Zowonjezera zambiri zimabweretsa chiopsezo kwa amuna ndi akazi
Kugonana ndi abambo ndi imodzi njira zazikulu zomwe munthu angathe kutenga kachilombo ka HIV. Amayi ambiri amapezeka pafupifupi 7,500 mwadzidzidzi chaka chilichonse ku US komanso matenda opitirira 1,000 mwa amuna okhaokha.
Padziko lonse, ziwerengerozo zimakhala zowopsya kwambiri. Ngakhale kutenga kachilombo ka HIV ku US kumakhala pakati pa amuna ogonana ndi amuna kapena akazi okhaokha (akuimira 63 peresenti ya matenda atsopano atsopano), amuna ndi akazi amodzi ndi omwe akugwiritsidwa ntchito kwambiri padziko lonse lapansi.
Izi ndizowona makamaka ku Africa kumene matenda onse atsopano anayi kapena asanu ali pakati pa amuna kapena akazi okhaokha. Mwa anthuwa, kugonana kwa abambo ndi njira yoyamba ya matenda.
Vuto la HIV pogonana
Pokambirana za chiopsezo cha HIV, anthu nthawi zambiri amayesa kuzindikira kuti "mtundu" wa kugonana ndi wotani; chachikazi, anal, kapena pakamwa. Kuchokera ku chiwerengero cha chiwerengero, kugonana kwa abambo kumaonedwa ngati chinthu chowopsa kwambiri chokhala ndi chiopsezo chachikulu cha matenda oposa 18 poyerekezera ndi chiwerewere.
Koma izi zikuwoneka ngati zikusocheretsa, mwina kuchokera payekha. Pamene chiwerengero cha abambo chikhonza kukhala "chochepetsera" chiwerengero, ziwerengero sizingaganizire njira yomwe matendawa amapatsidwira pakati pa abambo ndi amai komanso kusatetezeka komwe kumaika anthu ena pachiopsezo chachikulu chotenga matenda.
Mwachitsanzo, taganizirani kuti amayi ali ndi mwayi wokhala ndi kachilombo koyambitsa matenda a HIV kuchokera kwa amuna mpaka katatu.
Kapena kuti atsikana amakhala ndi kachilombo koyambitsa matenda a HIV kusiyana ndi mwamuna wamwamuna.
Mosiyana ndi zimenezo, pali amuna ena amene ali ndi kachirombo ka HIV kuposa ena. Mwachitsanzo, kafukufuku wasonyeza kuti amuna osadulidwa amakhala ndi kachilombo koyambitsa kachilombo koyambitsa kachilombo koyambitsa kachilombo ka HIV kuposa amuna odulidwa.
Zowonongeka zimasiyana mosiyana, kotero kufufuza chomwe chiwopsezo chenicheni cha kugonana chimafuna kumvetsetsa bwino zomwe zimachititsa amai ndi amuna ena kukhala pachiopsezo chachikulu kuposa ena.
Zowonongeka Zomwe Zingathe Kuonjezera Vuto la HIV mwa Akazi
Kuopsa kwa kachilombo koyambitsa matenda opatsirana pogonana kumakhala kosavuta pakati pa akazi pa zifukwa zingapo. Kuchokera ku maonekedwe a thupi, ziwalo za umaliseche (epithelium) zimakhala ndi kachilombo koyambitsa kachilombo koyambitsa kachilombo ka HIV kuposa za mbolo.
HIV imatha kudutsa m'matendawa pamene chitetezo cha mthupi chimazindikira kachilombo koyambitsa matenda ndi kutumiza maselo otetezera (otchedwa macrophages ndi maselo otchedwa dendritic) kuti "awagwiritse ndi kuwakokera" kudutsa mu chipinda kuti awonongeke. Mmalo mwake, HIV imatembenuza tebulo ndikuukira maselo omwe amatchedwa CD4 T-maselo kuti athandizidwe. Pochita zimenezi, thupi limathandiza kuthana ndi matenda.
Ndipo, chifukwa pamwamba pa mawere a epithelium ndi aakulu kwambiri kusiyana ndi a amuna achimuna, mwayi wodwala wawonjezeka, nthawi zambiri.
Zowonjezereka zamthupi zimaphatikizapo:
- Maselo pansi pa chiberekero ali pachiopsezo kwambiri ku HIV, makamaka pa nthawi ya unyamata, mimba yoyamba ya mzimayi, kapena kupezeka kwa matenda opatsirana pogonana monga chlamydia kapena papillomavirus (HPV) .
- Azimayi omwe ali ndi matenda opatsirana pogonana, kaya mabakiteriya, mavairasi, kapena fungal, ali pangozi yaikulu. Kafukufuku wina wasonyeza kuti bacterial vaginosis ikugwirizana ndi kuwonjezeka kwa maulendo asanu ndi atatu. Izi zikutanthawuza kukhala imodzi mwa mwayi 100 wokhala ndi kachilombo ka HIV pa nthawi yogonana.
