Njira zabwino zothandizira kuchepetsa kufala kwa HIV
Malinga ndi bungwe la United Nations Joint Program on HIV / AIDS, pafupifupi theka la mabanja onse omwe ali ndi kachilombo ka HIV padziko lapansi ndi serodiscordant, kutanthauza kuti wokondedwa mmodzi ali ndi HIV pamene wina alibe kachilombo ka HIV. Masiku ano, ku US yokha, akuganiza kuti pali anthu oposa 140,000 ogonana amuna kapena akazi okhaokha, omwe ambiri amakhala ndi zaka zakubadwa.
Ndi chitukuko chachikulu cha mankhwala ochepetsa kachilombo ka HIV (ART) , komanso njira zina zothandizira, maanja omwe ali ndi chiopsezo amakhala ndi mwayi wokhala ndi pakati kwambiri kuposa kale lonse-kulola kutenga pakati komanso kuchepetsa chiopsezo chotenga kachilombo ka HIV kwa mwanayo komanso mkaziyo.
Kuganizira zapadera
Masiku ano, anthu ambiri amavomereza kuti kugwiritsira ntchito mankhwala ochepetsa kachilombo ka HIV kumachepetsa kwambiri chiopsezo chotenga kachilombo ka HIV pakati pawo ndi:
- kuonetsetsa kuti kachilombo ka HIV kachepetsa kuchepetsa matendawa mwa kukhalabe ndi chiwerengero cha mavairasi pamagulu osadziwika (njira yotchedwa mankhwala monga kupewa, kapena TasP)
- kupereka wothandizana ndi kachirombo ka HIV ndi njira yowonjezera chitetezo pogwiritsa ntchito pre-exposure prophylaxis (PrEP)
Amuna omwe amagwiritsira ntchito TasP ndi PrEP, chiopsezo chotenga kachilomboka chikuwoneka kuti chachepa kwambiri. Kafukufuku wofukufuku wopita ku COMPNERS anawonetsa kuti anthu 1,166 omwe analembedwerapo mu September 2010 mpaka May 2014, omwe ali ndi kachirombo ka HIV okha ndi omwe ali ndi kachilombo ka HIV.
Komabe, kuyezetsa kwa majeremusi kunawonetsanso kuti onse khumi ndi anayi ali ndi kachilombo ka munthu wina yemwe sali pachibwenzi, kutanthauza kuti palibe wina amene ali ndi kachilombo koyambako.
Komabe, nkofunika kuzindikira kuti ngakhale njirazi zingathe kuchepetsa ngozi - mpaka 96 peresenti ndi 74 peresenti, motero - sizizichotseratu.
Zina mwazinthu zina, kuphatikizapo kachilombo ka HIV ndi matenda opatsirana pogonana, akhoza kubwezeretsa zambiri zomwe zimaperekedwa ndi TasP kapena PrEP ngati sizinayankhidwe bwino.
Kafukufuku waposachedwapa awonetsanso kuti munthu amene ali ndi kachilombo koyambitsa matenda a m'magazi sangakhale ndi kachilombo ka HIV kosawerengeka. Choncho, pamene kuyezetsa mwazi kungasonyeze kuti pangakhale chiopsezo chochepa chotengera matendawa, pangakhale chiopsezo chopitirirabe payekha. Ndikofunika, choncho, kufunafuna uphungu wovomerezeka ndi katswiri wodziwa bwino musanayambe kuchita chilichonse. Mapiritsi okha sali yankho.
Ngati Mkazi Wachikazi Ali ndi HIV
Mu chiyanjano chomwe mkazi ali ndibwino ndipo mwamunayo ndi woipa, njira yabwino kwambiri ndi inter-uterine insemination (amadziwikanso kuti insemination, kapena iUI). Zimathetsa kufunikira kwa kugonana komanso zimalola kuti anthu azidzipatula pogwiritsa ntchito umuna wawo.
Komabe, izi sizingakhale zotheka kwa ena, mwina chifukwa cha mtengo kapena zinthu zina. Choncho, sizingakhale zopanda nzeru kufufuza zogonana pogwiritsa ntchito kugonana popanda chitetezo chifukwa njira zomwe zilipo zowonetsera chiopsezo chotenga kachilombo ka HIV.
Zikatero, mkaziyo adzaikidwa pa ART yoyenera ngati sinalembedwe, n'cholinga chokwaniritsa chiwerengero cha tizilombo toyambitsa matenda.
Sikuti izi zimachepetsa kuthekera kwa kachilombo ka HIV kwa amuna, komanso zimachepetsa chiopsezo cha matenda a mayi ndi mwana.
Ngati chiwerengero chachikulu cha mavairasi atha kukhalapo, nthawi yothetsera kugonana popanda chitetezo pogwiritsa ntchito njira zowonongeka zimatha kuchepetsa chiopsezo. Makondomu ayenera kugwiritsidwa ntchito nthawi zina. Kugwiritsiridwa ntchito kwa PrEP ndi mwamuna wamwamuna kungaperekenso chitetezo chowonjezereka, ngakhale kuti zotsatira zidakalipo kuchokera ku kafukufuku wopenda kugwiritsa ntchito PrEP pathupi.
Musanayambe kupanga PEPP, mwamuna wamwamuna ayenera kuyang'anitsitsa kachilombo ka HIV, matenda a chiwindi, ndi matenda ena opatsirana pogonana, komanso apatsidwe ndondomeko yoyamba ya michere ya impso .
