Izvo zvinobatsira uye zvakanyanya zvepiritsi yekudzivirira HIV
Zvingangodaro zvisingashamisi zvishomanana kuti mukana wehutachiwana hutachiona hweHIV pakati pevanhu vakuru vanopfuura makore makumi mashanu hunokosha uye huri kukura. Nhasi inenge 21 muzana yehutachiwana hutachiona hweHIV huri pakati pevakwegura vakuru, iyo inenge yechina yeiyi ndeyevakwegura vane makore makumi matanhatu nemasere.
Kunyange mumwe angafungidzira kuti kufarirwa kwemarectile kudzvinyirira zvinodhaka seViagra kana Cialis ndiko kunokonzera huwandu hwehutachiona hwehuwandu, chokwadi chiri nyore ndechokuti, sevanhu, tinowanzofungidzira kuti vanhu vanopfuura makore makumi matanhatu nemakumi manomwe vasina hutano , uye kunyange zvakasimba, zvepabonde.
Uye izvi hazvisi chokwadi.
Sezvo zvakadaro, vanachiremba vanowanzokundikana kukurukura zvepabonde zvakachengeteka nevarwere vavo vakwegura kana kunyange kuvabvunza pamusoro pekuita kwavo zvepabonde. Mupi wekusagadzikana pamwe nemafungiro asina kunaka pamusoro pehutachiwana hweHIV kune vamwe vakwegura vanopedzisira vachisiya zvisingatauriki zvakanyanya.
Mumakore achangobva kupfuura, kuwanikwa kweHIV pre-exposure prophylaxis (PrEP) yakapa vanhu pangozi nzira dzokuzvidzivirira zviri nani kubva kune utachiona. Yakagamuchirwa neU.S. Food and Drug Administration muna 2012, iyo yaimbova-zuva rimwe nerimwe hurongwa hwepiritsi yakaratidzwa kuderedza dambudziko reHIV kune makumi mapfumbamwe nemazana 96 muzana mune vamwe vanhu vane ngozi yakawanda.
Kubva pane izvi, nhungamiro yemazuva ano kubva kuU.S. Public Health Services (USPHS) inokurudzira kuti munhu wese "ane ngozi yakawanda yehutachiona" inopiwa PrEP sechikamu chakakwana chekudzivirira HIV. Uye izvozvo zvinosanganisira vakwegura vakuru, pasinei nehupombwe, bondexual, kana ungochani.
Asi pasinei nekuedza kwehurumende kuwedzera kuwedzerwa kwePPR, vakawanda vakwegura vakaramba vasina chokwadi kana zvirizvo kwavari, kazhinji vachitaura nezvemishonga inodhura kana mutoro wekuchengetedza mishonga zuva nezuva sezvipingamupinyi zvinokosha. Vamwe, zvakadaro, vanotenda ivo pachavo vakachengetedzwa nemazvo nemakondomu kana nemabasa ekuita zvepabonde anofungidzirwa kuva edambudziko rakaderera.
Kune vamwe vachiripo, PREP ndiyo nzira yavanotenda inofanirwa kuyerwa zvakajeka uye pamunhu mumwechete, kuenzanisa zvingave zvingabatsira pamigumisiro.
Mutevedzeri weHIV Mibvunzo Mibvunzo EpEP Shandisa Vakwegura
Muhurukuro munyaya yaMay 2016 yeMurevereri , Stuart Sokol, ane makore makumi manomwe nemana, ane hutachiwana hweHIV asina hanya akashanda semutariri weNational AIDS Hotline uye Los Angeles County Commission pamusoro peHIV Health Services, akapa maonero ake sekuti vakuru uye PrEP vakanga vakakodzera kusanganiswa sevamwe vehutano vanoratidzira.
