Kunyange zvazvo iri pasi, zvidzidzo zvinoratidza njodzi haigoni kubviswa zvachose
Kutsvakurudza kwekliniki kwakaratidza kuti antiretroviral therapy (ART) inogona kuderedza zvikuru hutachiwana hwehutachiwana hweHIV mune hutano hwakasiyana-siyana (serodiscordant) vakaroorana-apo mumwe munhu ane HIV uye mumwe wacho haana HIV.
Nzira dzinosanganisira kuderedzwa kwehutachiwana hwehutachiwana hweHIV nekuchengeta hutachiona hwehutachiona husingaoneki (hunowanzonzi kurapwa sekudzivirira, kana kuti TasP ), pamwe nekushandiswa kwezuva nezuva kwepiritsiro repiritsivira kuti kuderedze kuve nehutachiwana hwemukondombera kune wausina kutarisana naye (inonzi pre-exposure prophylaxis, kana PrEP ).
Zvakarewo zvinofungidzirwa zvakakosha zvisiri izvo zvekudzivirira zveART, zvakadai semakondomu uye kudzingiswa kwevarume varume (vanozivikanwa kuti vaderedze hutachiwana hweHIV mune varume vasina kutapukirwa). Apo kutsvakurudza kwepakutanga kwakaratidza kuti zvibatsiro zveART zvinogona kuva zvakanaka muhutano hwakakanganisika-neTapP kuderedza hutachiwana hweHIV kusvika kusvika 96 muzana uye PrEP kuderedza ngozi kuburikidza ne75 muzana-vamwe vave vachibvunza kana zviyero izvi zvichabata nzvimbo chaiyo-nyika.
Kuita zvepabonde pasina HIV uye HIV
Pamusangano wegore re2014 pamusoro peRevroviruses uye Opportunistic Infections (CROI) muBoston, vatsvakurudzi vari kuenderera mberi muchikamu cheNERNER vakaratidza kuti, pakati pevanhu 767 vakaroorana-vakaroorana vachishandisa TPP voga, hapana chirwere chimwe chete chakaitika pasinei nemakore makumi mana nemakumi mashanu emakondomu ekuita zvepabonde. Chidzidzo chacho chaisanganisira vaviri vanoita zvepabonde uye varume vanoita zvepabonde avo vakarondedzera avhareji ye 37 kusvika ku43 kuita zvepabonde zvisina kukodzera gore negore.
Zvisinei, kunyange nevanopinda vatsvakurudzi pachake, zviyero zvinyanyisa. Kubva pane zvinhu zvakasiyana-siyana zvakasiyana siyana-kusanganisira maitiro ezvokuita zvepabonde uye kana kuvhara kunenge kuchiitika kana kwete-nguva yekuvimba (yakashandiswa kuenzanisa kuenzana kwehuwandu) yakamira pa 96 muzana.
Izvi zvinoshandura kune inenge inofungidzirwa 4 muzana yehutachiwana hwehutachiona-uye kwete 0 muzana iyo vamwe vangafunga. Kune avo vanoita zvepabonde zvepabonde, tsananguro inofungidzirwa yakawedzera kusvika 10 muzana. Zvimwe zvidzidzo zvakakonzera kusava nechokwadi kukuru pamusoro pekuti matanho aya okudzivirira anokwanisa kuderedza sei njodzi yehutachiwana kwenguva refu.
Kusiyana Nengozi Pakati peHeterosexual uye Gay Couples
Mukuongorora kwakaitwa neU.S. Centers for Disease Control and Prevention (CDC) , masayendisiti akaongorora ruzivo rwezvino pamusoro pekushanda kweTapP, PrEP, uye makondomu mu serodiscordant musikana pamwe chete nemadzimai evanhukadzi. Chinangwa chekudzidza chakanga chisingafanotauri ngozi chaiyo yekuendesa kune imwe nyika chaiyo, asi kuratidzira kuti ingozi inowedzera sei nguva-iyo, mushure memakore gumi nemakore.
Kubva pane nhamba yezvinhu zvinogona kuvhiringidza, mikana yehutachiona pakati pevanhu vakasiyana-siyana vakaroorana vanoshandisa ART chete inofungidzirwa kuva maviri muzana nekuda kwevakadzi pamwe chete uye inoshamisa 25 muzana mumadzimai evanhukadzi. Zvakawanikwa zvaive zvichienderana nemafungiro akawanda ekuongorora, kusanganisira:
- 80 muzana kuderedzwa mudambudziko kubva pakashandiswa kondomu
- 96 muzana kuderedzwa muhutachiwana apo avo vane HIV vane HIV / TasP
- 73 kubva muzana kuderedzwa muhutachiwana hwevasina kutarisana nevanokwidzirana nevasikana pamwe chete paPPR
- 44 kubva muzana kuderedzwa mudambudziko revasikana vasina kufanira vanoita zvepabonde paPPR
- 54 kubva muzana kuderedza mukana wehutachiona hwevasikana vasina kuonekwa avo vakadzingiswa
- 73 kubva muzana kuderedza mukana wevasina kutarirwa, vakadzingiswa varume vanoita zvepabonde murume anonyanya kuisa ("top") panguva yepabonde
- Avhareji matanhatu ekuita zvepabonde kuita zvepabonde pamwedzi
Zvakakosha kucherechedza kuti kuchinja kwehutano pakati pehutano hwepabonde nemadzimai evanhurume hazvirevi chete kune huwandu hwakawanda hwehutachiona kuburikidza nehupombwe hwakasangana , asi kune tsvakurudzo yezvino inoratidzira mitengo shoma yePPR pane vamwe vanoita zvepabonde. Vatsvakurudzi vanobvuma kuti kuwedzerwa kwePPR uye zvimwe kana kuwedzerwa kunamatira zvakakwana dhesi inogona kuvandudza zviyero izvi.
