Chifukwa Chimene Timagwiritsira Ntchito Nthawiyo ndi Momwe Imayendera Kupewa Kuyesera
Amuna omwe amagonana ndi amuna (MSM) ndi mawu omwe amagwiritsidwa ntchito pogawa amuna omwe amachita chiwerewere ndi amuna ena, mosasamala momwe amadzizindikiritsira okha. Mawuwa adalengedwa mu zaka za m'ma 1990 ndi odwala matenda opatsirana pogonana monga chida chowunika kuti adziwitse njira yopatsira kachilombo ka HIV ndi kufalikira kwa matenda kudzera mwa amuna.
Zisanayambe izi, ochita kafukufuku anali ochepa chifukwa cha zofufuza-zomwe amuna omwe amadziwika kuti "amphatikiza" kapena "amuna kapena akazi okhaokha" sali kwenikweni kugonana, pamene iwo omwe amadziwika kuti "olunjika" akhoza kugonana ndi amuna ena.
MSM mmalo mwake imayang'ana pa khalidwe m'malo mwa chidziwitso cha chikhalidwe kapena chikhalidwe cha anthu kotero kumapereka chithunzithunzi bwino cha kachilombo ka HIV . Izi zikutithandiza kumvetsetsa bwino momwe kutetezera kachirombo ka HIV kumatithandizira, kuphatikizapo zida zothandizira kuti anthu azigwiritsa ntchito.
Zofukufuku zimasiyana mosiyanasiyana ndi chikhalidwe, koma kafukufuku wopangidwa ndi a New York City Dipatimenti ya Umoyo ndi Ukhondo wa Mtheradi anavumbula kuti mwa amuna 4,200 omwe anafunsidwa ndi foni:
- Pafupifupi mmodzi pa khumi amene amadziwongola kuti agonana ndi amuna ena okhaokha.
- Amuna 70 pa amuna 100 aliwonse okwatirana omwe amadziwika kuti akuwongolera amuna ndi amuna.
- Amuna 10 pa 100 aliwonse okwatirana omwe amadziwika kuti anali olunjika adalengeza khalidwe lachiwerewere pakati pa miyezi 12 yapitayo
Vuto la HIV pakati pa MSM ku US
Ngakhale kuti MSM imaimira pafupifupi 2 peresenti ya anthu a ku United States, monga chiŵerengero cha anthu amawerengera 55 peresenti ya matenda onse a HIV.
Malinga ndi Center for Disease Control and Prevention (CDC), ngati machitidwewa akupitirira ambiri mwa MSM asanu ndi limodzi adzakhala ndi kachilombo ka HIV nthawi zonse. Chiyembekezo chikuoneka ngati choopsa kwambiri kwa African American MSM, pomwe zikuwonetseratu kuti ndi 50 peresenti yoopsa ya moyo wokhudzana ndi HIV .
Mu 2014, CDC inafotokozera kwambiri kusiyana kwakukulu kwa matenda a HIV pakati pa MSM:
- MSM imaimira 67 peresenti ya ma ARV onse atsopano ndi 83 peresenti ya ma diagnosti atsopano pakati pa amuna 13 ndi kupitirira.
- MSM wa pakati pa zaka 13 ndi 24 ali pangozi yaikulu, akuwerengera 92 peresenti ya matenda onse atsopano pakati pa amuna.
- Vuto la HIV pakati pa Hispanics / Latinos lirikudetsa nkhaŵa kwambiri. Ngakhale kuti kachilombo ka HIV ndi kachirombo ka African American MSM kakhala kosalekeza (pansi pa 6% ndi awiri peresenti, kuyambira 2010), chiwerengero cha anthu a ku Puerto Rico / Latino MSM chawonjezeka ndi 13 peresenti.
- Masiku ano, pali MSM 687,000 omwe ali ndi kachilombo ka HIV ku US.
- Ena mwa omwe ali ndi kachilombo ka HIV, ndi 57 peresenti yokha yomwe ikugwirizanitsidwa ndi chisamaliro chapadera cha kachirombo ka HIV kwa zaka zopitirira chaka chimodzi mutatha kuchipatala, ndipo 58 peresenti yokha ya kachilombo ka HIV imatha kusunga zowonongeka zomwe zimawoneka kuti ndizopambana.
