Kuparadzanisa Chokwadi kubva kuHallacy
Kushandiswa kwekudzingiswa kwevarume vekuzvipira kwevarume (VMMC) kuderedza dambudziko rekutapurirwa kweHIV mumunhu akasiyana-siyana kunoramba kuri kukakavara. Kunyange zvazvo kune humwe hwakasimba hwokuti varume vakadzingiswa havakwanisi kutapukirwa nehutachiona hweHIV kuburikidza nemurume nemurume asina kudzingiswa, tsika yacho inowanzomutsoropodza zvakanyanya kubva kune avo vanobvuma kusadzingiswa kana kusava nechokwadi chekuongorora kwepakutanga.
Mutsara wekuongororwa kwakaitwa nemaitiro akaitwa muAfrica kubvira muna 2005 kusvika muna 2007 wakaratidza kuti VMMC inogona kuderedza dambudziko rekuparidzirwa kweve vaginal-to-penile kubva kune 51% kusvika 60%.
Kubva pakugadzirisa kwezviedzo izvi, World Health Organization (WHO) uye Joint United Nations Program pamusoro peHIV / AIDS (UNAIDS) yakabudisa mazano muna 2007 achiti:
"Kudzingiswa kwevarume kunofanira kuonekwa seimwe nzira, inokosha yekudzivirira hutachiona hweHIV huri pakati pevarume ... (asi) haufaniri kutorazve nzira dzinozivikanwa dzekudzivirira HIV."
Pakazosvika gore ra2011, maMMC anopfuura 1.3 mamiriyoni ainge aitwa, kunyanya kuEastern uye kumaodzanyemba kweAfrica apo mazana ehuwandu hwehuwandu hwevanhu vanogona kutamba zvakanyanya se 26%. Mutungamiri Obama akazvipira zvakare kutsigira mamiriyoni 4.7 ekudzingiswa pakupera kwa2013.
Kudzingiswa seSekudzivirira: A-One-Way Street?
Pano flip parutivi rwenyaya yacho, zvizhinji zvekutsvaga kumwe chete zvinoratidza kuti kudzingiswa kwevarume hakuiti kuti kudzivirirwa kwakadaro kune mumwe musikana asina kuonekwa mushamwari ye serodiscordant .
Pane zviverengeka zvinokonzera izvi zvisingaiti-kusanganisira inherent biological vulnerability yevakadzi uye, mune dzimwe nguva, kusununguka kusati kwamboita zvepabonde musati maziso ekudzingiswa akanga apora zvakakwana.
Uye hapana humwe uchapupu hunoratidza kuti kudzingiswa kuchaderedza njodzi yehutachiona muvarume vanoita zvepabonde nevarume (MSM) , iyo nzira huru yekutapukirwa ishure repabonde .
Chero kudzingiswa kunogona kupa chidziviriro chekudzivirira mune varume vanoita zvepabonde nemurume nemudzimaikadzi vanenge vasina kufanana.
Imwe nhaurirano yekufambisa ndeyokuti kudzingiswa hakuratiki kunokonzera hutachiwana hutachiona hweHIV mune dzimwe nyika dzakabudirira sezvavanenge vachiita mumagariro evanhu vakawanda, vakawanda vanoita seSouth Africa yeSahara.
Kubva pane zvizhinji zvehuchapupu, WHO / UNAIDS yakaronga nzira yekutsvaga ichiti:
"Chimwe chinonyanya kukosha kwehutano hwehutano hwevanhu chichava mumamiriro ezvinhu umo HIV ine hutachiona (huwandu hwehutachiwana hwehutachiwana hwehutachiwana huwandu hunopfuura 15%), hunopararira zvakanyanya kuburikidza nehutachiona hwekutengesa, uye apo vanhu vakawanda (semuenzaniso vanopfuura 80%) havana kudzingiswa . "
Muna 2011, UNAIDS yakashuma kuti huwandu hwekuwanda kwevanhu vakawanda muAfrica yeSouth Africa hwakanga huri pakati pe10% (muMalawi) uye 26% (muSwaziland). Nokuenzanisa, kuwandisa kwevanhu vakuru kuAmerica kunosvika ku 0.6%.
