Chosiyanitsa Choonadi Kuchokera ku Chiphamaso
Kugwiritsidwa ntchito kwa mdulidwe wamwamuna mwachindunji (VMMC) kuchepetsa chiopsezo chotenga kachilombo ka HIV m'magulu amtundu wa amuna kapena akazi okhaokha kumakhalabe vuto lalikulu. Ngakhale kuti pali umboni wamphamvu wakuti amuna odulidwa sagwidwa ndi kachilombo koyambitsa matenda a Edzi kudzera mu kugonana amuna kapena akazi osadulidwa, kawirikawiri chizoloŵezichi chimayambitsa kutsutsidwa mwamphamvu kwa iwo omwe amatsutsa mdulidwe kapena kukayikira kuwona kwa kafukufuku woyambirira.
Mndandanda wa mayesero osiyanasiyana omwe anachitika ku Africa kuyambira 2005 mpaka 2007 asonyeza kuti VMMC ikhoza kuchepetsa chiopsezo chotenga kachilombo kwa penile kulikonse kuyambira 51% mpaka 60%.
Pogwiritsa ntchito mayeserowa, bungwe la World Health Organization (WHO) ndi bungwe la Joint United Nations Program on HIV / AIDS (UNAIDS) mu 2007 linati :
"Mdulidwe wa amuna uyenera kuzindikiranso ngati njira yowonjezera, yowunikira kupewa HIV kudzera mwa amuna ... (koma) sayenera njira zodziwika za kupewa HIV."
Pofika mu 2011, VMMC zoposa 1.3 miliyoni zakhala zikuchitidwa, makamaka ku Africa ndi Kum'maŵa komwe chiwerengero cha anthu akuluakulu chikhoza kufika poyerekeza ndi 26%. Pulezidenti Obama adalimbikitsanso kuthandizira maiko okwana 4,7 miliyoni kumapeto kwa chaka cha 2013.
Mdulidwe monga Chitetezo: Msewu umodzi wa Njira?
Pazifukwa zowonjezera, kafukufuku wofanana amasonyeza kuti mdulidwe wamwamuna sungapereke phindu lofanana kwa mkazi yemwe alibe kachilombo mu chiyanjano cha serodiscordant .
Pali zifukwa zingapo zomwe zimachititsa kuti izi zisawonongeke-kuphatikizapo chiopsezo cha chilengedwe cha amayi komanso, nthawi zina, kuyambiranso msanga kugonana asanayambe kuchiritsidwa.
Palibe umboni wosonyeza kuti mdulidwe udzachepetsa chiopsezo chotenga kachilombo koyambitsa matenda pakati pa amuna omwe amagonana ndi amuna (MSM) , kumene njira yoyamba ya kachilombo ka HIV ndi kugonana .
Kaya mdulidwe ungapereke chitetezo kwa amuna omwe amagonana ndi abambo ndi akazi omwe amakhala osakwatiwa amakhalabe osadziwika.
Kuonjezeranso kutsutsana ndikutanthauza kuti mdulidwe suwoneka kuti umakhudza chiwerengero cha kachilombo ka HIV m'mayiko otukuka monga momwe amachitira m'madera ambiri, omwe ali ochuluka kwambiri m'madera akumwera kwa Sahara.
Malingana ndi kuchuluka kwa umboniwo, WHO / UNAIDS inakhazikitsa njira yowunikira ponena kuti:
"Zomwe zingakhudzidwe ndi thanzi labwino lidzakhala m'madera omwe HIV imakhala yowonongeka (kufalitsa kachilombo ka HIV pakati pa anthu oposa 15%), imafalikira kwambiri chifukwa cha kugonana kwa amuna kapena akazi okhaokha, ndipo kumene anthu ambiri (mwachitsanzo, oposa 80%) sanadulidwe . "
Mu 2011, bungwe la UNAIDS linanena kuti chiwerengero cha anthu akuluakulu m'mayiko a kum'mwera kwa Sahara ndi pakati pa 10% (ku Malawi) ndi 26% (ku Swaziland). Poyerekeza, chiwerengero cha anthu akuluakulu omwe amafala kwambiri ku US pafupifupi 0,6%.
