Kuziva zvipingamupinyi zvekushandisa PrEP
Yakaratidzwa kuti kushandiswa kwezuva nezuva kwemishonga inorwisa mabhakitiriya, Truvada , kunogona kuderedza zvikuru njodzi yehutachiona mune vanhu vane HIV isina hukama muhukama hwevaSerodiscordant (kureva, apo mumwe munhu ane HIV uye mumwe wacho haana HIV). Iyo nzira, inonzi pre-exposure prophylaxis (kana PrEP) , yakaratidzwa kuderedza dambudziko rekutapurirwa nekubva kupi kubva pamapfumbamwe kubva pamakumi maviri kusvikira ku75 muzana kana inotorwa nekusagadzikana, kusinganzwisisiki kumatira.
Kubva pane maonero, nhamba dzinotsigira zvakasimba kushandiswa kwePrEP sechikamu chegadziriro yekudzivirira HIV. Zvisinei, kubva pakuona kwehupenyu-chaihwo, nhamba dzingasava dzose dzinogutsa, nemashoko okuti "kusagadzikana" uye "asinganzwisisiki" kupa zvipingamupinyi kune avo vangave vakakumbira.
Zvechokwadi, maererano nehutsvakurudzo hutsvakurudzo, vanhu 1 774 chete muUnited States vakange vazadza mitemo yeTruvada yePrEP pakati paJanuary 2011 neMarch 2013. Muna July 2016, chiyero ichi chakanga chakura kusvika 76 000. Icho chichiri chimiro chisingatauriki chinonyatsoratidza kuti 50 000 mishonga yeHIV inotarisirwa kuitika muU.S. gore rose.
Nhamba yacho inounza kuonekwa kwezvinhu zvakawanda zvinoita kuti PrEP iite zvakanaka mukutsvakurudza, asi zvishoma kana yakaiswa mumamiriro ezvinhu chaiwo enyika. Uye haisi nyaya yekudzidzisa kana kuziva (kunyange izvi zvikonzero zvinokosha). Zviri pachena kuti pane chimwe chinhu chiri kuitika.
The Impact of Price and Adherence
Kuongororwa kwe2012 kwakaitwa neU.S. Centers for Disease Control and Prevention (CDC) yakagumisa kuti zvinodarika chetatu chevaAmerica vane hutachiwana hweHIV pamusoro pehutachiona hweHIV (ART) havakwanise kuchengetedza mishonga zuva nezuva- uye izvi kune HIV kune vanhu vanobatanidzwa rinorondedzera kune zvakananga kuhurefu uye hupenyu hwehupenyu.
Tingatarisira here kuti zvipingamupinyi zvive zvishoma kune vanhu vanotora chirongwa cheRIV kwete che "kupona" pane imwe chete, asi kudzivirira HIV? Pashure pezvose, apo makondomu anozivikanwa kuti anopa kudzivirirwa kukuru, nhamba dzinoratidza kuti dzinoshandiswa mune zviviri chete pane zvitatu zvepabonde pane zvakanakisisa.
Nokudaro vamwe vachigona kubvunza, "Zvingava zvakaoma sei kutora piritsi imwe chete pazuva?", Tsvakurudzo dzakawanda dzinoratidza kuti kuterera zuva nezuva kunogona kuva dambudziko rinotyisa kukunda. Funga kuti mishonga isingaperi yechirwere cheshuga kana chirwere chemwoyo chinofanira kunge isina zvishoma sezana makumi manomwe ekutenderera (kana kuti yakaenzana nepamusoro mapfumbamwe asina kuenzana pamwedzi). Kusiyana neizvi, PrEP inoda kuswedera pedyo nekuteerera kwakakwana kuitira kuti uwane zvinangwa zvekudzivirira.
Tsvakurudzo dzinoverengeka dzichangobva kuitwa dzinosimbisa matambudziko. Muna 2013, Chidzidzo che VOICE chakatarisa kushandiswa kwePrEP pakati pevakadzi 5,029, vari pangozi dzevakadzi veAfrica-yakanzi haina maturo apo zvakaratidzwa kuti 30 muzana chete ndivo vakakwanisa kuchengetedza zuva nezuva maitiro ekurapa. Zvimwe zvakawanikwa zvakaratidzwa mu FEM-PrEP Yokudzidza, iyo yakagadziriswawo nekuda kwekuteerera kwemitengo kune avo vanotora zuva reTruvada.
Mukuona kwezvidzidzo izvi uye nhamba dzepasi-kudarika-dzinotarisirwa dzeVP registrants, kunyanya kusimbiswa kungada kuiswa kune dzidzo inotarisirwa, iyo vanhu vari muSerodiscordant relationships ( kusanganisira avo vanoda kutora mimba ) vanorayirwa pamusoro pePPR semhuri yakawanda tsika, pane kungova mune imwe nzvimbo yakasiyana yeHIV.
Vavaki vezano vanogonawo kuongorora kana mari yePPRI, inofungidzirwa kuva yepamadhora madhora 12 000 pagore, inogona kuva inopera kune avo vane zvirongwa zvehushuwarisi izvo zvisinganyatsovharidzire kushandiswa kwayo.
Mukutsvakurudza kwakaitwa muna 2013 kuUnited States uye kuCanada vadzidzisi vezvirwere zvinotapukira, 74 muzana vakatsigira kushandiswa kwePPR pane huwandu hwevanhu. Zvisinei, zveboka iri, 9% chete ndivo vakanyora izvi kuvarwere.
Zvinotarisirwa kuti mazano anogadzirwa neCDC munaMeyi 2014, achikumbira kushandiswa kwePrEP muvanhu vanofungidzirwa vari pangozi yehutachiona, huchawedzera kuregererwa kunyoresa kuUnited Groups dzakakonzerwa neCDC dzinosanganisira:
- varume vanoita zvepabonde nevarume (MSM) vasingashandisi makondomu ;
- Vanhu vasina hutachiona hweHIV vanogara vachiita zvepabonde nemunhu ane HIV;
- injecting drug users (IDUs), uye;
- vakomana vanoita zvepabonde vanoita zvepabonde nevanokuvadza zvikuru.
Sources:
Rawlings K, Mera R, Pechonkina A, et al. "Nzvimbo yeTruvada yeHIV pre-exposure prophylaxis (PrEP) muUnited States: kushandiswa kwekutanga kwekushandisa zvinodhaka." 53I ICAAC Interscience Conference pamusoro peAntimicrobial Agents uye Chemotherapy; Denver, Colorado; Svondo 10-13, 2013; abstract H-663a.
US Centers for Disease Control and Prevention (CDC). "CDC Fact Sheet | HIV muUnited States : Matanho Ekutarisira." Atlanta, Georgia; yakabudiswa muna July 2012.
Anderson, J. "Kushandisa Kondomu uye Chetachiwana pakati pevanhu veUnited States." American Journal of Public Health. June 2003; 93 (6): 912-914.
Microbicides Trial Network (MTN). "Mutemo weMTN pamusoro peKusarudza Kurambidza Kushandiswa Kwemapepanhau Emumuromo Tenofovir mu VOICE, Chidzidzo Chekudzivirira Kuvhara HIV mune Vakadzi." Dhiyabhorosi yakabudiswa musi waSeptember 28, 2011.
National Institute of Allergies and Infectious Diseases (NIAID). "IE FEM-PrEP Chidzidzo chekudzivirira hutachiwana hweHIV uye Zvarinoreva paNIAID Research." Bethesda, Maryland; gwaro rehurukuro rakabudiswa musi waApril 18, 2011.