Kuyera Uhupupu
Pakazosvika 1989 na2005, dzidzo dzakawanda dzekucherechedza muAfrica dzakaona ukama huri pakati pehuwandu hwevarume vakadzingiswa mukati mehuwandu hwehuwandu hwevanhu uye huwandu hunotapukira hweHIV. Kunyange zvazvo zvimwe zvezvibereko zvaive zvakamanikidzira-kusanganisira kudzidza kukuru kweboka kuUganda kwakaratidza kuti maitiro ehutachiona aiva makumi mana nezana pasi pevarume vakadzingiswa-paiva neongororo dzakawanda dzinopikisana nemigumisiro kana kuti kubvunza munyori kugumisa.
Muna 2005, kuongororongedzwa kwemasangano makumi matatu nemakumi mashanu ekuongorora zvidzidzo kwakasimbisa kushamwaridzana pakati pehuwandu hwekudzingiswa uye kutapudzwa kwemadzimai ekutengesa mazinga. Kunyange zvakadaro, uchapupu hwaionekwa husina kukwana kuratidza kushandiswa kwekudzingiswa sevanhu-based blockative tool.
Kubva muna 2005 kusvika muna 2007, mhando dzakasiyana- siyana dzakarongedzwa zvakaitwa munyika nhatu dzeAfrica dzakazopa uchapupu hunobatsira pakutsigira tsika.
- MuKenya , varume 2 784 vari pakati pemakore 18 ne24 vakanyoreswa nekuda kwechidzidzo chakatungamirirwa neYunivhesiti yeIllinois. Dare racho rakagumiswa musati rapera apo kudzingiswa kwakaratidzwa kuva nehutano hwe 53% mukudzivirira kutapurirwa kweHIV.
- MuSouth Africa , varume 3 273 pakati pe16 ne24 vakanyoreswa mukutongwa kwakabhadharwa neAgence Nationale de Recherches sur l'AIDS (ANRS). Dare racho rakagumiswa mushure memwedzi 17 pashure pekutsvaga kwemukati kwakaratidza 60% madiki maswere muboka rakadzingiswa.
- MuUganda , varume 4996 pakati pe15 ne49 vakanyoreswa kutongwa kunoitwa naJohn Hopkins Bloomberg School yeHurumende yeHurumende. Dare racho rakabviswawo nguva isati yamboitika mushure mekuratidza kushanda kwe 51%.
Kunyange zvazvo meta-kuongororwa yakanyatsotsigira zvinowanikwa mumamiriro ekupararira kweAfrica, vamwe vakabvunza kana kushandiswa kwezvinetso-kusanganisira kushandiswa kwekondomu kushandiswa uye tsika dzekudzivisa zvirwere-hazvisati zvanyatsogadziriswa.
Nzira dzinogona kuitika dzehupenyu dzekutapudza kutumirwa
Zvidzidzo zvakawanda mumakore achangopfuura zvakaratidza kuti bhakitiriya bome iri pasi pepamberi inogona kuva chikonzero chekuwedzera kwehutachiwana hwehutachiwana kune varume vasina kudzingiswa. Kutsvakurudza kunoratidza kuti huwandu hwebhakitiriya huwandu hunoita kuti zvinonzi " Langerhans" masero ari pamusoro peganda kuva "vatengesi" kuzvidziviririra zvekuzvidzivirira.
Kazhinji, Langerhans masero anobata nekutora uye kutakura zvipembenene zvinopinda mumasero omusodzivirira (kusanganisira CD4 masero ), uko kunotamirwa neutralization. Zvisinei, apo mutoro webhakitiriya unowedzera, sezvinoitika pasi pechifukidzo, kuputika kwemuviri kunowanikwa uye maLangerhans masero anokonzera masero ane zvipembenene zvinokanganisa pane kungovaudza.
Nokudzingisa peni, mabhakitiriya anaerobic ari pasi pepamberi haakwanisi kubudirira, nokudaro achidzikisa kupisa kwekuvhiringidza. Kuwedzera kutsvakurudza kunogona kutungamirira kukurudzirwa kwe microbicidal agents kana dzimwe nzira dzisiri dzekuvhiya kuti dzigadzirise.
Kubudirira Kwepurogiramu muAfrica
Mathematical modeling ne WHO, UNAIDS uye South African Center for Epidemiological Modeling and Analysis (SACEMA) inoratidza kuti, mune imwe nzvimbo yakawanda yekupararira kwepabonde ndiyo inonyanya kushandisa nzira yekuparadzanisa, chirwere chimwe chitsva chichadziviswa kune varume vashanu vese vakadzingiswa . Panofungidzira, kana 90% yevarume vakadzingiswa mukati mevanhu ava, pane kukanganisa kushandiswa kwezvirwere zvevakadzi kubva kune 35% kusvika 40% (zvichienderana nehutachiwana hutachiwana hwehutachiwana hwehutano).
