Zviri nani kudzivirira nzira dzinopedza ngozi yekutapukira kweHIV
Maererano neUnited Nations Joint Program pamusoro peHIV / AIDS, inenge hafu yevose vane hutachiwana hweHIV munyika yose serodiscordant, zvinoreva kuti mumwe munhu ane HIV kana mumwe asina HIV. Mazuva ano, muUnited States chete, inofungidzirwa kuti kune vanopfuura 140 000 serodiscordant vanopesana nemurume nemudzimai, vazhinji vavo vane makore ekurera vana.
Nekufambira mberi kwakanyanya mu antiretroviral therapy (ART) , uyewo mamwe maitiro ekudzivirira, serodiscordant vakaroorana vane mikana yakawanda yakawanda yekuita pamuviri kupfuura kare kare-kubvumira kuberekwa asi kuderedza dambudziko rekutapurirwa kumwana pamwe chete neshamwari dzisina kukodzera.
Kufungidzira kusarangarira
Mazuva ano, zvinowanzowanikwa kuti kushandiswa kwakakodzera kwemishonga inorwisa mabhakitiriya kunogona kuderedza zvakanyanya ngozi yehutachiwana pakati pehutachiona hweHIV nevanodiscordant ne:
- kuve nechokwadi chokuti munhu ane HIV ane kuderedza kusagadzikana kuburikidza nekuchengetedza hutachiwana hwehutachiona pane zvisingagoni kuonekwa (chirongwa chinonzi kurapwa sekudzivirira, kana TasP)
- kupa hutachiwana hutachiwana hweHIV nechisarudzo chekudzivirirwa kwakawedzerwa nekushandiswa pre-exposure prophylaxis (PrEP)
Mumabereki anoshandisa zvose TasP uye PrEP, mungozi yekuparidzika inoonekwa kunge yakanyanya kuderera. Tsvakurudzo inobva kuNGONERS inenge ichienderera mberi yakaratidza kuti 1 166 vakaroorana vakanyoreswa mujeri kubva munaSeptember 2010 kusvika munaMeyi 2014, vane 11 vane HIV vasina hutachiwana vane HIV.
Zvisinei, kuongorora mazita evanhu vakaonesa kuti vose vane gumi nomumwe vane utachiona nemumwe munhu kunze kwehukama, zvichireva kuti hapana munhu ane ukama hunenge huri pakati pehukama hwakakonzerwa.
Zvisinei, zvakakosha kuziva kuti kunyange zvazvo kupindira uku kunogona kuderedza dambudziko-kusvika kusvika 96 kubva muzana uye 74 kubva muzana, zvichienderana-havasi kubvisa zvachose.
Zvimwe zvinhu zvakasiyana-siyana, zvinosanganisira kushandiswa kwemishonga yeHIV uye zvirwere zvepabonde, zvinogona kutora zvakawanda zvezviwanikwa zvakagadzirwa neTapP kana PrEP kana zvisina kutongororwa uye zvakarapwa.
Zvidzidzo zvenguva pfupi zvakaratidzawo kuti munhu ane simba risingaoneki rema plasma rinogona kunge risingareve kuti rine simba risingaoneke rekuberekwa kwepabonde. Saka, apo kuongororwa kweropa kunogona kuratidzira njodzi yakaderera yekupererwa, kunogona kunge kune ngozi inopfuurira kune mumwe munhu. Saka zvakakosha, saka, kutsvaga mazano ekutanga mazano kuburikidza nenyanzvi yakakodzera asati atanga chero nzira yekuita. Mapiritsi chete haasi mhinduro.
Kana Mukadzi Wemudzimai Ane HIV-Yakanaka
Muukama apo mukadzi ane hutano uye murume haana kunaka, sarudzo yakachengeteka inonzi inter-uterine insemination (inozivikanwawo sekuti insemination, kana IUI). Inogumisa kudiwa kwepabonde uye inobvumira kuzvidzora-shandisa uchishandisa mbeu yemukomana.
Zvisinei, izvi zvingasava nzira yakakodzera kune vamwe, zvichida nekuda kwemari kana zvimwe zvinhu. Saka, hazvisi zvisinganzwisisiki kutsvaga kubata pamuviri kuburikidza nekuita zvepabonde zvisina kudzivirirwa izvo zviyero zviri munzvimbo kuti kuderedze ngozi yekuparadzira.
Mumamiriro ezvinhu akadaro, mukadzi wacho aizoiswa paAIDS yakakodzera kana isati yasarudzwa, nechinangwa chekuwana simba risingaoneki rehutachiwana.
Izvi hazvisi izvo chete zvinoderedza kukwanisa kwevakadzi-kutenda kutengesa varume, kunoderedza ngozi yekutapukira kwaamai kune mwana.
Kakawanda kuwandisa kwehutachiona hwehutachiwana kwakagadziriswa, kunonoka kwepabonde pasina kudzivirira kushandisa ovulation kuona nzira dzinogona kuderedza kuderedza ngozi. Makondomu anofanira kushandiswa pane dzimwe nguva dzose. Kushandiswa kwePrEP munhurume nemukomana kunogona kupawo kumwe kudzivirirwa, kunyange zvazvo zvigadziriro zvichiri kumirira kubva kuongororo yekuongorora kushandiswa kwePrEP pakuberekwa.
Usati watanga PrEP, mukomana ane mukomana anofanira kuongororwa nezveHIV, hepatitis B, nezvimwe zvirwere zvinotapurirana pabonde, uyewo kupiwa tsanangudzo yekutanga yevhenekisi dzepfungwa .