Kuwunika kawirikawiri kumachitidwa kuti tipeŵe zotsatira zoyamba za mankhwala, kuphatikizapo kuchepa kwa chiwindi ndi zina zotero za poizoni. Kuphatikiza apo, abambo ndi abambo onse ayenera kuyang'aniridwa ndi matenda opatsirana pogonana. Ngati matenda amapezeka, ayenera kuchiritsidwa ndikukhazikitsidwa asanayambe kugonana.
Pamene mimba yatsimikiziridwa, ART idzapitilizidwa ndi mzimayi wamkazi, ndi zotsatila zamakono zomwe zimapereka chithandizo chokhalitsa, chokhalitsa moyo mosasamala za chiwerengero cha CD4 . Zina zonse zomwe zingathandize kupewa kachirombo ka HIV kuchokera kwa mayi kupita kwa mwana zidzatha kukhazikitsidwa, kuphatikizapo njira yothandizira gawo lokonzedweratu komanso kuyang'anira mankhwala osokoneza bongo omwe amapita kwa mwana wakhanda.
Ngati Mwamuna Wogonana Ali ndi HIV
Mu ubale umene mwamunayo ali ndi kachilombo ndipo mkazi alibe, kusamba kwa umuna pamodzi ndi IUI kapena in vitro fertilization (IVF) kungapereke njira zabwino kwambiri zogonana. Kusamba kwa umuna kumaphatikizapo polekanitsa umuna kuchokera kumtsempha wamadzimadzi, omwe poyamba umayikidwa mu chiberekero pambuyo pozindikira nthawi ya ovulation.
Ngati IUI kapena IVF ndizosankha - ndi IUI ikuwononga $ 895 ndipo IVF ikuwononga madola 12,000, pafupipafupi-ndiye ziyenera kuchitidwa kuti zifufuze njira zotetezeka za kulera.
Zimalimbikitsidwa kuti kusanthula kwa azitsamba kuchitidwe poyambira. Kafukufuku wambiri wanena kuti kachilombo ka HIV (ndipo mwina mankhwala opatsirana pogonana) angagwirizane ndi kuchuluka kwa nthenda za umuna, kuphatikizapo kuchepa kwa umuna ndi kuchepa kwa motility. Ngati zovuta zoterezo zatsala zosadziwika, amai akhoza kuika pangozi yosafunikira ndi pang'ono kapena mwayi weniweni wokhala ndi pakati.
Chimodzimodzinso chidziwitso chokhalira chitsimikizo, choyamba ndi chofunika kwambiri ndi kukhazikitsa mwamuna wamwamuna pa ART kuti cholinga chake chikhale ndi mphamvu yowonjezera yosasinthika. Wokondedwayo angathe kuyesa kugwiritsa ntchito PrEP kuti athe kuchepetsa ngozi, ndi malingaliro ofanana ndi owonetsa chithandizo chisanachitike.
Kugonana kosatetezeka kuyenera kugwiritsidwa ntchito mosamalitsa nthawi yowonjezera, pogwiritsira ntchito njira zowunikira komanso / kapena ovulation makina kiti monga testblue Easy kapena First Resistance kuyesa mkodzo. Makondomu ayenera kugwiritsidwa ntchito nthawi zina.
Pamene mimba yatsimikiziridwa, mkaziyo ayenera kuyesedwa kuti ali ndi kachilombo koyambitsa matenda a HIV monga mbali ya mayesero omwe amachititsa kuti asatenge kachilombo ka HIV. Ayeneranso kulangizidwa kuti apitirize kugwiritsira ntchito kondomu komanso zizindikiro za matenda a acrovirus (ARS) kuti athe kuwunikira bwino momwe angathere kachilombo ka HIV.
Tikulimbikitsanso kuti kachiwiri kayezetsa kachirombo ka HIV kachitidwe kachitatu pa mimba, makamaka patangotha masabata makumi asanu ndi atatu (36), kapena kuti kachilombo kofulumira ka HIV kapezeke panthawi yobereka kwa omwe sanayesedwe pa trimestre yachitatu. Ngati kachilombo ka HIV kakuchitika, pangakhale njira zoyenera kuperekera chiopsezo chotenga kachilombo koyambitsa matenda, kuphatikizapo kuyambitsa mankhwala oyenera oteteza ku matenda a antiretroviral prophylaxis komanso kulingalira kwa gawo lachisankho chodziletsa.
> Zotsatira:
> United Nations Joint Program on HIV / AIDS (UNAIDS). "UNAIDS World AIDS Day Report 2011." Geneva, Switzerland; ISBN: 978-92-9173-904-2.
> Lampe, M .; Smith, D .; Anderson, G ;; et al. "Kupeza chiopsezo chotetezeka ku mabanja omwe alibe HIV: udindo wa oral preexposure prophylaxis (PrEP) ku United States." Journal American Obstetrics ndi Gynecology . 2011; 204 (6); 488.e1-488.e8.
> 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.
> Dipatimenti ya US Health and Human Services (DHHS). "Malangizo a Gwiritsirani Ntchito Mankhwala Ochepetsa Matenda a Edzi Amayi Oyembekezera omwe ali ndi kachirombo ka HIV kwa amayi omwe ali ndi kachilombo ka HIV komanso njira zothandizira kuchepetsa kufala kwa HIV ku United States." January 16, 2014.
> Rodger, A .; Cambiano, V .; Bruun, T .; et al. "Kuchita Zogonana Popanda Kondomu ndi Kuopsa kwa Kugonana kwa Edzi M'mabanja Osiyana Pamene Wogwirizana ndi HIV Akugwiritsa Ntchito Mankhwala Ochepetsa Matenda a Antiretroviral." Journal ya American Medical Association. July 12, 2016; 31 (2): 171-181.