Kukosha-kugadzirisa kuongororwa kwakaratidza kuti, nekudzivisa zvirwere izvi, mutoro wehutano hwehutano hwaigona kuderedzwa zvikuru. Chimwe chekudzidza kweGauteng Province muSouth Africa-uko chirwere chetachiona chinopfuura 15%-chinotarisirwa kuti mari inosvika 1 000 kudzingiswa kwevarume (anenge $ 50,000) inogona kubhadhara mari yeupenyu hwose inodarika $ 3.5 mamiriyoni mune remishonga inorwisa maidetroviral chete, kwete kureva zvakananga kurapwa uye / kana kugadziriswa mari.
Kunyange zvakadaro, vamwe vakatsigira kuti kuverenga kwakanyanyisa kuvimba, asi imwe (yakakakavadzana) kuongorora inofunga kuti kushandiswa kwemasununguko emakondomu asina mahwendekeri kune dzimwe nguva zvinodhura-zvinoshanda kudarika kudzingiswa mukudzivirira hutachiona hweHIV.
Muna 2013, WHO yakabvumira kushandiswa kwePrepex, iyo yekutanga kusasarudzwa kwechidziro chevarume. Iro rinoshandiswa rinonamatira rinorema rinoda kusina anesthetic uye rinonamatira zvakananga chepamberi, nokudaro rinochera ropa rinopa. Munenge vhiki imwechete, mafupa akafukidzwa akafa anogona kubviswa pasina ronda rakazaruka kana zvigunwe. Iyi teknolojia itsva inotarisira kuwedzera nhamba yeVMMCs nemamiriyoni 27 kusvika 2020.
Kudzingiswa Sekudzivirira Inogona KuAmerica here?
Kubva pane maonero ehutano hwehutano, zvakakosha kuziva kuti hapana muviri wepasi rose wakamborayira kudzingiswa kwevarume vose sechisarudzo chekudzivirira HIV. Zviri pachena kuti pane zvakasiyana zvikuru muhutano hwehurombo hweAfrica kurwisana neyo nyika yakagadziridzwa, kunyanya kubva kune 60% zvezvitsva zvitsva muUnited States zviri pakati peMSM.
Uyezve, kuipa kwakaipa kuvadzimai-vatotambura nekuda kwezvinhu zvehupenyu uye zvehupfumi-kunoonekwa kudarika chero ipi zvayo inobatsira yekukura kwekushandiswa kwepamusoro, kunyange mumharaunda inotambura apo hutachiona hwehuwandu hwehuwandu hwehuwandu hwehuwandu hwehuwandu hwehuwandu hwakakosha huri pamusoro. Vamwe vanototenda kuti mazano ane chokuita nekudzingiswa angava nemigumisiro yakaipa kune vagari vemunharaunda umo kushorwa kwekare kunotanga kukwirira uye kushandiswa kwekondomu kunowira pasi pasi pe50%.
Kunyange zvakadaro, zvidzidzo zvakawanda zvakaratidza kuti kudzingiswa kwevana vasati vaberekwa kunogona kuderedza dambudziko rehupenyu hwevarume veUnited States reHIV rinotapukira kazhinji ne20%. Muna 2012, American Academy of Pediatrics yakabudisa chirevo chekuita sarudzo chinoratidza kuti "mararamiro ehutano hwekudzingiswa kwevarume vachangobva kuberekwa anopfuura mungozi uye kuti maitiro anobatsira anopa kubvumirwa kweiyo nzira yemhuri inoisarudza." Pakati pezvinyorwa zvakarongwa ndezvekudzivirira zvirwere zvinokonzera urinary , kenza yepenile , nekupararira kwezvirwere zvepabonde zvepabonde , kusanganisira HIV .
Vazhinji vanachiremba uye vane hutano vane hutano vanotora nzvimbo isina kukanganisa panyaya yekudzingisa varume vakadzingiswa, vachitsigira kuti inoderedza pane kuvhara dambudziko rekudzivirira hutachiona hweHIV. Parizvino hapana mazano kuU.S. kuitira kushandiswa kwekudzingiswa kwevarume kuderedza hutambudziro hwekutengesa kuvanhu.
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