"Pasinei nemararamiro anoita kuti munhu atangotapukirwa awane kurapwa," akadaro Sokol, "tinoziva kuti zvinotora makore kubva pakatanga kuonekwa neHIV kusvika zviratidzo zvokutanga zvizvizivikanwe. Izvi zvinogona kuva nguva yakareba kubva pamakore masere kusvika kumakore gumi nemaviri, kana kunyange 15. "
"Mazuva iwayo aizondiisa mumakore angu makumi masere," Sokol akaenderera mberi, achiwedzera, "Zvechokwadi, dai ndaive mumakore angu makumi maviri, makumi matatu, makumi mana, makumi mashanu kana makumi matanhatu, ndinosvetuka pane mukana, asi mumakore angu makumi manomwe, ini handisi chokwadi. "
Sokol akawedzera kubvunzurudza kana vanhu vezera rake, avo vangangodaro vane zvinetso zvezvechiremba zvinoda nguva dzose check-ups uye mabhii ekuongorora, vangada kuzviisa kune dzimwe kuongororwa kweropa kuti vaongorore zvose zvehutachiwana hweHIV uye zvinogona kuitika pamigumisiro yemishonga.
Uye apo Medicaid uye hutano hwehutano inshuwarisi huchazadza PrEP mumishonga yavo yezvinodhaka, mari yekubhadhara pamwe uye zvigadziriswa zvingangove zvisingabvumirwi kune vamwe.
Sokol akataurawo kushayikwa kwezivo pakati pevanachiremba sezvinetso zvinotarisana nevazhinji vanoda ruzivo pamusoro pezvipo zvePPR uye zvipingamupinyi.
"Handizvo chiremba wangu mukuru wekuchengetedza kana chiremba wangu weruzivo akanga achiuya pamusoro pemafungiro avo (pamusoro pePrEP)," akadaro Sokol. "Vanga vanyevera nezvemigumisiro kana kuti vanoratidzira kliniki yeHIV."
Kutsvakurudza kunobatsira kutsigira kuda kweSokol. Muna 2015, Central Centers for Disease Control and Prevention (CDC) yakashuma kuti 34 muzana yevashandi vehutano hwepabonde muUnited States vakanga vasina kumbonzwa nezvePPR.
Paya avo vakaita, vazhinji vakataura varwere kune vanyori vanoziva pasinei nekuedza kweCDC ne USPHS kuti vaone vanachiremba kuti PrEP vanogona-uye vanofanirwa-kutarisirwa mukati memakore ekutarisira.
Kunyangwe pakati pehutachiona hweHIV, kune zvimwe zvisingatauriki kuisa PPR pane varwere, uye vane 17 muzana chete vanorondedzerwa pavakarayira mishonga.
(Kazhinji, mutengi anowanikwa muUnited States anoramba akazvininipisa, uye mamwe mazano anoratidza kuti pakati pe 22,000 ne25,000 veAmerica zvingave zviripo kuPrEP.)
Nharo muKutsigira kwePrEP muVakuru
Pasinei nekuwandisa zviyero, kushandiswa kwePPR kwaive kwakapetwa kanomwe pakati pevanhu vari pakati pekupedzisira-makumi masere-kusvika kune avo vari mumakore avo makumi maviri, vachiratidza kuti kukwegura (pamwe nemari, mafungiro, uye ruzivo rwakanyanya rwehutano hwekuchengetedza huzhinji) hwakapiwa zvishoma zvipingamupinyi zvekurapa.
Vatsigiri vePrEP vanowedzera pfungwa dzepabonde nemitoo inogona kuisa vazhinji vakwegura pamatambudziko makuru ehutachiona. Pakati pezvinetso:
- Kutsvakurudza kunoratidza kuti vazhinji vanomwe-mu-vashanu vakura vanopfuura makore makumi mashanu vanopinda mukutengesa kwakawanda se x , vangave vakafanirwa kana vaginhi.
- Kushandisa kondomu kunowedzera kuderera apo mumwe achikura, kubva pa24 muzana kune vanhu vane makore 50 kusvika ku 59 kusvika zvishoma ne17 muzana kune vanhu vane makore 60 kusvika ku69.
- 62 muzana yevarume uye 78 muzana yevakadzi havana kumbokurukura nezvehutano hwavo hwepabonde nechiremba kubva pakutendeuka 50.
- Tsvakurudzo dzinoverengeka dzakaratidza kuti varume vakwegura kakawanda havashandisi makondomu nekuda kwekusakwanisa kuchengeta erection.