Kufufuza Umboni
Pakati pa 1989 ndi 2005, maphunziro ochuluka a ku Africa adawona mgwirizano womwe ulipo pakati pa amuna odulidwa omwe ali pachiopsezo chachikulu komanso kachilombo ka HIV. Ngakhale zina mwa zotsatirazo zinali zovuta-kuphatikizapo maphunziro akuluakulu ku Uganda omwe amasonyeza kuti zovuta za matendawa zinali 42% ochepa mwa amuna odulidwa-panali maphunziro ochuluka omwe amatsutsa zotsatira kapena kufunsa mafunso olemba.
Mu 2005, ndondomeko yowonongeka ya maphunziro okwana 35 adawonetsa kuti mgwirizanowu ulipo pakati pa kuchuluka kwa mdulidwe komanso kuchepetsa chiwopsezo cha amayi. Komabe, umboniwu unkayesedwa wosakwanira kuti agwiritse ntchito mdulidwe monga chida chothandizira anthu.
Kuchokera mu 2005 mpaka 2007, mayesero angapo olamuliridwa mwakhama omwe anachitika m'mayiko atatu a ku Africa, adapereka umboni wotsimikizirika kuti awathandize.
- Ku Kenya , amuna 2,784 a zaka zapakati pa 18 ndi 24 adayesedwa pa phunziro lotsogolera ndi University of Illinois. Mlanduwu unathetsedwa nthawi isanakwane pamene mdulidwe ukuwonetsedwa kuti uli ndi mphamvu 53% poletsa kuteteza HIV.
- Ku South Africa , amuna 3,273 a pakati pa 16 ndi 24 adayesedwa mu mayesero a bungwe la National Agency for Research on AIDS (ANRS). Chigamulocho chinathetsedwa patadutsa miyezi 17 zotsatira zapakati pazomwe zinasonyeza 60% zochepa zochepa m'magulu odulidwa.
- Ku Uganda , amuna 4,996 pakati pa 15 ndi 49 adayesedwa kuti ayesedwe ndi mlandu wa John Hopkins Bloomberg School of Health Public. Chigamulocho chinathetsedweratu pasanapite nthawi pambuyo powonetsa kuti mphamvu ya 51% yatha.
Ngakhale kuti kafukufuku wa meta wathandizira zowonjezera pa mlili wa Africa, ena adakayikira ngati ntchito zoyenera kutsata-kuphatikizapo kuchepetsa kugwiritsira ntchito kondomu ndi kusokoneza khalidwe - siziyenera kukambidwa bwino.
Ndondomeko Zotheka Zopangidwira Zomwe Zidaperekedwe Kutumizidwa
Kafukufuku wambiri m'zaka zaposachedwapa akuti mabakiteriya omwe ali pansi pa chifuwachi angakhale chifukwa cha kuopsa kwa chiwopsezo kwa amuna osadulidwa. Kafukufuku amasonyeza kuti mabakiteriya ochulukirapo akhoza kutembenuza maselo omwe amatchedwa Langerhans pamwamba pa khungu kuti akhale "opandukira" ku chitetezo chawo cha mthupi.
Kawirikawiri, maselo a Langerhans amagwira ntchito pogwira ndi kutumiza tizilombo toyambitsa matenda kupita ku maselo a chitetezo cha m'thupi (kuphatikizapo CD4 maselo ), kumene amavomerezedwa kuti asatengere. Komabe, pamene chiwerengero cha bakiteriya chimawonjezeka, ngati chikuchitika pansi pa chifuwa, kutuluka kwa kutupa kumachitika ndipo maselo a Langerhans amatenga maselo ndi tizilombo toyipa mmalo mowawonetsera iwo.
Mwa kudulira mbolo, mabakiteriya a anaerobic pansi pa chikopa sangathe kukula bwino, motero amachepetsa kuyankha kotupa. Kafukufuku wina angapangitse kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda .
Kuchita Mapulogalamu ku Africa
Maphunziro a masamu a WHO, a UNAIDS ndi a South African Center for Epidemiological Modeling and Analysis (SACEMA) akusonyeza kuti, pamalo omwe anthu ambiri amagonana ndi amuna kapena akazi okhaokha, ndiye kuti njira yatsopano yofalitsira amuna ndi ana asanu asadulidwe. . Mwachidziwitso, ngati amuna 90 ali odulidwa pakati pa anthuwa, pangakhale kuchepetsa kugonana kwa amayi omwe ali pafupi ndi 35% mpaka 40% (chifukwa cha chiwerengero cha m'midzi).