- Kutalika kwa chiwopsezo ndi kuchuluka kwa kachilombo ka HIV ndizimene zimapangitsa munthu kutenga kachilomboka kapena ayi. Momwemo, kugonana kosatetezeka kungawonjezere chiopsezo cha HIV kwa mayi ngati mwamunayo akulowetsa m'mimba mwake.
- Matenda otsegula kapena zilonda kuchokera kumagulu opatsirana pogonana monga syphilis akhoza kuonjezera chiopsezo mwa amuna onse awiri mwa amayi. Komabe, kwa amayi, zilondazi zimangokhala mkati mwazidzidzidzi.
- Pamene kugwiritsa ntchito tsiku ndi tsiku kachilombo ka HIV kotchedwa pre-exposure prophylaxis (PrEP) kungathe kuchepetsa chiopsezo cha kachilombo ka HIV kwa munthu yemwe alibe kachilomboka, pali umboni umene umagwira ntchito bwino mwa amayi. Kafukufuku amasonyeza kuti mlingo wa mankhwala osokoneza bongo m'magazi siwowoneka ngati wam'mimba.
- Mchitidwe wokayikira ukhoza kusinthiranso mavitamini a "bwino" a bakiteriya, ngakhale kuti izi zikukambiranabe .
Palibe chimodzi mwa izi, chimaganizira zovuta zomwe zimachititsa kuti amayi azikhala ndi chiopsezo chowonjezeka. Izi zimaphatikizapo nkhanza za kugonana mu maubwenzi omwe amachititsa kuti mwayi wa amayi ukhale wotetezeka koma ukhoza kuwonongera minofu yofewa.
Umphawi, zikhalidwe za anthu, ndi kusalinganizana pakati pa amuna ndi akazi zimatsimikiziranso kuti ulamuliro uliwonse womwe munthu angakhale nawo kunja kwa chipinda adzapitanso kuchipinda. Zonsezi zimathandiza kuti amayi apitirize kukhala ndi kachilombo ka HIV.
Zowonongeka Zowonjezera Vuto la HIV mwa Amuna
Mfundo yakuti amuna sakhala ndi kachilombo koyambitsa matenda a Edzi kusiyana ndi amayi omwe sayenera kunyalanyaza mfundo yakuti iwo ali ndi zofooka zomwe zingawonjezere chiopsezo chawo chotenga matenda.
Mwachitsanzo, tikudziwa kuti mbolo yosadulidwa ikhoza kuyambitsa matenda chifukwa cha chilengedwe cholemera cha bakiteriya. Poyankha, thupi lidzabala mtundu wa dendritic cell (wotchedwa Langerhans maselo ) kuti athetse mabakiteriya.
Mwamuna akamagonana popanda chitetezo ndi mayi yemwe ali ndi kachilombo ka HIV, maselo omwewo akhoza "kuwatenga" ndikuwatsitsirako "kachilomboko ndikuwapereka kwa CD4 T-maselo kuti awone. Matenda opatsirana pogonana komanso matenda opatsirana pogonana amapititsa patsogolo chiopsezo cha HIV.
Kuchokera ku chikhalidwe cha chikhalidwe, kufotokozera kwa chikhalidwe cha chikhalidwe cha abambo kungathe kuonetsetsa kuti kugonana kwa amuna ndikumalimbikitsa. Izi zimapangitsa kuti munthu akhale ndi chiopsezo chachikulu chotenga kachilombo koyambitsa matenda a Edzi poyanjana ndi anzake ambiri kapena makhalidwe ena oopsa.
Zowonongeka mwa Amuna ndi Akazi Onse
Pali zovuta zomwe zimapangitsa kukhala ndi kachilombo kwa amuna ndi akazi. Mwa iwo:
- Kuwonjezeka kulikonse kwa wodwala amene ali ndi kachirombo ka HIV (kachilombo ka HIV mumagazi) kumawonjezera chiopsezo kwa wokondedwayo. Kafukufuku wasonyeza kuti kuwonjezeka kwa chigamulo chilichonse pa nthendayi - kuchokera, kunena, 100 mpaka 1,000 - kukhoza kufala katatu kapena katatu.
- Kuonjezera apo, chiwerengero cha mavairasi akuluakulu pa matenda oopsa (siteji yomweyo pamapeto pake) chikuphatikizidwa ndi chiwopsezo cha 28 pangozi. Izi zikutanthawuza mwayi umodzi wokhala ndi kachilombo ka HIV ngati muli mkazi ndipo wina ngati mwayi ngati 500 ngati ndinu mwamuna.
- Kumwa mowa kapena kugwiritsa ntchito mankhwala osokoneza bongo kungachepetse kukhumudwitsa ndipo kumakhudza zomwe munthu angathe kuchita posankha bwino, monga kugwiritsa ntchito makondomu kapena kukhalabe ndi kachilombo ka HIV.
