Kuwopsa Kwambiri pa Amuna Ogonana ndi Amuna Kapena Akazi Okhaokha
Kuopsa kwa kachilombo koyambitsa matenda a Edzi kumakhala kovuta kwambiri, ndipo nthawi zambiri zimakhala zazikulu kwambiri kuposa kugonana. Zifukwa za chiopsezo chowonjezereka zimadziwika bwino ndipo zimaphatikizapo zinthu monga:
- Kukula kwa tizirombo ta tizilombo toyambitsa matenda, kuti tizilombo toyambitsa matenda tilowetse magazi mwazidzidzidzi kapena misozi.
- Kuwopsa kwa matenda a rectal ndi kukwera kwawo kumawopsa kwa matenda ngakhale pamene osasokonezeka.
- Matenda omwe ali ndi kachilombo koyambitsa matenda a HIV m'mimba komanso masana ("pre-cum"), omwe amatha kukhala ndi kachilombo ka HIV ndi kachilombo ka HIV .
Kuwonjezera apo, kutsekemera kwa magazi kuchokera kumatenda owonongeka omwe angawonongeke kungawonjezere chiopsezo chokwanira ("pamwamba") mnzawo, kupereka kachilombo njira yopatsirana pogwiritsa ntchito chiberekero ndi matenda omwe amatsamira mutu wa mbolo (makamaka pansi pa chifuwa).
Kuyezetsa HIV Pangozi "Per-Act" ndi "Per-Partner"
Phunziro lawo la maphunziro apamwamba apamwamba 16, ofufuza a Imperial College ndi London School of Hygiene and Tropical Medicine adanena kuti chiopsezo chotenga kachilombo ka HIV kudzera m'kondomu osagonana ndi abambo anali pafupifupi 1,4 peresenti kuti alandire (" pansi ") mnzanu.
Ngakhale kuti chiwerengero cha chiopsezo sichinali chosiyana ndi kugonana, kaya amuna kapena akazi omwe amagonana ndi amuna (MSM) , chiwopsezochi chimawoneka chikuwonjezeka kwambiri ngati wokondedwayo asadulidwe (0.62 peresenti osadulidwa ndi 0.11 peresenti adadulidwa) .
Poyerekezera, munthu amene ali ndi chiopsezo cha wina ndi mnzake -omwe munthu wokhala ndi kachilombo ka HIV ali pa chiyanjano chapadera ndi wokhala ndi kachilombo ka HIV alibe chithunzi chowonekera bwino kwa onse omwe amamvetsera komanso omvera.
Maphunziro khumi omwe anawongosoledwa adayendetsedwa kokha pakati pa MSM ndipo sanatengere kutalika kwa chiyanjano kapena chiwerengero cha kugonana kosachepera.
Kufufuza kwa deta kunatha kunena kuti:
- abwenzi omwe analumikizana ndi kugonana koyambanso popanda kulandira makondomu anali ndi chiopsezero cha 39.9 peresenti.
- Wopanda HIV amene anangogonana ndi abambo okhaokha popanda makondomu anali ndi chiopsezo cha chiwerengero cha 21.7 peresenti, pomwe wokondedwa yemwe alibe kachilombo ka HIV anali ndi chiopsezo cha 40.4 peresenti.
(Ngakhale kuti zotsatira za kufotokozera zamakono zili zovuta, ndizofunikira kuzindikira kuti mitundu yosiyana ya maphunziro omwe akutsatiridwa amachoka m'malo ena kutanthauzira.)
Njira zothandizira kuchepetsa chiopsezo cha kachilombo ka HIV
Mofanana ndi njira ina iliyonse yopezera kachilombo ka HIV , kupewa kupewa kumafuna njira imodzi yogwirira ntchito bwino:
- Kuchepetsa chiopsezo cha wokondedwa wa HIV.
- Pewani kuganiza kwa wokondedwa wa HIV.
- Pewani HIV kuti muyanjane ndi maselo osokonezeka.
Kugwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito antiretroviral (ART) kwa wodwala kachilombo ka HIV kumadziwika kuti amachepetsa kwambiri chiopsezo chotenga kachilombo ka HIV pamene ntchito ya mavairasi imatsitsimutsidwa mokwanira ndi magawo osadziwika. Njirayi, yomwe imadziwika kuti Treatment as Prevention (TasP) , yasonyezedwa kuti kuchepetsa chiopsezo cha HIV ndi 96 peresenti mkati mwa kukhazikitsidwa kwa chiyanjano (serodiscordant).
Pakalipano, kugwiritsa ntchito pre-exposure prophylaxis (PrEP) -momwe wokondedwa yemwe sali payekha amapatsidwa mlingo wa tsiku ndi tsiku wa mankhwala omwe ali ndi kachirombo ka HIV Truvada- amadziwika kuti amachepetsa chiopsezo pakati pa 44 peresenti ndi 75 peresenti.
Kugwiritsira ntchito kondomu kumagwiritsidwa ntchito moyenera komanso koyenera kuti tipewe kutenga kachilombo ka HIV, ndi mabungwe a US Otsindika za Kuletsa ndi Kuteteza Matenda kuti kugwiritsira ntchito kondomu kumatha kulepheretsa anthu asanu ndi awiri mwa magawo 10 aliwonse opatsirana. (Lipoti lomwelo linanenanso kuti MSM mmodzi yekha mwa asanu ndi mmodzi amavomereza kugwiritsa ntchito kondomu nthawi zonse.)
Detayi imathandiza kwambiri kugwiritsira ntchito TasP, PrEP, ndi makondomu monga njira zothandiza kuchepetsa chiopsezo cha kachirombo ka HIV, onse ogonana amuna kapena akazi okhaokha komanso a MSM amachita chiwerewere.
Mosiyana ndi zimenezi, kugonana kosakondana sikungakonzedwe , ngakhale ngati TasP ndi PrEP zimagwiritsidwa ntchito, chifukwa zingakhale zotheka kuika chiopsezo kwa nthawi yaitali m'mabanja ena osakanikirana.
Kuwonetsa Mwadzidzidzi ndi Kugonana Kwachidakwa
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 .
Zotsatira:
Baggaley, R .; White, R .; ndi Boily, C. "Kutenga kachilombo koyambitsa kachilombo koyambitsa matenda a Edzi kudzera m'magulu akuluakulu e: Kuwongolera ndondomeko, kufotokozera mwachidule komanso kuteteza HIV." International Journal of Epidemiology . August 2010; 39 (4): 1048-1063.
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.
Grant, R .; Lama, J ;; Anderson, P .; et al. "Preexposure Chemoprophylaxis kwa Kupewa HIV mu Amuna Amene Amagonana ndi Amuna." New England Journal of Medicine. December 30, 2010; 363 (27): 2587-2599.
Baeten, J ;; Donnell, D .; Ndase, P .; et al. "Antiretroviral Prophylaxis ya Kupewa HIV mu Amuna ndi Akazi Ogonana." New England Journal of Medicine. August 2, 2012; 367 (5): 399-410.
Supervie, V .; Viard, J; Costagliola, D .; et al. "Kuopsa koopsa kwa kachilombo koyambitsa matenda a Edzi pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito ma ARV: njira zowonongeka komanso machitidwe achi Bayesi." Matenda opatsirana pogonana. April 19, 2014; pii: ciu223 [Epub patsogolo pa kusindikiza].