Nguva dzose kuongororwa kunofanira kuitwa kuitira kuti usabatwa nemigumisiro yechirwere, kusanganisira renal kushanda uye zvimwe zvinogona kuipa. Uyezve, zvose zvevakadzi nevanhurume vanofanirwa kuongororwa zvirwere zvepabonde. Kana chirwere chinowanika, chinofanira kurapwa nekugadziriswa vasati vamboita mitezo yekuita.
Pane imwe nguva kuberekwa kwave kuri kusimbiswa, ART yaizoenderera mberi mumudzimai wevakadzi, pamwe nemirayiridzo yemazuva ano inorumbidza chirwere chekugara, kwenguva refu pasinei neCD4 count . Zvimwe zvose zvigadziro zvekudzivirira kutapurirwa kwemaamai kusvika kumwana zvichange zvichishandiswa, kusanganisira sarudzo yegadziriro yakarongwa yakarongeka uye kushandiswa kwemashure ekuberekwa kwemishonga yemishonga yemucheche.
Kana Mudiwa weHIV ane HIV
Mune ukama uko murume ane hutano uye mukadzi haana kunaka, kushambidza kwemurume pamwe neIUI kana mu in vitro fertilization (IVF) kunogona kupa nzira dzakachengeteka dzekuita pamuviri. Sermon yekugeza inogadzirwa nekuparadzanisa hutachiona kubva mumvura inotapukirwa, iyo yekare iyo inobva yaiswa mubereki mushure mekutarisa nguva yekuvhara.
Kana iUI kana IVF isingasarudze-neIUI inodhura madhora 895 uye IVF inodhura madhora 12 000, pamwero wega-ipapo zvinofanirwa kuitwa kuti iongorore nzira dzakachengeteka, "yepanyama" yekuberekwa.
Inonyatsokurudzirwa kuti kuongorora kwemajeri kuitwe panguva yokutanga. Tsvakurudzo dzinoverengeka dzakaratidza kuti HIV (uye zvichida chirwere chetachiona chetachiona chetachiona) chinogona kuwirirana nehuwandu hwakawanda hwehuta husina kuchena, kusanganisira pasi peperm count uye pasi motility. Kana kusagadzikana kwakadaro kusara kusingawaniki, mukadzi anogona kuiswa pachinzvimbo chisingadikanwi neine zvishoma kana kuti kwete mukana chaiwo wekutora pamuviri.
Kana imwe nguva kubereka kunogadziriswa, chekutanga uye chinonyanya kukoshesa ndezvekuisa mumiriri wevarume paAART nechinangwa chekuwana simba risingaoneke, rekushaya utachiona. Mudzimai wechikadzi anogona kutsvaga kushandiswa kwePPREP kuti awedzere kuderedza ngozi, pamwe nemazano akafanana ekugadzirisa kurapwa kwekare mberi nekutevera.
Kusabatwa kwakadzivirirwa kunofanirwa kuve kwakanyatsorongedzwa nguva yekutengesa, kushandiswa kwemaitiro ekucherechedza maitiro uye / kana ovulation predictor kits seSerblue Easy kana kuti First Response urine test. Makondomu anofanira kushandiswa pane dzimwe nguva dzose.
Pane imwe nguva kuberekwa kwave kuri kusimbiswa, musikana wechikadzi anofanira kuongorororwa nezveHIV sechikamu chechiitiko chekuongorora kweperiyata. Anofanirawo kurayirwa nezvekuenderera mberi kwekushandisa kondomu uye zviratidzo zveacute retrovirus syndrome (ARS) kubatsira kubatsira zviri nani kuti utachiona hweHIV huvepo.
Izvi zvinokurudzirwa kuti rwechipiri kuongororwa kweHIV kuitwe panguva yechitatu yemamiriyoni ekuzvitakura, zvichida musati mavhiki makumi matatu nemaviri, kana kuti kukurumidza kuongororwa kweHIV kunopiwa panguva yekuberekwa kune avo vasina kuongororwa munguva yechitatu mamiriyoni. Muchiitiko chekuti hutachiona hweHIV hwaitika, matanho akakodzera anofanira kupiwa kuderedza dambudziko rekutengesa kwemaininatal, kusanganisira kuiswa kweyakakodzera antiretroviral prophylaxis uye kuongorora sarudzo yekusarura yakasarudzwa.
> Sources:
> United Nations Joint Program yeHIV / AIDS (UNAIDS). "UNAIDS World AIDS Day Report 2011." Geneva, Switzerland; ISBN: 978-92-9173-904-2.
> Lampe, M .; Smith, D .; Anderson, G ;; et al. "Kuwana mimba yakachengeteka muhutachiona hweHIV-isina kukanganisika: inogona kuita yemuromo preexposure prophylaxis (PrEP) muUnited States." American Journal of Obstetrics uye Gynecology . 2011; 204 (6); 488.e1-488.e8.
> Baeten, J .; Donnell, D.; Ndase, P .; et al. "Antiretroviral Prophylaxis yekudzivirira hutachiwana muHeterosexual Men and Women," New England Journal of Medicine. August 2, 2012; 367 (5): 399-410.
> Dhipatimendi reUnited Health of Health and Human Services (DHHS). "Zvirongwa zveKushandisa Antiretroviral Zvinodhaka Madzimai Akaberekwa neHIV-1-Akabatwa neHana hweMadzimai uye Matongerwo Ekuita Kuti Kuderedza Kuparara kweAIDS kuPininatal kuUnited States." January 16, 2014.
> Rodger, A .; Cambiano, V .; Bruun, T .; et al. "Kuita zvepabonde Kushanda Pasina Makondomu uye Njodzi yeHIV Kuendesa Munharaunda Vakasiyana Kana Muwani weHIV-Akanaka Anoshandisa Kuderedza Antiretroviral Therapy." Nyaya yeAmerican Medical Association. Nyamavhuvhu 12, 2016; 31 (2): 171-181.