Studies question question direct link uye inokurudzira kushamwaridzana nehutano hwepabonde
Iko kune nguva refu mazano maitiro ekutapisa, zvose zvepabonde uye rectal, anogona kuwedzera njodzi yeHIV nekubvisa izvo zvinonzi "zvakanaka" mabhakitiriya kubva kumadzimai / rectal flora paanokonzera kushungurudzika kune utachiona hwemumukati hunoisa zvikamu izvi.
Izvi zvingave zvechokwadi here? Zvingaita here kuti maitiro anofungidzire kuvandudza utano hwehupenyu uye hutsanana asingazivi achiwedzera ngozi yeHIV pasina isu kunyange tichizviziva?
Kudzidza Kwepakutanga Kunokonzera Kusawirirana uye Kusanganiswa
Sezvo kure kumashure kwekupera kwema1990, zvidzidzo zvakawanda zvakange zvichinyatsobatana nekutengesa kuHIV nemamwe zvirwere zvepabonde (zvirwere zvepabonde) . Zvizhinji zvezviongorori izvi zvakaitwa muAfrica, uko zvakarongerwa kuti vaginal vaginosis havana kungowedzera ngozi yebhakitiriya vaginosis ne 60% asi vakaita kazhinji kune vakadzi vane HIV. Kunyange zvazvo vatsvakurudzi vakanga vasingakwanisi kugadzira hukama hwakajeka pakati peHIV uye douching, vakanyatsokurudzira kuti mikana yekufambisa yakanga yakakwirira.
Zvisinei, paiva nezviitiko zvakawanda zvakagadzira pachena zvakajeka kusangana kuoma. Pakati peizvi ndedzidzo yezvidzidzo zvepakutanga dzaitungamirirwa mune zvigadziriswa-zvishoma, zvakadai seAfrica, uko hutano huzhinji hwehuwandu hwevanhu uye ruzivo rwekutarisira kazhinji ruziviswa zvinoguma. Nyaya dzakawanda dzekutsvakurudza dzave dzichiitwawo pakati pevashandisi vezvepabonde (CSWs) , iyo iyo sangano iri pakati peHIV nemamwe maitiro (zvakadai sekushandiswa kwekondomu , zvepabonde zvekare , kushandiswa kwezvinodhaka ) zvingangove zvakakonzera zvakawanda kune ngozi yekutapukisa pane kunyora pachayo.
Uyezve, migumisiro kubva mumiedzo yaiwanzopesana. Chimwe chekudzidza muKenya, somuenzaniso, chakagumisa kuti vaginal douching yaibatanidza 1.5 kusvika ku2,5 kushandisa kondomu yakawanda pakati peCWW kana ichienzaniswa nevamwe vavo vasina-douching. Mumwe mutauro wechiChinese akadzidza makore akawanda gare gare akaratidzira zvakasiyana, nevakadzi vekunamatira kusangana nekanyanya kushandiswa kondomu.
Kusiyana kwehutsva hwekutsvakurudza chete kwakashanda kupisa mhirizhonga inoenderera mberi, nevakawanda vachiti kune vanhu vazhinji vanogona kuparadza vanogona kuisa hukama hwakajeka pakati peHIV uye douching.
Zvidzidzo Zvenguva Ichangobatsira Zvinopa Kubwinya Kwazvo
Pakazosvika gore ra2012, zvidzidzo zvakawanda zvepamusoro zvakapa mazano akajeka pamusoro pehutachiwana hutachiona hweHIV pakati pevaya vanogara vachitamba.
Yokutanga, yakaitwa sechikamu che HPTN 035 HIV microbicide miedzo, yaisanganisira varume 3099 vanoita zvepabonde, vakadzi vasina HIV vari muMalawi, South Africa, Zambia, Zimbabwe, uye Philadelphia. Maererano nekutsvakurudza, chikamu chetatu chevatori vechikamu chaiva neBacterial vaginosis pakuvamba kwekutongwa, chikamu chacho chisina kuchinja mumakore matatu ose emakore, kana pakati pevakadzi vaiita zvekushambidzika kwevakadzi kana avo vasina.
Ichitaridzirwa nhamba inobatsira, migumisiro yeHTT 035 yakanyatsopesana nevakawanda vezvidzidzo zvepakutanga izvo zvakaratidza kuti bhakitiriya vaginosis-iyo inobatanidza nehuwandu hwehutachiwana hweHIV-inogona kukurudzirwa nevakadzikadzi douching.