Ziŵerengero zimenezi zimagwirizana, pamlingo wina, ndi matenda a HIV m'madera ena padziko lapansi. Ngakhale chiwerengero cha HIV (chiwerengero cha matenda omwe akuchitika pa nthawi inayake) chikhoza kukhala chapamwamba m'mayiko ena, kufalikira kwa kachilombo ka HIV (gawo la anthu omwe akukhudzidwa) ndilopamwamba kwambiri pakati pa MSM.
Kafukufuku wa epidemiological wanena kuti kufalikira kwa HIV pakati pa MSM kuli pakati pa katatu ndi kasanu ndi umodzi ku Middle East, Europe, East ndi Central Asia, ndi dera la Oceanic, ndipo paliponse paliponse kuyambira 15 mpaka 25 ku Africa, kum'mwera kwa Sahara, Central America , South America, ndi South ndi Southeast Asia.
Kufufuza kwa Epidemiological Kumapereka HIV Kupewa mu MSM
Cholinga cha kafufuzidwe ka matenda a matenda ndi kuonetsetsa kuti matendawa akufalikira mosasamala komanso osati omwe ali ndi udindo pa chiwopsezo. Momwemo, zimatithandizira kugwiritsa ntchito njira zopewera popanda chiweruzo komanso (popanda) popanda zandale kapena makhalidwe.
Chitsanzo chimodzi chotere ndi kugwiritsa ntchito HIV pre-exposure prophylaxis (PrEP) mu MSM. Njirayi, yomwe ntchito ya Truvada (tenofovir + emtricitabine) ya tsiku ndi tsiku ingachepetse mwayi wa munthu kutenga kachilombo ka HIV ndi 90 peresenti kapena kuposerapo, yawerengedwa kwambiri mu MSM kuti ione komwe idzakhala yogwira mtima kwambiri. Zoterezi, PrEP sichivomerezeka kwa MSM onse koma m'malo mwa omwe ali pachiopsezo chotenga matenda.
Chifukwa chiyani? Monga njira, PrEP imafuna kuika tsiku ndi tsiku kuti amuna ambiri satha kusunga. Choncho, ochita kafukufuku amaopa kuti mankhwala osokoneza bongo angapangidwe mosayenera mu MSM omwe angathe kale kukhala ndi njira zina zotetezera okha. Izi, pamodzi ndi mtengo wamachiritso komanso zomwe zingatheke, zimakhazikitsa PrEP monga chida chofunikira kuti magulu angakhale opanda njira zina zotetezera.
Izi zimaphatikizapo MSW kapena amuna kapena akazi okhaokha omwe angakhale amanyazi m'midzi mwawo ndikuwopa kufotokoza za kugonana kwawo. Zitha kuphatikizapo MSM wamng'ono (kuyambira pamene achinyamata ambiri amagwiritsa ntchito makondomu) ndi ogwiritsa ntchito mankhwala osokoneza bongo omwe ali pachiopsezo chotenga matenda.
Kufufuza kwa PREP ku MSM woopsa kwambiri watenga njira yowonjezera "yeniyeni," kuyesa momwe amuna achiwerewere ndi amuna kapena akazi okhaokha amachitira zinthu m'malo moyesera kusintha khalidwe lawo. Pochita izi, zipangizo zothandizira monga PrEP ndizokhazikika. Izi, zimathandizira kuti zowonongeka zimayikidwa pamalo pomwe adzalandira phindu lalikulu.
Zotsatira:
> Pathela, P .; Hajat, A .; Schillinger, J .; et al. "Kusagwirizana pakati pa khalidwe la kugonana ndi kudzidzimva nokha: Kufufuza kwa anthu ku New York City Amuna." Annals of Internal Medicine. September 19, 2009; 145 (6): 416-425.
> Zolinga za Kuletsa ndi Kuteteza Matenda. "Kuopsa kwa Moyo wa HIV ku United States." Atlanta, Georgia; inafalitsidwa pa 23 February, 2016.
> Beyrer, C .; Baral, S.; van Griensven, F .; et al. "Matenda apadziko lonse a kachilombo ka HIV amuna omwe agonana ndi amuna." Lancet. July 28, 2012; 380 (9839): 367-377.