Kufufuza mafunso ndichondomeko ndikuwonetseratu kugwirizana ndi kugonana koopsa
Pali zifukwa zambiri zomwe machitidwe omwe amachititsa kuti thupi likhale lopatsirana, likhoza kuonjezera chiwopsezo chotenga kachilombo ka HIV pochotsa mabakiteriya omwe amawatcha "abwino" kuchokera ku zinyama zakuthambo / kumtunda.
Kodi izi zingakhale zoona? Kodi zochitika zomwe zingaganize kuti zikhale bwino ndi thanzi lawo ndi ukhondo, mosadziwa, ziwonjezere chiopsezo cha HIV popanda ife ngakhale kudziwa?
Maphunziro Oyambirira Kulimbana Kwambiri Ndi Kusokonezeka
Pofika kumapeto kwa zaka za m'ma 1990, maphunziro angapo adalumikizana mwachindunji kuwonjezera kachilombo ka HIV ndi matenda ena opatsirana pogonana . Ambiri mwa maphunzirowa anachitidwa ku Africa, komwe kunanenedwa kuti vaginitis douching sanangowonjezera chiwopsezo cha bakiteriya vaginosis ndi 60% koma makamaka mwa amayi omwe ali ndi HIV. Ngakhale kuti ochita kafukufuku sakanatha kukhazikitsa chiyanjano chodziwika pakati pa kachilombo ka HIV ndi douching, iwo ankanena mwamphamvu kuti mwayi wopatsirana unali wapamwamba.
Komabe, panali zifukwa zingapo zomwe zinapangitsa kuti kugwirizana kuli kovuta kukhazikitsa. Zina mwazimenezo zinali zochitika kwambiri pazinthu zopanda malire, monga Africa, kumene umoyo wa anthu komanso mwayi wopezera chisamaliro nthawi zambiri umadziwa zotsatira. Zambiri zafukufuku zachitanso pakati pa ogwira ntchito za kugonana (CSWs) , pomwe mgwirizano pakati pa HIV ndi zina (monga kugwiritsa ntchito kondomu , kugonana kwa abambo , kugwiritsira ntchito mankhwala osokoneza bongo ) mosakayikira zathandiza kwambiri kuopseza kachilombo kusiyana ndi kudzipangira okha.
Komanso, zotsatira za mayeserozo nthawi zambiri zimatsutsana. Mwachitsanzo, kafukufuku wina ku Kenya, anapeza kuti kugwiritsira ntchito ubongo kumagwirizanitsidwa ndi 1.5 / 2.5 nthawi zambiri pogwiritsira ntchito kondomu poyerekeza ndi anzawo omwe si a douching. Kuphunzira Chitchaina patapita zaka zingapo, kunasonyeza mosiyana, ndi kugonana kwachikazi komwe kumagwiritsidwa ntchito kwambiri ndi kondomu.
Chikhalidwe chosagwirizana cha kafukufukucho chinangowonjezera zokambirana zomwe zikuchitika, ndipo ambiri amanena kuti pali anthu ochuluka omwe angathe kupasula kuti athetse mgwirizano wowoneka pakati pa kachirombo ka HIV ndi machitidwe odzola.
Maphunziro Aposachedwa Amapereka Umboni Wowonjezereka
Pofika chaka cha 2012, maphunziro angapo akuluakulu adawunikira momveka bwino momwe angathe kukhalira ndi kachilombo ka HIV pakati pa iwo omwe nthawi zonse amadzipereka.
Yoyamba, yomwe inayesedwa ngati gawo la mayesero a HPTN 035 HIV , inaphatikizapo amuna 3,099 ogonana, amayi omwe alibe kachilombo ka HIV ku Malawi, South Africa, Zambia, Zimbabwe, ndi Philadelphia. Malinga ndi kafukufuku, oposa atatu mwa ophunzirawo anali ndi bacterial vaginosis kumayambiriro kwa mayesero, chiwerengero cha zomwe sizinasinthe pa maphunziro onse a zaka zitatu, mwina mwa amayi omwe ankachita kusamba kwa amayi kapena omwe sanatero.
Atawerengedwa kuti ndi ofunikira, zotsatira za HPTN 035 mwachindunji zinatsutsana ndi maphunziro ambiri oyambirira omwe ankanena kuti bacterial vaginosis-yomwe imakhudzana ndi kuwonjezeka kwa chiopsezo cha HIV-ikhoza kuyambitsidwa ndi ubweya wachisanu.
Phunziro lachiwiri lomwe linapangidwira ku Los Angeles silinasonyeze kugwirizana pakati pa abambo kapena abambo opatsirana pogonana ndi kachilombo ka HIV mwa amayi. Phunziroli makamaka makamaka kuti 71% mwa anthu omwe adagwira nawo ntchito adanena kuti agonana ndi abambo, ndipo 18% amawauza kuti amatha kuyanjana nawo mwezi watha.