- Uyezve, vakadzi vakawanda vakwegura vane HIV vanotenda kuti ivo kana ivo vane HIV havana kukodzera vanoda kondomu nekuti ivo vanotevera-menopausal.
Kudzivisa hutachiona hunova kunyanya kukosha kune vakwegura vakuru vakapa huwandu hwakanyanya hwehutano hwehutano huripo kana huchienzaniswa nevanhu vaduku. Uyezve, vatsva vane utachiona hwepakutanga vane huwandu hwakaderera hweCD4 panguva yekuongororwa, uyewo kuva neCD4 inowedzera-ichipa kukurumidza kufambira mberi kwezvirwere .
Utachiona hweHIV hunogonawo kuva hwakaoma kune vakwegura vakuru sezvavanenge vachida kurapwa kune mamwe mamiriro ezvinhu akadai soutachiona hwepamusoro, chirwere chemwoyo, zvirwere zvepapu, uye chirwere cheshuga. Izvi zvinoshandura kune njodzi yakakwirira yekubatana kwezvinodhaka-zvinodhaka , uyewo zvinetso zvine chokuita nekurapa zvirongwa uye kushandiswa kwemishonga.
Pamwe chete, nyaya idzi dzose dzinotsigira kushandiswa kwePrEP, kana kuti kungodzivisa zvinetso zvehutachiona uye kurapwa kune vakwegura vakuru.
Kuita Sarudzo Yakanaka Kwauri
Zvichida PrEP ndiyo yakakodzera kwauri chimwe chinhu iwe uye chiremba wako unoda kusarudza pamunhu mumwechete, nekujekesa zvizere zvose zviri nani uye zvinoshandiswa zvekushandisa zvichienderana nemamiriro ako ega uye pangozi. Chaizvoizvo hachisi icho chimiro chimwe chete-chinokodzera-yose mhinduro.
Inofanirawo kurangarirwa kuti PrEP haisati yafanirwa kuva chigadziro chega-chega. Makondomu, kuderedzwa kwevanhu vanoita zvepabonde, uye kushandiswa kwemishonga inorwisa mabhakitiriya muhutachiwana hweHIV kunofanira kuongororwa sechikamu chekubatanidza nzira yekudzivirira.
"Ndinoda pfungwa yokuti kune mhinduro dzinogona kushanda," akadaro Sokol. "Ini ndiri zana muzana yeiyo asi ini ndinofanira kufunga kana (PrEP) yakarurama kwandiri."
Pakupedzisira, ichisarudzo chega-yakagadzirwa nemashoko akazara, asingasaruri-ayo achaona kana PrEP isarudzo yakanaka kwauri. Taurirana nachiremba wako kana taura nharaunda yako yeAIDS yeharaunda kuti uwane mamwe mashoko kana kutumira kune unyanzvi uri pedyo newe.
Sources:
Ipai, R. "Kuparadzirwa kwePPREP Innovations." 10th International Conference pamusoro peHIV Kuchengetedza nekudzivirira Kutsigira. Paris, France; October 2015; slide presentation.
US Public Health Service (PHS). "Preexposure Prophylaxis yekudzivirira hutachiona hweHIV muUnited States - 2014: A Guideline Practice Guideline." Washington, DC; yakabudiswa musi waMay 14, 2014;
Castel, A .; Kufamba, D .; Tang, W .; et al. "Kunzwisisa hutachiwana hwekutarisira utachiona Maonero pamusoro pechinangwa chekupa PrEP." Nhoroondo yeAkawana Immune Deficiency Syndrome. 2015; 70 (5): 520-528.
Pillowsky, D. uye Wu, L. "Zvinetso zvepabonde zvekuita zvepabonde nehutachiwana hweHIV pakati pevanhu veAmerica vane makore makumi mashanu nekure: kuongorora." Kudhakwa Kwemishonga Kuvandudza. 2015; 6: 51-60.
Guaraldi, G; Zona S, Hama, T ;; Stentareli C, et al. "Kukwegura neHIV nehutachiona hwehutachiwana hweHIV pazera remakore mazhinji: huwandu hwakasiyana nehuwandu hwakawanda huri huwandu hwemaprofiles." PLoS One. April 2015; 10: e0118531.