Zoopsa Zowonongeka Ndi Zachiwerewere
Kuchokera ku lingaliro la "chiwonongeko cha munthu aliyense" (mwayi wokhala ndi kachilombo koyambitsa chiwerewere), chiopsezo chingasinthe malinga ndi chiwerengero cha amai, chiwerengero cha tizilombo ta HIV, komanso gawo la dziko lomwe mumakhalamo .
Ziwerengerozi sizikuganiziranso zinthu zina zomwe zingapangitse ngozi, kuphatikizapo kukhala ndi matenda opatsirana pogonana, kugwiritsa ntchito mankhwala osokoneza bongo, kapena matenda omwe alipo monga matenda a hepatitis C.
Chiwonetsero | Mtundu Wotsatsa | Ngozi Yowonongeka |
Vaginal | Kugonana kwa amayi, abambo ndi abambo (dziko lolemera kwambiri) | 0.04% (imodzi mwa 2500) |
Kugonana kwa abambo, amuna ndi akazi (dziko lolemera kwambiri) | 0.08% (imodzi mwa 1250) | |
Kugonana kwa amuna okhaokha, amayi ndi abambo (dziko lopindula) | 0.38% (imodzi mwa 263) | |
Kugonana kwa abambo, amuna ndi akazi (dziko lopindula) | 0.3% (imodzi mwa 333) | |
Kugonana kwa abambo, kusagonana kwa HIV | 0.07% (imodzi mu 1428) | |
Kugonana kwa abambo, kugwiritsira ntchito nthawi yochedwa HIV | 0.55% (imodzi mwa 180) |
Kuwonetsa Mwadzidzidzi ndi Kugonana Kwaokha
Ngati mukukhulupirira kuti mwakhala mukupezeka ndi kachilombo koyambitsa matenda a Edzi, mwinamwake mukugwiritsa ntchito kondomu yopanda kachilombo ka HIV, muli mankhwala omwe angathe kuchepetsa chiopsezo chotenga post-exposure prophylaxis (PEP).
PEP ili ndi maphunziro a antiretroviral masiku 28, omwe ayenera kutengedwa mwangwiro komanso osasokonezeka. Pofuna kuchepetsa chiopsezo chotenga matenda, PEP iyenera kuyambitsidwa mwamsanga - mwangwiro mkati mwa maola oposa 36 .
Mawu Ochokera
Kuwonekeratu kuti muli ndi chiopsezo chotenga kachilombo ka HIV sikuyenera kukhala masewera. Kaya zovuta zili chimodzi mwa khumi kapena chimodzi mwa 100,000, nkofunika kukumbukira kuti mukhoza kutenga kachilombo ka HIV mutangodziwonekera.
Fufuzani zipangizo zonse zomwe zilipo zokhudzana ndi HIV. Kuphatikiza pa PrEP, njira yomwe ingachepetse chiopsezo cha HIV mwa magawo 76 peresenti, nthendayi yosaoneka yomwe ili ndi kachilombo ka HIV ikhoza kuchepetsa chiopsezo cha 96% kapena kuposa. Ndipo musaiwale kondomu yowoneka-ndi-yeniyeni, kugwiritsiridwa ntchito komwe kumagwiritsidwa ntchito ndi kamphindi 20 kumachepetsa chiopsezo.
Mwa kupanga njira yowonjezera yopewera, mukhoza kupitiriza kukhala ndi moyo wathanzi wodzitetezera pamene mutetezeka nokha kapena wokondedwa wanu pachiopsezo cha HIV.
> Zotsatira:
> Boily, M .; Baggaley, R .; Wang, L .; et al. "Kutenga kachilombo koyambitsa matenda a HIV-1 pazochitika zogonana: Kukonzekera mwatsatanetsatane ndi kufufuza kafukufuku wophunzira." Matenda Opatsirana a Lancet. February 2009; 9 (2): 118-129.
> Zomwe Zingathetsere Kudwala ndi Kuteteza Matenda (CDC). " Mlili wa HIV lero ." Atlanta, Georgia; August 2016.
> Cohen, C .; Lingappa, J .; Baeten, J ;; et al. "Bacterial vaginosis yokhudzana ndi kuchuluka kwa chiopsezo cha amayi ndi abambo ku HIV: kukambirana kwa gulu la azimayi ku Africa." PLoS Medicine. June 2012; 9 (6): e1001251.
> Hollingworth, T .; Anderson, R .; ndi Fraser, C. "Kupatsirana kachilombo ka HIV, potsata matenda." Journal of Infectious Diseases. September 1, 2008; 198 (5): 687-693.
> United Nations Program on HIV / AIDS (UNAIDS). " Kukonzekera kwa Edzi padziko lonse 2016. " Geneva, Switzerland; 2016: 9.