( Kugonana ndi kugonana kwachinyamata kumakhalabe ntchito yoopsa kwambiri yokhudzana ndi kachilombo ka HIV, mochulukitsa 18 kuposa kugonana.)
Kachilombo ka HIV ndi kawonekedwe ka amuna
Phunziro lomaliza, kufufuzira kugwirizana pakati pa kachilombo ka HIV ndi kachilombo kokhala ndi abambo amuna omwe amagonana ndi amuna (MSM) , kujambula chithunzi chovuta kwambiri. Pa MSM 413 omwe ankachita mavitamini awiri, 44% anali ndi HIV ndi 18 peresenti ya iwo omwe sanapatse. Kukwapula kunathandizidwanso ndi kuchuluka kwa chiwerengero cha matenda opatsirana pogonana pakati pa ophunzira (21% ndi 11%).
Ngakhale, pamtunda, zomwe anazipeza zikuwonekera, ofufuzawo anafulumira kunena kuti kupuma kwapadera, mkati mwake, sikumene kunayambitsa kuchulukitsa mitengo.
M'malo mwake, kuphwanya mazira kumagwirizanitsa mosavuta ndi zizolowezi zomwe zimadziwika kuti zowonjezera chiopsezo cha kachirombo ka HIV, zomwe zimagwiritsidwa ntchito pazogonana komanso kugwiritsira ntchito mankhwala osokoneza bongo.
Mwachidule, pakati pa MSM mufukufukuwo, omwe adawonetsera kuti anali ndi anthu asanu ogonana pa miyezi itatu yapitayi kuphatikizapo osakhala amphindi omwe anali ndi awiri. Ntchito yosakaniza zosokoneza bongo ikuwonetseratu kuti ikuwonjezera kuwonjezereka kwapakati pa ma HIV poyerekeza ndi MSM osagwiritsira ntchito mankhwala osokoneza bongo.
Malingana ndi deta, ochita kafukufukuwo anapeza kuti mavitamini a rectal anali ozoloŵera kwambiri okhudzana ndi zochitika zapamwamba kwambiri kusiyana ndi choyimira-chokhacho komanso kuti pamapeto pake chiwerengero cha anthu ogonana ndi omwe amachititsa kuti chiwerengero chawo chikhale chokwanira. Ndipotu, kafukufuku ambiri masiku ano amasonyeza kuti MSM ndi anayi kapena ambiri ogonana pakati pa miyezi isanu ndi umodzi ali ndi chiopsezo chachikulu chotenga kachilombo ka 32.3% mosasamala kanthu kali konse kachitidwe, kuphatikizapo kumwa mowa / mankhwala osokoneza bongo komanso kugonana kosagonana .
Ofufuzawo anapeza kuti njira zamatsenga zowonongeka zili kale kale, makamaka pakati pa MSM, ndipo sizingakhale zovuta kuti zikhale ndi matenda opatsirana pogonana.
Zotsatira:
Fonck, A .; Kaul, R .; Keli, F .; et al. Matenda opatsirana pogonana ndi abambo opatsirana m'mimba mwa akazi ogonana nawo ku Nairobi, Kenya. " Matenda opatsirana pogonana . August 2001, 77 (4): 271-275.
Wang, B ;; Li, X ;; Stanton, B ;; et al. "Kugwiritsa ntchito kondomu, kugwiritsira ntchito kondomu, ndi matenda opatsirana pogonana pakati pa akazi achiwerewere a ku China." Matenda Opatsirana pogonana . November 2005, 32 (11): 696-702.
Kasaro, M .; et al. "Zotsatira za uphungu wokhudza ukhondo wa umayi pazomwe zimagwiritsidwa ntchito mu umuna wa HIV pochita nawo HIV Prevention Trials Network microbicide mayesero HPTN 035." Msonkhano wa International Microbicides; Sydney, Australia; April 17, 2012.
Brown, J .; et al. "Kujambula kwazimagulu ndi mavitamini ndi kuzilowetsa pakati pa akazi ku Los Angeles." Msonkhano wa International Microbicides; Sydney, Australia; April 17, 2012.
Javanbakht, M .; Stahlman, S .; Picket, J; et al. "Zitsanzo Zopweteka Zowononga Kugonana." XIX Msonkhano Wadziko Lonse wa Edzi; Washington, DC; 22-27 March 2012.
Koblin, B ;; Husnik, M ;; Colfax, G ;; et al. "Zowopsa za kachirombo ka HIV pakati pa amuna omwe agonana ndi amuna." AIDS . March 21, 2006; 20 (5): 731-739.