Chidzidzo chechipiri chakaitwa muLos Angeles chakaratidzawo kusawirirana pakati pevakadzi kana rectal douching uye HIV mune vakadzi. Chidzidzo chacho chakanga chiri kunyanya sekuti 71% yevatori vechikamu vakataura kuti vane zvepabonde, uye 18% vanotaura zvekubatana kwakadaro pamwedzi wapfuura.
( Kubvuma zvepabonde rekare kunoramba kuri mukana wepamusoro wehutano hunobatanidza nekutengesa HIV, zvakapetwa kanopfuura makumi masere kupfuura zvepabonde.)
HIV uye Rectal Douching muMurume
Chidzidzo chekupedzisira, kuongorora kubatana pakati peHIV ne rectal douching mune varume vanoita zvepabonde nevarume (MSM) , vakanyora mufananidzo wakaoma zvikuru. Pamusoro pe 413 MSM avo vaiita rectal douching, 44% vaiva neHIV kusvika 18% chete yeavo vasina kuita douche. Douching yakabatanidzwawo kaviri nenhamba yezvirwere zvepabonde pakati pevatori vechidzidzo (21% ne11%).
Apo, pamusoro pepamusoro, zvakawanikwa zvakaonekwa pamusoro, vatsvakurudzi vakakurumidza kuratidza kuti rectal douching, mukati uye pachayo, yakanga isiri chikonzero chekuwedzera kwehuwandu.
Pane kudaro, rectal douching yakanga ichibatanidzwa nyore nyore nemitemo inonyatsozivikanwa kuwedzera njodzi yeHIV, iyo yakawanda yekuita zvepabonde pamwe nekushandisa zvinodhaka zvekushandisa zvinodhaka.
Zvimwe chete, pakati peSMSM muongororo yacho, avo vakapa kuti vaive nevhareji yevashanu vanoita zvepabonde pamusoro pemwedzi mitatu yapfuura nekusati vasiri mabheji avo vaiva nevaviri. Kushandiswa kwezvinodhaka zvinoshandiswa zvinodhaka kunoonekwawo kuti zvinoita kuti kuwedzera kwechina kuve nekutapukirwa kweHIV kuchienzaniswa nekusina kushandisa-kushandisa MSM.
Kubva pane deta, vatsvakurudzi vakapedzisa kuti rectal douching yakanga iri tsika inowanzobatana nemabasa anokonzera njodzi kupfuura kumira-ndoga uye kuti pakupedzisira ndiyo nhamba yevanhu vanoita zvepabonde iyo yakaita basa guru mukuwedzera kwemari. Ichokwadi, kunyanya kutsvakurudza mazuva ano kunoratidza kuti MSM ine vana kana kupfuura vakawanda vanoita zvepabonde mukati pemwedzi mitanhatu ine 32.3% yakawanda yehutachiona hweHIV pasinei nezvimwe zvinhu zvose zvounhu, kusanganisira doro / kushandisa zvinodhaka uye kondomu-zvishoma zvepabonde .
Vatsvakurudzi vakagumisa kuti maitiro ehutano hwezvehutsanana atove akajairika, kunyanya pakati peMSM, uye haingabatanidzwi nehutachiona hweHIV.
Sources:
Fonck, A .; Kaul, R .; Keli, F .; et al. "Zvirwere zvepabonde zvepabonde uye vaginal douching mumhomho yevasikana vanoita zvepabonde kuNairobi, Kenya." Zvirwere zvepabonde . August 2001, 77 (4): 271-275.
Wang, B ;; Li, X ;; Stanton, B ;; et al. "Vaginal douching, kushandiswa kwekondomu, uye zvirwere zvepabonde pakati peChinese vakadzi vanoita zvepabonde." Zvirwere zvepabonde . November 2005, 32 (11): 696-702.
Kasaro, M .; et al. "Kukanganisa kwehutano hwepabonde kupiwa hutachiona hwema microflora panguva yekubatana neHIV Prevention Trials Network microbicide muedzo HPTN 035." International Microbicides Conference; Sydney, Australia; April 17, 2012.
Brown, J .; et al. "Vaginal uye rectal douching uye kuiswa kwepamusoro pezvimwe zvinhu pakati pevakadzi muLos Angeles." International Microbicides Conference; Sydney, Australia; April 17, 2012.
Javanbakht, M .; Stahlman, S ;; Picket, J; et al. "Rectal Douching Patterns for Anal Sex." XIX International AIDS Conference; Washington, DC; 22-27 March 2012.
Koblin, B ;; Husnik, M .; Colfax, G .; et al. "Zvinhu zvinotyisa zvekutapukirwa kweHIV pakati pevarume vanoita zvepabonde nevarume." AIDS . March 21, 2006; 20 (5): 731-739.