Current PrEP Nhungamiro kubva kuUnited States Public Health Service
Kushandiswa kwezuva nezuva kwechirwere Truvada (tenofovir + emtricitabine) yakaratidzwa kuderedza dambudziko rehutachiwana hweHIV neanosvika 92%. Nzira iyi, inozivikanwa seHIV pre-exposure prophylaxis (PrEP) , inoonekwa senzira inobatsira inogadzirisa kupararira kweHIV kune vanhu vasina kutaridzika uye kuti inogona kuchinja kupararira kwehutachiwana muhuwandu hwehuwandu hwevanhu.
Parizvino, kune dzimwe nyika dzakapfuma zvikuru muNorth America neEurope, maUnited States ane mbiri yakawanda yehutachiwana hweHIV (50,000 hutachiwana hwehutachiwana gore negore) uye yechipiri inotapurika yehutachiwana hweHIV (0.6%, kana vanenge vanenge vane mamiriyoni 1.2 vane HIV) nyika dzose. Chete Latvia, nyika ine vanhu vasingapfuuri mamiriyoni maviri vagari uye zviuru gumi zvinowanikwa zvirwere, ine chikwata chapamusoro (0.7%).
Sekuguma kwezviverengera izvi, US Public Health Service (USPHS) yakabudisa mirayiridzo yakarongeka yemakiriniki anovandudzwa musi waMay 14, 2014, ichikumbira kushandiswa kwezuva nezuva kwePPR pane vane HIV vasati vari pangozi yekutapukirwa, sezvinotevera:
Varume vanoita zvepabonde vanoita zvepabonde nevarume (MSM) vasina hukama hwemunhu mumwe chete achangobva kuongororwa neHIV, uye vanosangana chimwe kana zvimwe zvezvinotevera:
- Ivai nekondomu musikana wepabonde (kubvuma kana kuisa) .
- Wakave nehutachiona hwepabonde (STI) mumwedzi mitanhatu yapfuura.
- Ari mune serodiscordant (mamiriro akavhenganiswa) ukama nehutachiwana hweHIV.
Varume vanoita zvepabonde vanoita zvepabonde nevarume nevakadzi (MSMW) vasina hukama hwemumwe chete nevanenge vachangobva kuongororwa neHIV, uye vanosangana chimwechete kana zvimwe zvezvinotevera:
- Ivai nekondomu musikana wepabonde (kubvuma kana kuisa).
- Wakave nehutachiona hwepabonde (STI) mumwedzi mitanhatu yapfuura.
- Ari mune serodiscordant (mamiriro akavhenganiswa) ukama nehutachiwana hweHIV.
Kuita zvepabonde varume vanoita zvepabonde kana vakadzi vasina huri pakati pehukama hwemumwe chete nevechangobva kuongororwa vasina HIV, uye vanosangana nechimwe kana zvinopfuura zvinotevera:
- Kusashandisa kondomu nemumwechete kana kuti vamwe vanopindirana nehutachiwana hweHIV husingazivikanwi nehuwandu hwehutachiwana hweHIV (injecting drug users, MSMW).
- Ari mune serodiscordant (mamiriro akavhenganiswa) ukama nehutachiwana hweHIV.
Injecting drug users (IDUs) vanosangana vakayira mishonga mumwedzi mitanhatu yapfuura, uye vanosangana chimwe kana zvimwe zvezvinotevera:
- Shandisa nheyo kana kuti makagovana zvirairo mumwedzi mitanhatu yapfuura.
- Wanga uri pamethadone, buprenorphine kana suboxone chirongwa chekurapa mumwedzi mitanhatu yapfuura.
- Iva neipi yezvakataurwa pamusoro apa zvinotarisirwa zvekuita zvepabonde.
Mukuwedzera, PrEP inogona kurongerwa kune mamiriro akasiyana-siyana (serodiscordant) vakaroorana avo vanoda kuve nemuviri kana kuti vanototarisira. Zvose mbiri dzeDAA uye mazita ekurapa maitiro ekurapa majekesiti anobatsira izvi.
Zvakadini Kana Ndisisiri Panyorwa?
Pakupedzisira, chisarudzo chekupa PrEP chinofanira kuitirwa pane-case-by-case basis, nechinangwa chekuongorora munhu wega panjodzi yehutachiona uye nzira dzekudzivirira dambudziko rakadaro.
Kana iwe uchidavira kuti iwe unofanirwa kutenga PrEP, zvakakosha kushanda nemudzidzisi wakadzidziswa kana unyanzvi hwehutano kuitira kuti uve nechokwadi chokuti unonzwisisa kubatsirwa uye kusagadzikana kwehutano .
PrEP haifaniri kumboonekwa sechinotsiva makondomu kana kushandiswa panzvimbo yekugara kwenguva yakazara kurapwa nemunhu ane HIV.
PrEP inongorongedzerwa nachiremba uye inoda zvose kuongororwa kweHIV musati yatanga kurapwa uye mwedzi mitatu inotevera. Medicaid uye hurongwa hwehutano hweUnited States hwakavhara mari yePPR, apo kubhadhara mari yekushandisa zvinodhaka kunowanikwa kune avo vanokodzera kuburikidza neGiriyedhi yeTruvada yePrEP Medication Assistance Program.
Sources:
Nzvimbo dzeDaase Control and Prevention (CDC). "Pre-Exposure Prophylaxis (PrEP)." Atlanta, Georgia; yakasvika musi waNovember 6, 2014.
World Health Organization (WHO). "Kuwandisa kweHIV pakati pevanhu vakuru kusvika kune makumi mana nemakumi mashanu nemakumi mana nemana makumi mashanu (49 kusvika ku49)." Data nedzimwe nyika. "Geneva, Switzerland; yakasvika musi waNovember 6, 2014.
Bhanga Renyika Yose. "Nyika uye Kukweretesa Mapoka." Washington, DC; yakasvika musi waNovember 6, 2014.
US Public Health Service (PHS). " Preexposure Prophylaxis yekudzivirira hutachiona hweHIV muUnited States - 2014: A Guideline Practice Guideline." Washington, DC; yakabudiswa musi waMay 14, 2014; yakasvika musi waNovember 6, 2014.
National Institutes of Health (NIH). "Zvirongwa zvekushandisa ma antiretroviral madzimai muvakadzi vane HIV vane 1 vane utachiona hweHIV-1 nekuda kwehutano hwemwana uye nzira dzekugadzirisa kuderedza kutapurirwa kweHIV muUnited States." Bethesda, Maryland; yakasvika musi waNovember 6, 2014.