwe ali ndi kachilombo ka HIV sakudziwa kuti ali ndi chikhalidwe chotani. Poyankha, bungwe la US Prevention Services Task Force likuyamikira kuyesa kamodzi kwa anthu onse a ku America a zaka zapakati pa 15 mpaka 65 monga gawo la ulendo wa dokotala.
- Zidzakhala zofuna kuti odwala akwaniritsidwe. Malingana ndi Centers for Disease Control and Prevention (CDC), okhawo 44 peresenti ya anthu a ku America omwe ali ndi kachilombo ka HIV amathandizidwa ndi chithandizo chamankhwala. Kafukufuku amasonyeza kuti kuopa kufotokoza komanso kusowa kwa chisamaliro cha HIV ndi chimodzi mwa zifukwa zomwe amachedwa kuchepetsa chithandizo mpaka kudwala matenda ozindikiritsa.
- Zingafunike njira zowonetsetsa kuti anthu akugwirizanitsa, kupambana kumene kuli kovuta komanso kovuta kulosera. Malinga ndi CDC, anthu omwe ali ndi kachilombo ka HIV pakalipano akuchiritsidwa, pafupifupi mmodzi pa anayi sangathe kukhalabe oyenerera kuti athe kukwaniritsa chiwopsezo chokwanira.
- Potsirizira pake, mtengo wa kukhazikitsa ntchito ukuwoneka kuti uli chopinga chachikulu makamaka kuti ndalama zokhudzana ndi HIV zikupitirirabe kuchepetsedwa.
Umboni Pothandiza pa TasP
Mzinda wa San Francisco ukhoza kukhala chinthu chofunikira kwambiri pa umboni wa TasP. Ndi amuna omwe ali ndi chiwerewere ndi amuna kapena akazi okhaokha omwe ali pafupifupi 90 peresenti ya anthu omwe ali ndi kachilombo ka HIV. Kugawidwa kwa ART kwakukulu kwachititsa kuti 33 peresenti yafooke matenda atsopano kuyambira 2006 mpaka 2008. Mu 2010, kuyambitsidwa kwa chilengedwe chonse pa matenda odwala matendawa kunabweretsa kuchulukitsa kawiri pa chiwerengero cha anthu omwe angathe kusunga ma ARV. .
Koma ambiri amavomereza kuti San Francisco ili ndipadera kwa ena omwe ali ndi HIV. Pali umboni wosakwanira woonetsetsa ngati TasP ikhoza kuchepetsa chiwopsezo chotenga matenda mumtundu womwewo kwina kulikonse.
Ndipotu, phunziro la 2015 kuchokera ku yunivesite ya North Carolina lawonetsa kuti zenizeni zenizeni za TasP zingakhale zochepa m'madera ena ofunikira. Phunziroli, lomwe linayang'ana mabanja okwana 4,916 omwe ali ndi chigawo cha Henan m'chigawo cha China kuyambira 2006 mpaka 2012, adaphunzira momwe ART imakhudzidwira pa chiwerengero cha anthu omwe ali ndi kachilombo ka HIV (63%) komanso kuchuluka kwa matenda opatsirana pogonana. kugonana kosakwatirana kunali kochepa kwambiri (0.04 ndi 0.07 peresenti, motero).
Malinga ndi kafukufukuyu, 80 peresenti ya anthu omwe ali ndi kachilombo ka HIV, onse omwe adangotengedwa kumene kumayambiriro kwa mayesero, adayikidwa pa ART ndi 2012. Panthawi imeneyo, kugwidwa kwa matenda atsopano kumagwirizana ndi kuchepetsa ngozi ya pafupifupi 48 peresenti.
Komanso, pamene phunziroli linapitirira ndipo anthu ambiri omwe ali ndi kachilombo ka HIV adayikidwa pa ART, mitengo inawoneka ikupitirirabe. Kuchokera mu 2009 mpaka 2012, kugwiritsa ntchito ART mobwerezabwereza kumachepetsa chiopsezo cha HIV ndi 67 peresenti, pafupifupi katatu zomwe zinawonetsedwa kuyambira 2006 mpaka 2009 pamene zinali 32 peresenti.
Mawu Ochokera
Zokakamiza monga zotsatirazi ndizofunikira kuzindikira kuti, payekha, TasP siinayambe yongoganiziridwa kukhala njira yokhazikika, ngakhale pakati pa mabanja odzipereka, osasamala. Sizinayambe kutengera kondomu kapena kupereka chilolezo chaulere chosiya njira zogonana zogonana.
Ndizinenedwa kuti, zolinga za njirayi zikhalebe zamphamvu. Izi ndi zoona makamaka kwa anthu omwe akufuna kukhala ndi ana kapena anthu omwe ali pachiopsezo chotenga HIV . Zikatero, pre-exposure prophylaxis (PrEP) ingathenso kulangizidwa kuti muteteze kwambiri munthu amene alibe HIV. Pogwiritsidwa ntchito pamodzi, TasP ndi PrEP zingachepetse chiopsezo cha matendawa pafupi-osayenerera.
Nthawi zonse muzikambirana za dokotala wanu musanayambe njirayi.
> Zotsatira:
> Cohen, M ;; Chen, Y .; McCauley, M .; et al. "Kupewa kachilombo ka HIV-1 ndi mankhwala oyambirira a antiretroviral." New England Journal of Medicine. August 11, 2011; 365 (6): 493-505.
> Gill, V .; Lima, V .; Zhang, W ;; et al. "Zotsatira Zowonongeka Kwachiwawa ku British Columbia Zotsutsana ndi Chiwerengero Chochepa cha HIV. Matenda opatsirana pogonana. January 1, 2010; 50 (1): 98-110.
> Zomwe Zilikulu za US Zokhudza Kuletsa ndi Kupewa Matenda (CDC). "Zizindikiro Zofunika: Kuteteza HIV Kupyolera Mu Kusamalira ndi Chithandizo - United States." Kuipa ndi Kufa Sabata Lamlungu (MMWR). December 2, 2011; 60 (47): 1618-1623.
> Charlebois, B ;; Das, M .; Porco, T ;; ndi Havlir, D. "Zotsatira za Njira Zowonjezera Matenda Ochepetsa Matenda a Edzi pa Mliri wa HIV pakati pa Amuna Ogonana ndi Amuna ku San Francisco." Matenda opatsirana pogonana. April 15, 2011; 52 (8): 1046-1049.
> Smith, K .; Westreich, D .; Liu, H ;; et al. "Kuchiza Kuchepetsa Kutsekula kwa HIV M'banja la Serodiscordant ku Henan, China, 2006 mpaka 2012." Matenda opatsirana pogonana. March 13, 2015; pii: civ200. [Epub patsogolo pa kusindikiza].