Kuderedza Ngozi muHeterosexual uye Madzimai Akaroorana
Ngozi yeHIV kuburikidza nehupombwe husina kudzivirirwa inoratidzika kuva yakakwirira zvikuru, yakawanda kanopfuura makumi masere nemashanu kupfuura zvepabonde. Zvikonzero zvehuwandu hwehuwandu hunozivikanwa uye hunosanganisira zvinhu zvakadai sokuti:
- Iko kubvongodza kwemashure emakona, zvichibvumira hutachiona kupinda zvakananga muropa mumvura kuburikidza nemisodzi mishoma kana kubra.
- Kuvhiringidzika kwemasumbu emakona uye kukwirira kwavo kunokonzerwa nehutachiona kunyange kana kusina kunaka.
- Iyo yakanyanya kukanganiswa kweHIV mune imwe nhengo uye pre-seminal fluid ("pre-cum"), iyo inogona kudarika dambudziko rehutachiona nehomwe imwe-yega (kureva, chidimbu chimwe chete) inokura mumutana wehutachiona hwemunhu.
Uyezve, kuchengetedzwa kweropa kubva pamakemikari akaora zvakakonzerwa kunogona kuwedzera njodzi yekuisa ("top") shamwari, zvichipa hutachiona nzira yekufambisa kuburikidza nehutachiona uye mishonga inotarisa musoro wepente (kunyanya pasi pepamberi).
Kuongororwa neHIV Risk "Per-Act" uye "Per-Partner"
Mukuongorora kwavo kwezvedzidzo 16 zvakasiyana-siyana, vatsvakurudzi veImperial College neLondon School of Hygiene uye Tropical Medicine vakapedzisa kuti chiito choga chega cheHIV kuburikidza nekondomu-isina kunyanya kurara pabonde chakanga chava nepamusoro pe4% pamusana pekugamuchira (" pasi ") shamwari.
Kunyange zvazvo huwandu hwehutambudzi hwaisati hwaonekwa sehunosiyana nekuita zvepabonde, pasinei nehupombwe kana varume vanoita zvepabonde nevarume (MSM) , dambudziko racho rakaonekwa richiwedzera zvakanyanya kudai munhu aisimudza asi asina kudzingiswa (0.62 muzana asina kudzingiswa vs. 0.11 muzana akadzingiswa) .
Nokuenzanisa, munhu wese anokonzerwa nehutachiona hwehutachiona hwehutachiona hweHIV huri muukama hwakakwana nehutachiwana hweHIV-asina kuvepa mufananidzo wakajeka kune vose vanogamuchira uye vanoisa pamwe.
Zvidzidzo gumi zvakaongororwa zvakaitwa chete pakati peMSM uye hazvina kubatanidza urefu hwehukama kana huwandu hwomukondomu husati huri pabonde.
Kuongororwa kwe data kwakakwanisa kuratidza kuti:
- vashandi vanobatana mune zvepabonde vanogamuchira uye vanopinza mushure misina makondomu vaiva nechirwere chemufupisi we 39.9%.
- uyo ane HIV asina kukanganisa akangoita zvepabonde chete asi asina kondomu aive nehupfumi hwema 21.7 muzana, asi mudzimai weAIDS asina kugamuchira aiva nehutano hwekunenge 40.4 muzana.
(Kunyange zvazvo migumisiro ye meta-analysis iri kumanikidzira, zvakakosha kuziva kuti mhando dzakasiyana dzezviongororwa zvakaongororwa dzinobva pane imwe nzvimbo yekududzira.)
Nzira dzekudzivirira kukanganisa hutachiwana hweHIV kubva kune unzenza
Sezvimwe chero imwe nzira yekutapurirwa kweHIV , kudzivirira kunoda kusanganisa mazano ekubudirira zvakanyanya:
- Deredza kuderedzwa kwehutachiwana hweHIV.
- Deredza kudengenyeka kweavo vasina HIV.
- Kudzivirira hutachiwana hwekusangana nemasero akaoma.
Kushandiswa kwekubatanidza antiretroviral therapy (ART) mumukomana anokonzerwa neHIV inozivikanwa kuti inonyanya kuderedza dambudziko rekutengesa kana chirwere chevirusi chakanyatsopererwa uye chichigadziriswa kuti chirege kuonekwa. Nzira iyi, inozivikanwa seChirango seKubvisa (TasP) , yakaratidzwa kuderedza dambudziko reHIV nepamusoro pe 96% mukati mekuvakwa kwehukama hwakasanganiswa (serodiscordant).
Panguva iyi, kushandiswa kwe -pre-exposure prophylaxis (PrEP) -kudaro shamwari isina kutaridzika inorayirwa chiitiko chezuva nezuva chemukondombera weHIV Truvada -inozivikanwa kuderedza dambudziko chero kupi zvako pakati pe44 ne75 muzana.
Kushandiswa kwakakwana uye kwakakodzera kwekondomu kunowanikwawo kuti inokosha mukudzivirira utachiona hweHIV, neUnited States Century for Disease Control uye Kudzivirira inotaura kuti kushandiswa kwekondomu kusingagumi kunogona kudzivirira vanomwe kubva pane gumi kunotapurirana. (Mharidzo imwechete yakagumisawo kuti imwe chete mumatanhatu MSM inoshandisa kushandiswa kwekondomu nguva dzose.)
Nhoroondo yacho inonyanya kushandiswa kushandiswa kwakashandiswa kweTapP, PrEP, uye makondomu senzira inonyanya kushandiswa yekudzivirira hutachiwana hwehutachiwana hweHIV, pamwe nevanokwidzirana nevakadzi pamwe neMSM vanoita zvepabonde.
Kusiyana neizvi, kondomu isati yamboita zvepabonde haisati yakurudzirwa, kunyange kana zvose zviri muTapP uye PrEP zvichishandiswa, sezvo zvichigona kunge zvingave zvingangodaro mukana wenguva refu mune vamwe vakaroorana-vakaroorana.
Chiitiko Chinoitika Nenguva Dzepabonde
Kana iwe uchida kuti iwe wakambove wakananga neHIV, zvichida kuburikidza nemakondomu akaputika mune zvepabonde zvisina kukodzera, kune mishonga inogona kuderedza zvikuru njodzi yehutachiwana inonzi post-exposure prophylaxis (PEP).
PEP inosanganisira mazuva 28 emazuva emishonga inorwisa mabhakitiriya, iyo inofanira kutorwa zvakakwana uye isinganzwisisike. Kuti udzikise hutachiwana hwehutachiona, PEP inofanira kutanga nekukurumidza sezvinobvira - zvakanaka mukati meawa makumi matatu nemaawa ekuzarura .
Sources:
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Cohen, M ;; Chen, Y ;; McCauley, M .; et al. "Kuchengetedzwa kweHIV-1 utachiona nehutano hwekare hwehutachiona hweHIV." New England Journal of Medicine. August 11, 2011; 365 (6): 493-505.
Ipai, R .; Lama, J .; Anderson, P .; et al. "Preexposure Chemoprophylaxis yeHIV Prevention in Men Who Have Sex With Men." New England Journal of Medicine. December 30, 2010; 363 (27): 2587-2599.
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.
Supervie, V .; Viard, J; Costagliola, D .; et al. "Heterosexual ngozi yekutapurirwa kweHIV kuburikidza nekuita zvepabonde pasi pehutachiona hwehutachiona hwehutachiona hwehutachiona hwehutachiona hwehutachiona hwehutachiona hwehutachiona hwehutachiona hwehutachiona. Clinical Infectious Diseases. April 19, 2014; pii: ciu223 [Epub mberi kwekudhinda].