Chikonzero nei Tashandisa Nguva uye Iyo Inotungamirira Sei Kuedza Kudzivirira
Varume vanoita zvepabonde nevarume (MSM) ndiro izwi rinoshandiswa kuronga varume vanoita zvepabonde kune vamwe varume, pasinei nokuti vanozviziva sei. Izwi iri rakasikwa muma1990 nemapidemiologist senzira yekucherechedza kunonyatsoziva nzira yekutapurirwa kweHIV nekupararira kwechirwere kuburikidza nemurume-murume zvepabonde.
Izvi zvisati zvaitika, vatsvakurudzi vakanga vashoma kuburikidza nehuzivi-hunotsvakurudza-apo varume vanozviti "gayana" kana kuti "bonoxual" vakanga vasingaiti zvepabonde, nepo avo vanozviti "vakarurama" vangave vachiita zvepabonde nevamwe varume.
MSM panzvimbo pacho inotarisa pane mufambiro panzvimbo pemaitiro emagariro evanhu kana maitiro evanhu kuti vawane mifananidzo yakajeka yehutachiona hweHIV . Izvo, pamwe chete, zvinotipa kunzwisisa kwakanakisisa kwezvinoreva kudzivirirwa kweHIV, kusanganisira zvipi zvidziviriro zvekudzivirira zvinoshandiswa mune vanhu.
Zvidzidzo zvakasiyana-siyana neruzhinji uye tsika, asi kutsvakurudzwa kwakaitwa neNew York City Department of Health uye Mental Hygiene kwakaratidza kuti yevarume 4 200 vakabvunzwa nefoni:
- Inenge imwe chete pairi iyo yakaratidza kuti yakarongedza zvakananga nevamwe varume.
- 70 muzana yevarume vakaroora avo vanoonekwa sevakarurama vachiita zvevarume-varume zvebonde pane imwe nguva kana imwe.
- 10 kubva muzana yevarume vakaroora avo vakaonekwa sevakarurama vakange vaudza tsika dzepabonde imwechete mukati memakore gumi apfuura
HIV Inowanikwa pakati peMSM muSouth America
Kunyange zvazvo MSM inomirira chete inofungidzirwa maviri muzana yevanhu vemuUnited States, sevanhu vanoverengera 55 muzana yehutachiona hweHIV.
Maererano neCentral for Disease Control and Prevention (CDC), kana maitiro aripo anoenderera mberi anoenderera mberi akawanda kune imwechete muSMSM inotapukirwa neHIV mumazuva ehupenyu hwose. Izvo zvinotaridzika zvinotonyanya kuora mwoyo zveAfrica American MSM, uye kuratidzirwa kwemazuva ano kunoratidzira 50% inoshamisa yehupenyu hwehupenyu hwekuwana HIV .
Mukurongedza kwavo gore re2014, CDC yakaratidza zvakare kusawirirana kukuru kwehutachiona hweHIV pakati peSMSM:
- MSM yakamirira 67 kubva muzana yehutachiwana hutachiona hweHIV uye 83 kubva muzana yehutano hutsva pakati pevarume 13 uye kupfuura.
- Wechidiki MSM pakati pezera remakore gumi nemaviri nemakumi maviri nematanhatu pamatambudziko makuru, kuverenga zvikamu 92 muzana zvese zvitsva zvirwere pakati pevarume.
- Utachiwana hutachiwana hweHIV pakati peSpainan / Latinos ndehwekuwedzera kunetseka. Nepo hutachiwana hutachiona hweHIV huchichena uye hweAfrica hweMMM MS huve hwakasimba (pasi ne6 kubva muzana uye maviri kubva muzana, zvichienzaniswa, kubva muna 2010), mutengo pakati peSpanishi / Latino MSM yakawedzera ne13 muzana.
- Nhasi, kune inofungidzirwa 687 000 MSM inotapukira HIV mune US. Izvozvi, 15 muzana vanoramba vasingazivikanwi.
- Pakati peavo vakaonekwa vane HIV, 57 chete muzana vanoramba vachibatana nekutarisana neHIV kune makore anotevera mushure mekuongororwa, asi 58 muzana chete yehutachiona hweHIV vakakwanisa kuchengetedza zvisingaoneki zvehutachiona hwezvirwere zvinoratidza kurapa kubudirira.