Kafukufuku wamtengo wapatali wasonyeza kuti, poletsa matendawa, katundu wathandizira wathanzi ukhoza kuchepetsedwa kwambiri. Kafukufuku wina wa Gauteng Province ku South Africa-kumene chiwerengero cha matendawa chikuposa 15% -chiwonetseratu kuti mtengo wa mdulidwe wa amuna 1,000 (pafupifupi $ 50,000) ukhoza kubweza ndalama zokwana madola 3.5 miliyoni pa mankhwala ochepetsa tizilombo toyambitsa matenda okha, osatchula zachindunji ndalama ndi / kapena kuchipatala ndalama.
Komabe, ena adanena kuti ziwerengerozo ndi zowonjezereka, pomwe phunziro limodzi (lomwe likutsutsana kwambiri) likusonyeza kuti kukhazikitsa kwa mapulogalamu a kondomu opanda ufulu ndi oposa 95 kuposa odulidwa popewera kachilombo ka HIV.
Mu 2013, WHO inavomereza kugwiritsa ntchito Prepex, chipangizo choyamba chodula amuna. Mpweya wosakanikirana umasowa kupweteka thupi ndipo umamangiriza ku khungu, motero kudula magazi. Pa pafupi sabata, minofu yakufa imatha kuchotsedwa popanda chilonda chotseguka. Makina atsopanowa akuyembekeza kuwonjezera chiwerengero cha VMMCs ndi 27 miliyoni pofika 2020.
Kodi Mdulidwe Uli Ngati Chitetezo Chachikulu ku US?
Kuchokera kuchidziwitso cha thanzi la anthu, ndikofunika kuzindikira kuti palibe thupi lonse lomwe lapereka mdulidwe wa amuna onse ngati njira yothetsera HIV. Mwachiwonekere, pali kusiyana kwakukulu mu mliri wa mliri wa Africa motsutsana ndi wa dziko lotukuka, makamaka popeza kuti opitirira 60% mwa matenda atsopano ku US ali pakati pa MSM.
Kuwonjezera apo, zotsatira zowopsya kwa amayi-omwe ali pachiopsezo chifukwa cha zinthu zamoyo ndi zachikhalidwe-zikuwoneka kuti zikuposa momwe zingathere kupindula kwakukulu, ngakhale m'madera omwe ali pachiopsezo chomwe chiwerengero cha anthu omwe ali ndi chiopsezo choterechi ndi chokwanira. Ena amakhulupirira kuti mauthenga okhudzana ndi mdulidwe angakhale ndi zotsatira zolakwika kwambiri m'midzi komwe anthu amatsutsa kale ndipo kugwiritsa ntchito kondomu kumagwa pansi pa 50%.
Komabe, kafukufuku angapo asonyeza kuti mdulidwe wosabereka mwana ukhoza kuchepetsa chiopsezo cha mzimayi wa US kuti adziwe kachilombo ka HIV pogwiritsa ntchito 20%. Mu 2012, American Academy of Pediatrics inapereka ndondomeko yowonjezera yosonyeza kuti "ubwino wa thanzi la mdulidwe wamwamuna wochuluka woposa anawo komanso kuti njira zowonjezera zimapereka mwayi wopeza njirayi kwa mabanja omwe amasankha." Zina mwazinthu zomwe zatchulidwapo ndizoletsera matenda opangira mkodzo , khansa ya penile , ndi kulandira matenda ena opatsirana pogonana , kuphatikizapo HIV .
Madokotala ambiri ndi akuluakulu a zaumoyo amatenga udindo wosasamala pankhani yodula mdulidwe wa amuna akuluakulu, akudandaula kuti amachepetsa m'malo mochotsa chiopsezo cha HIV penile. Panopa palibe maumboni ku US kuti agwiritse ntchito mdulidwe wodula amuna kuti athe kuchepetsa chiopsezo chotenga kachilombo kwa amuna.
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