Uyezve, zvidzidzo zvenguva ichangobva kuitwa zvakanyatsoratidza kuti kushandiswa kwepachirongwa chePEPE muSMSM kunogona kuva nechidziro chakafanana chekudzivirira sekushandiswa kwePEP zuva nezuva. Kana zviitiko zvakadaro zvinogona kusimbiswa, sekuwanda kwevari kutarisira, kukanganisa kwePEPEP kubudirira mumhuri dze MSM kunogona kusimbiswa zvikuru.
Zvinhu Zvengozi Zvenguva Pfupi uye Yenguva refu
Vatsvakurudzi vakaramba vachiratidza kuti vakaroorana vanoshandisa nzira imwechete yekudzivirira vaiva nemukana mukuru kwazvo wehutachiona, zvose munguva pfupi uye kwenguva refu. Pakati pezvavakawana:
- Madzimai evanhu vanoita zvepabonde vaivimba chete pamakondomu vaiva ne13 muzana yekutengesa HIV mune rimwe gore uye zvinoshamisa makumi mapfumbamwe nezana makumi manomwe nezana nemakumi matatu ematambudziko anopfuura makore gumi, zvichienderana nekushandiswa kwekushandiswa kwemashoko. Kusiyana neizvi, varume vanorambana nemurume vakaratidzwa kuva ne1 muzana uye 11 muzana yengozi, maererano.
- Madzimai evanhu vane gayi avo vaivimba chete neTapP vaiva nehuwandu hwepakati pehupfumi kune rimwe gore uye 25 muzana yengozi kupfuura makore gumi. Nokuenzanisa, vanhu vakaroorana vakaroorana vaiva ne2 muzana uye 2 muzana ngozi, maererano.
- Pamadzimai evanhu vanoita zvepabonde avo vakabatana neTPP, PrEP, uye kudzingiswa, vakashandisa makondomu nguva dzose, uye vasingabatanidzi zvepabonde rekunamatira nekuda kwevasikana vasina hutachiwana, utachiwana hweHIV hwakakwira kusvika ku1% pane rimwe gore uye 1 muzana kupfuura makore gumi.
- Saizvozvowo, madonhwe akaonekwa mumurume nemudzimai vakaroorana avo vaisanganisira TasP, PREP, kudzingiswa, uye kushandiswa kwekondomu nguva dzose . Kune varume, ngozi kune rimwe gore yaiva 0.1 muzana uye 1 muzana kupfuura makore gumi. Dambudziko pakati pevakadzi rakanga rakaderera pa055 uye 0.5 muzana.
Izvi zvakatsigirwa, muchidimbu, nekugadziriswa kwegore ra2014 neS Sorbonne Université muParis, iyo yakatsvaga dhiyabhorosi kubva kune zvidzidzo zvitanhatu zvakasiyana nezvekushandiswa kweTapP pakati pevanhu vakasiyana-siyana vakaroorana vakaroorana. Vakaroorana vanobatanidzwa mukudzidza vakaita zvepabonde pakati pematatu ne12 pamwedzi, pamwe ne80 muzana yekushandisa kondomu.
Vatsvakurudzi vakagumisa kuti deta iripo haibatsiri pfungwa yokuti ART inogona kuderedza dambudziko reHIV kusvika kune zero. Pane kudaro, kutsvakurudza kwavo kunofunga kuti, asi njodzi yehutachiona yakanyanya kuderera mumakore maviri ekutanga, ngozi iyo inogona kuwedzera kusvika 1 muzana mushure memwedzi 18. Chidzidzo chacho hachina kuongorora kubudirira kwenguva yakareba kweART mune sangano revarayidayidzani.
> Sources:
> Baeten, J .; Donnell, D.; Ndase, P .; et al. "Antiretroviral Prophylaxis yekudzivirira hutachiona muHeterosexual Men and Women." New England Journal of Medicine. August 2, 2012; 367 (5): 399-410.
> Rodger, A: Bruun, T .; Cambiano, V .; et al. "Kutapurika kwehutachiwana hweHIV kuburikidza nekuita zvepabonde pasina kondomu kana HIV + ari pamwe chete pamusana peART: PARTNER kudzidza." Musangano weChipiri pamusoro peRevroviruses uye Mikana Inopesana (CROI); Boston, Massachusetts; March 3-6, 2014; abstract 153LB.
> Lasry, A; Rudzikinuro, S .; Wolitski, R .; et al. "Kuita zvepabonde nehutachiwana hwehutachiwana hwehutachiwana hwehutachiwana hwehutachiwana hweHIV huri pakati pevasodisciscantant: kuongorora migumisiro yekubatanidza maitiro ekudzivirira AIDS . June 14, 2014; 28 (10): 1521-1529.
> Supervie, V .; Viard, J; Costagliola, D .; et al. "Heterosexual dambudziko rekutapurirwa kweHIV kuburikidza nekuita zvepabonde pasi pehutachiwana hwehutachiona hwehutachiona hwehutachiona: hutongorudzo hwakarongeka uye kuenzanisira kweBasesian." Clinical Infectious Diseases. April 19, 2014; 223 [Epub pamberi pekunyora].
> Molina, J; Fonsart, C .; Spire, B; et al. "Paunoda PrEP ne Oral TDF-FTC mu MSM: Zviwanikwa zveAnrS Ipergay Trial." 2015 Musangano weRevroviruses uye Opportunistic Infections (CROI); July 24, 2015; Seattle, Washington; abstract 23LB