Pulogalamu ya PrEP Yopereka kuchokera ku US Public Health Service
Kugwiritsira ntchito tsiku ndi tsiku kwa Truvada (tenofovir + emtricitabine) kwawonetseredwa kuti kuchepetsa chiopsezo cha munthu cha HIV ndi 92%. Njirayi, yomwe imatchedwa HIV pre-exposure prophylaxis (PrEP) , imatengedwa ngati njira zabwino zothetsera kufalikira kwa kachilombo ka HIV kwa anthu osatetezeka ndipo zingathetsere anthu omwe ali ndi kachilombo ka HIV.
Pakalipano, m'mayiko onse olemera kwambiri ku North America ndi ku Ulaya, dziko la US lili ndi chiwerengero cha anthu omwe ali ndi kachilombo koyambitsa matenda a HIV (50,000 atsopano chaka chilichonse) komanso kachiwiri ka HIV chiwerengero cha anthu omwe ali ndi kachirombo ka HIV (0,6%, kapena pafupifupi 1.2 miliyoni omwe ali ndi HIV) mayiko onse. Dziko la Latvia okha, dziko lokhala ndi nzika zosakwana miyiti miliyoni ndi ma 10,000 omwe ali ndi matendawa, ali ndi chiwerengero choposa (0,7%).
Chifukwa cha ziŵerengerozi, US Public Health Service (USPHS) inamasula machitidwe awo ochiritsira ochizira odwala pa May 14, 2014, akuyesa kugwiritsa ntchito tsiku ndi tsiku PrEP kwa anthu omwe alibe kachilombo ka HIV pa chiopsezo chachikulu chotenga matenda, motere:
Amuna ogonana omwe amagonana ndi amuna (MSM) omwe sali pachiyanjano chokha ndi munthu yemwe alibe kachilombo ka HIV, ndipo amakwaniritsa chimodzi kapena zingapo zotsatirazi:
- Gwiritsani ntchito kugonana kosakondomu (kumvetsera kapena kuika) .
- Wakhala ndi matenda opatsirana pogonana m'miyezi isanu ndi umodzi yapitayi.
- Ali mu chikhalidwe cha serodiscordant (wosakanikirana) ndi wokondedwa wa HIV.
Amuna ogonana omwe amagonana ndi abambo ndi amai (MSMW) omwe sali pachiyanjano chokha ndi wokondedwa yemwe alibe HIV, ndipo amakwaniritsa chimodzi kapena zingapo zotsatirazi:
- Gwiritsani ntchito kugonana kosakondomu (kumvetsera kapena kuika).
- Wakhala ndi matenda opatsirana pogonana m'miyezi isanu ndi umodzi yapitayi.
- Ali mu chikhalidwe cha serodiscordant (wosakanikirana) ndi wokondedwa wa HIV.
Amuna kapena akazi ogonana amuna kapena akazi okhaokha omwe sali mumsinkhu wofanana ndi wokondedwa yemwe alibe kachilombo ka HIV, ndipo amakwaniritsa chimodzi kapena zingapo zotsatirazi:
- Nthawi zambiri mugwiritse ntchito makondomu ndi amodzi kapena ambiri omwe simudziwa kuti muli ndi kachilombo ka HIV ndipo muli ndi kachilombo ka HIV (ogwiritsa ntchito mankhwala osokoneza bongo, MSMW).
- Ali mu chikhalidwe cha serodiscordant (wosakanikirana) ndi wokondedwa wa HIV.
Omwe amagwiritsira ntchito mankhwala osokoneza bongo (omwe amagwiritsa ntchito mankhwala osokoneza bongo) omwe adakumana nawo adamwa mankhwala osokoneza bongo m'miyezi isanu ndi umodzi yapitayo, ndipo amakumana ndi imodzi kapena izi:
- Gawani singano kapena munagawana singano m'miyezi isanu ndi umodzi yapitayo.
- Wakhala ali pa methadone, buprenorphine kapena masewera amodzi okhudza chithandizo cha mankhwala m'miyezi isanu ndi umodzi yapitayi.
- Khalani ndi zoopsa zapamwamba zokhudzana ndi kugonana.
Kuonjezerapo, PrEP akhoza kuitanitsidwa kwa maukwati osakanikirana (omwe ali ndi serodiscordant) omwe akufuna kukhala ndi pakati kapena omwe akuyembekezera kale. Malemba onse a FDA ndi ma antiretroviral treatment guidelines amapereka izi.
Kodi Ndingatani Ngati Sindiri M'ndandanda?
Pamapeto pake, chisankho chokhazikitsa PrEP chiyenera kukhazikitsidwa pazochitika, pogwiritsa ntchito cholinga choyesa kuti munthu adziwe kuti ali ndi chiopsezo chotenga kachilombo ka HIV komanso njira zomwe angachepetsere chiopsezo chotere.
Ngati mumakhulupirira kuti mukuyenerera kuti mukhale PrEP, nkofunika kuti mugwire ntchito ndi mlangizi wophunzitsidwa kapena a zaumoyo kuti muwone kuti mumvetsetsa ubwino ndi zoperewera za mankhwala .
PrEP sayenera kuonedwa kukhala m'malo mwa makondomu kapena kugwiritsa ntchito malo ogwiritsira ntchito nthawi zonse ndi munthu yemwe ali ndi HIV.
PrEP ikhoza kulamulidwa ndi dokotala ndipo amafunika kuyesa kachirombo ka HIV musanayambe kumwa mankhwala ndi miyezi itatu yotsatira. Dipatimenti ya inshuwalansi ya US Medicaid ndi yambiri ya inshuwalansi imayendera mtengo wa PrEP, pomwe kulipira thandizo la mankhwala kumapezeka kwa iwo omwe akuyenerera kupyolera mu Truvada ya Giliyadi ya PrEP Medication Assistance Program.
Zotsatira:
Maofesi a Kuletsa ndi Kuteteza Matenda (CDC). "Pre-Exposure Prophylaxis (PrEP)." Atlanta, Georgia; inapezeka pa November 6, 2014.
Bungwe la World Health Organization (WHO). "Kufalikira kwa HIV pakati pa 15 mpaka 49 akuluakulu - Dera la dziko." Geneva, Switzerland; inapezeka pa November 6, 2014.
Gulu la Banja la Dziko. "Dziko ndi Kukongoza Magulu." Washington, DC; inapezeka pa November 6, 2014.
US Public Health Service (PHS). " Preexposure Prophylaxis ya Kupewa Kachilombo ka HIV ku United States - 2014: Buku Lophunzitsira Ophunzira." Washington, DC; inafalitsidwa May 14, 2014; inapezeka pa November 6, 2014.
National Institutes of Health (NIH). "Malangizo othandizira kugwiritsa ntchito mankhwala ochepetsa kachilombo ka HIV m'mimba mwa amayi omwe ali ndi HIV / 1 omwe ali ndi kachilombo koyambitsa matenda a amayi komanso njira zothandizira kuchepetsa kufala kwa HIV ku United States." Bethesda, Maryland; inapezeka pa November 6, 2014.