Aya mazamu akafananidza, pane imwe nguva, neHIV zvirwere mune dzimwe nzvimbo dzenyika. Kunyange zvazvo hutachiona hweHIV (huwandu hwehutachiona hunenge huchiitika pane imwe nguva) hungave hwakanyanya mune dzimwe nyika, kupararira kweHIV (chikamu chevanhu vanobatwa) kune inenge yakakwirira kupfuura dzose mune MSM.
Tsvakurudzo yepidemiological yakaratidza kuti kupararira kweHIV pakati peSMS kunowanikwa katatu uye katanhatu zvikuru kuMiddle East, Europe, East neCentral Asia, uye nzvimbo yeOceanic, uye chero ipi zvayo kubva kune 15 kusvika ku25 inopfuura muSouth Africa yeSouth Africa, Central America , South America, uye South uye Southeast Asia.
Iko Epidemiological Research Inoparidzira HIV Kudzivirira muMSM
Chinangwa chekutsvakurudza kwepidemiological ndechekupa kutarisa kusasarura kuti chirwere chacho chinoparidzirwa sei uye kwete uyo aiva "mutoro" wekutapurirana. Sezvo zvakadaro, zvinotibvumira kushandisa maitiro ekudzivirira pasina kutonga uye (zvakakodzera) pasina zvematongerwe enyika kana tsika.
Imwe mienzaniso yakadaro kushandiswa kweHIV pre-exposure prophylaxis (PrEP) muMSM. Iyo nzira, iyo kushandiswa kwezuva nezuva kweTruvada (tenofovir + emtricitabine) kunogona kuderedza mukana wevanhu wekutapukirwa neHIV ne 90 muzana kana kupfuura, yakadzidzwa zvakanyanya muSMSM kuti ione kuti yaizobudirira zvikuru. Sezvo zvakadaro, PrEP haina kukurudzirwa kune vose MSM asi pane avo vari pangozi yakawanda yehutachiona.
Sei? Sangano, PrEP inoda zuva nezuva kuti varume vakawanda havagone kuchengeta. Sezvo zvakadaro, vatsvakurudzi vanotya kuti kusagadzikana kwezvinodhaka kunogona kukura zvisina basa muMSM iyo inogona kunge iine dzimwe nzira dzokuzvidzivirira pachavo. Izvi, pamwe chete nemari yekurapa uye zvinogona kuitika, zvinogadzirisa PEPP sechinhu chakakosha chemazvikwata zvishoma kudarika kune dzimwe nzira dzokuzvidzivirira.
Izvi zvinosanganisira gay kana vevakadzi veMMM vanogona kunyadziswa mumharaunda yavo uye vanotya kubudiswa kwepabonde ravo. Inogonawo kusanganisira MSM muduku (sezvo vechidiki vakawanda vanogona kushandisa makondomu) nevashandisi vemishonga vasingabvumirwi avo vari munharaunda vanotambura nehutachiona.
PrEP tsvakurudzo kune MSM inotyisa yakatora imwe nzira ye "nyika chaiye", kuongorora kuti varume vanoita zvepabonde nevarume vakaroorana vanoita sei pane kuedza kungochinja maitiro avo chete. Nokuita izvozvo, zvidziviriro zvekudzivirira sePPR zvinowedzera. Izvi, zvekare, zvinogadzirisa kuti kuvharidzira kwekudzivirira kunoiswa pachena apo kwavanenge vaine ruzivo rwakanyanya.
Sources:
> Patha, P .; Hajat, A .; Schillinger, J .; et al. "Kuwirirana pakati pekuita zvepabonde uye kuzvidzora kuzvitaura zvepabonde: A Population-Based Survey yeNew York City Men." Anals of Internal Medicine. Svondo 19, 2009; 145 (6): 416-425.
> Centres for Disease Control and Prevention. "Ngozi yehupenyu hwehutachiona hweHIV Inosangana muUnited States." Atlanta, Georgia; yakabudiswa naFebruary 23, 2016.
> Beyrer, C .; Bharal, S ;; van Griensven, F .; et al. "Kurwisana kwenyika yose yehutachiwana hweHIV mune varume vanoita zvepabonde nevarume." Lancet. July 28, 2012; 380 (9839): 367-377.