Isizathu sokuba Sisebenzise Ixesha kunye nendlela eLawula ngayo imizamo yokuthintela
Amadoda abelana ngesondo kunye namadoda (i-MSM) ligama elisetyenziselwa ukuhlukanisa abantu abenza umsebenzi wesondo kunye nabanye abesilisa, kungakhathaliseki ukuba bazichaza njani. Eli thuba lenziwe ngama-1990s ngabadlali besifo se-epidemiologist njengethuluzi lokubheka ukuqwalasela ngakumbi indlela yokudluliselwa kwe-HIV kunye nokusasazeka kwesi sifo ngokusebenzisa umsebenzi wesini wesilisa.
Ngaphambi koku, abaphandi bancitshiswa ngokuhlalutya-ngokusekelwe kwimiba-apho amadoda awathatyathwa ngokuthi "gay" okanye "abesini ngokwesini" awazange asebenze ngokwesondo, ngelixa abo "bachanekileyo" bangabelana ngesondo kunye namanye amadoda.
I-MSM kunoko igxininise ekuziphatheni kunokuba zizenzele iinkcukacha zentlalo okanye zentlalo ngokubonelela ngokucacileyo umfanekiso we- HIV . Oko, ngokubhekiselele, kusinikwa ukuqonda okungcono imiphumo yokukhusela i-HIV, kubandakanywa naziphi izixhobo zokukhusela ezisetyenziswayo.
Izifundo ziyahluka ngommandla kunye nenkcubeko, kodwa uphando oluqhutywe yiSebe lezeMpilo leNtsholongwane yaseNew York lityhila ukuba kuma-4,200 amadoda axoxwa ngefowuni:
- Phantse omnye kwabayishumi abaye bachonga ngokuchanekileyo balala ngesondo kuphela namanye amadoda.
- Amaphesenti angama-70 amadoda athile abatshatileyo abachongekileyo ababandakanyeka kwizinto zesini zesini kwindoda ngexesha elinye.
- Amaphesenti angama-10 amadoda athile abatshatiweyo abachongileyo baxelele ukuziphatha ngokobulili obufanayo ngexesha leenyanga ezili-12 ezidlulileyo
Izibalo ze-HIV phakathi kwe-MSM e-US
Ngexa i-MSM ibonisa kuphela ipesenti ezimbini ze-United States, njengabantu abaninzi bayabelana ngamaphesenti angama-55 abo bonke abane-HIV.
Ngokutsho kweZiko loLawulo lokuLawula kunye nokuVikela (i-CDC), ukuba umgangatho oqhubekayo uqhubeka uninzi kwi-MSM yesithandathu iya kuhlaselwa yi-HIV ngexesha lokuphila. Iimbono zibonakala zibuhlungu ngakumbi kwi-African American MSM, ngokucaciswa kwangoku kubonisa ukuba kukho i- 50% engozi yokuphila kwengozi yokufumana i-HIV .
Ngohlolo lwawo lwe-2014, ii-CDC ziqwalasele ukungafani okuphambili kwi-HIV kwi-MSM:
- I-MSM imele iipesenti ezingama-67 zazo zonke iintsholongwane zentsholongwane kaGawulayo kunye neepesenti ezingama-83 zezifo ezintsha zokuxilonga phakathi kwamadoda 13 nangaphezulu.
- I-MSM eselula phakathi kweminyaka engama-13 no-24 kumngcipheko omkhulu, ukubalwa kwama-92 ekhulwini kuwo onke ama-infections amasha phakathi kwamadoda.
- Iirhafu ze-HIV phakathi kwe-Hispanics / iLatinos zixhalabele. Ngoxa i-HIV entsha kunye ne-Afrika yaseMelika i-MSM sele ihlambuluke (phantsi kweepesenti ezithandathu kunye neepesenti ezimbini, ngokulandelana, ukususela ngo-2010), amaxabiso phakathi kwamaSpanishi / i-Latino MSM anyukile ngama-13 ekhulwini.
- Namhlanje, kuqikelelwa ukuba yi-687,000 MSM ene-HIV e-US Kula manqaku, iipesenti ezingama-15 zihlala zingekho.
- Phakathi kwabo bafumene i-HIV, kuphela i-57 ekhulwini ixhomekeke kwiinkathalo ezithile ze-HIV ezingaphezu konyaka emva kokuxilongwa, ngelixa i-58 kuphela ekhulwini kwi-HIV yonyango yayingakwazi ukugcina imithwalo engenakubonakalayo yentsholongwane yentsholongwane .
Ezi nani-manani zivumelanisa, kwinqanaba elithile, neengculaza kwiindawo ezithile zehlabathi. Nangona iziganeko ze-HIV (inani lezonyango ezenzeka kwithuba elithile) lingaba phezulu kumazwe athile, ukuxhaphaka kwe-HIV (isabelo sabemi abachaphazelekayo) phantse phezulu kwi-MSM.
Ucwaningo lwe-Epidemiological luye lwaphakamisa ukuba ukuxhaphaka kwe-HIV phakathi kwe-MSM kuphakathi kwamanqanaba amathathu nantandathu kwiMiddle East, iYurophu, iMpuma kunye ne-Central Asia, kunye ne-Oceanic, kwaye naphi na ukusukela kuma-15 ukuya kuma-25 aphindaphindiweyo kuma-Afrika ase-Afrika ase-Sahara, eCentral America. , EMzantsi Melika, naseMzantsi nasezantsi-mpuma ye-Asia.
Uphando lwe-Epidemiological Ulwazisa njani ukukhusela i-HIV kwi-MSM
Injongo yocwaningo lwe-epidemiological kukubonelela ngokungakhangekanga kwindlela isifo esasasazeka ngayo kwaye kungekhona "ophetheyo" wokudluliselwa. Ngaloo ndlela, kusenza sikwazi ukusebenzisa izicwangciso zokuthintela ngaphandle kokugweba kwaye (ngokufanelekileyo) ngaphandle kweempembelelo zezopolitiko okanye zokuziphatha.
Omnye umzekelo ukusetyenziswa kwe- HIV ngaphambi kokuchaswa kweprophylaxis (PrEP) kwi-MSM. Isicwangciso, apho ukusetyenziswa kwansuku zonke kweTruvada (tenofovir + emtricitabine) kunokunciphisa ithuba lomntu lokufumana i-HIV ngamaphesenti angaphezu kwe-90 okanye ngaphezulu, kuye kwafundwa ngokubanzi kwi-MSM ukubona apho kuya kusebenza khona. Ngaloo ndlela, i-PrEP ayilunyanzelwanga kuwo wonke ama-MSM kodwa ke kulabo abasengozini enkulu yokusuleleka.
Ngoba? Njengesiqhinga, i-PrEP idinga ukulandelwa kwansuku zonke ukuba amadoda amaninzi akakwazi ukugcina. Ngaloo ndlela, abaphandi banentshiseko yokuba ukunganyangeki kweziyobisi kungahlawuleka ngokungenasiphelo kwi-MSM othe wayenayo enye indlela yokuzikhusela. Oku, kunye neendleko zonyango kunye nempembelelo yecala, lenze i-PrEP njengesixhobo esibalulekileyo kumaqela angaphantsi ukuba abe nezinye iindlela zokuzikhusela.
Ezi zibandakanya i-Gay okanye i-MSM yobundlobongela abangaxhatshazwa kwiindawo zabo kwaye bayesaba ukudalulwa koqhelwano lwabo ngokwesondo. Ingabandakanya kwakhona i-MSM encinane (ekubeni ulutsha ngokubanzi luyakwazi ukusebenzisa iikhondom) kunye nabasebenzisi beziyobisi abangekho mthethweni abasemngciphekweni.
Uphando lwe-PrEP kwi-MSM enobungozi obuninzi uye wathatha indlela "yehlabathi lenene", ukuvavanya indlela abantu abesilisa nabasemlonyeni abaziphatha ngayo kunokuba bazama ukutshintsha nje ukuziphatha kwabo. Ngokwenza njalo, izixhobo zokuthintela njenge-PrEP zizinzileyo. Oku ke, kuqinisekisa ukuba imizamo yokukhusela ibeka ngokucacileyo apho iza kuba nenzuzo enkulu.
Imithombo:
> Pathela, P .; Hajat, A .; Schillinger, J .; okqhubekayo. "Ukuhlukana phakathi koBuchule boBuchule kunye noLwazi oluzimeleyo loLwabiwo loLuntu: I-Survey Based Survey yaseNew York City Men." Amanqaku angamayeza angaphakathi. NgoSeptemba 19, 2009; 145 (6): 416-425.
> Amacandelo okuLawula nokuLawula izifo. "Ingozi yokuphila kweNtsholongwane kaGawulayo e-United States." Atlanta, Georgia; papashwa ngoFebhuwari 23, 2016.
> Beyrer, C .; Baral, S; van Griensven, F .; okqhubekayo. "I-epidemiology yehlabathi jikelele yesifo se-HIV kumadoda alala namadoda." Lancet. Julayi 28, 2012; 380 (9839): 367-377.