Ukunciphiselwa ingozi kwi-Sexual Sexual and Same-Sex Couples
Umngcipheko weNTSHOLONGWANE NGEZIVIVANE NGEZITHOMBE NGEZITHOMBE ZONYAKA ZI-HIV ZONYAKA ZONYAKA ZONYAKA. Izizathu zengozi eyongeziweyo ziyaziwa kwaye ziquka izinto ezinjengoku:
- Ukuxakeka kwamathambo e-rectal, okwenza ukuba intsholongwane ibe nokufikelela ngokuthe ngqo kwigazi ngenxa yezinyembezi ezincinane okanye iinyembezi.
- Ukuxhamla kwezicubu ezinama-rectal kunye nokuphakama kwawo kufikeleleke ekubeni usuleleke nangona ungakhange uhlalutye.
- Uxinzelelo olusenyongweni lwe-HIV kwimbilini kunye nokuhamba phambili komzimba ("pre-cum"), enokuziphinda kabini umngcipheko wokusuleleka kwi-log log (ie, idijithi enye) ukunyuka komthwalo wentsholongwane yomntu.
Ukongezelela, ukukhutshwa kwegazi kumathambo omonakalo okonakalisiweyo kunokunyusa umngcipheko wokufakelwa ("phezulu") iqabane, ukunika intsholongwane indlela yokudluliselwa nge-urethra kunye nezicubu ezihamba ngentloko yepenis (ngokukodwa phantsi kwebhuba).
Ukuvavanya ingozi ye-HIV "Ngomthetho ngamnye" kunye ne "Per Partnerner"
Kuphononongo lwabo lwezifundo ezili-16 ezahlukeneyo eziphambili, abaphandi kwi-Imperial College kunye neLondon School of Hygiene kunye neTransic Medicine bagqiba ukuba isenzo sobungozi besandulela ngculazi nge-condom-engaphantsi kwesini esasifanelekileyo ngokwesondo sasingama-1.4 ekhulwini ukufumana (" ezantsi ") iqabane.
Nangona inqanaba lomngcipheko lingazange libonwe litshintshe ngokuzibandakanya ngokwesondo, nokuba ngaba ngabafazi okanye abantu abalala ngesondo kunye nabesilisa (MSM) , ubungozi babonakala banda kakhulu xa umlingani obengenalukanga (engama-0.62 ekhulwini angalukanga kunye nama-0.11 ekhulwini asokile) .
Ngokuthelekiswa, umngcipheko womlingane- apho umntu onentsholongwane kaGawulayo ebudlelwaneni obukhethekileyo kunye nomlingane ongenagciwane le-HIV wenza umfanekiso ocacileyo kubo bobabini abathobelayo nabamkelekileyo.
Izifundo ezilishumi zihlaziywe kuphela phakathi kwe-MSM kwaye azibandakanyi ubude bobudlelwane okanye ubude bekhondomu engaphantsi kwesini.
Uhlalutyo lweedatha lukwazi ukubonisa ukuba:
- amaqabane asebenzisana ngesondo lesibini esamkelekileyo kunye nokufaka ingqumbo ngaphandle kokuba ikhondom zineengozi yokusasaza kwi-39.9 yeepesenti.
- Umlingane ongenagciwane lengculaza owenzela kuphela ngesondo sangasese engangenayo ngaphandle kokuba ikhondom ibe neengcipheko ze-summary ye-21.7 ekhulwini, ngelixa i-partner-negative negative partner inomngcipheko we-40.4%.
(Nangona iziphumo zohlalutyo lweemeta ziphoqeleka, kubalulekile ukuqaphela ukuba imodeli eyahlukileyo yezifundo ezihlaziyiweyo zishiye indawo yokuchazwa.)
Isicwangciso sokunciphisa ingozi yeHIV kwi-Sex Anal
Njengoko nayiphi na enye indlela yokudluliselwa kwe-HIV , ukuthintela kufuna ukuhlanganiswa kwezicwangciso ukuphumelela ngakumbi:
- Ukunciphisa ukutshatyalaliswa komlingani we-HIV.
- Ukunciphisa ubunzima beqabane elingenayo i-HIV.
- Ukuthintela i-HIV yokudibanisa neeseli kunye nezicubu ezinobungozi.
Ukusetyenziswa kwe- antiretroviral therapy (i-ART) kumlingane osuleleke nge-HIV uyaziwa ngokunciphisa kakhulu umngcipheko wokusasazeka xa umsebenzi wentsholongwane uphephelwa ngokupheleleyo kwaye uhlale unqandekile kumanqanaba angabonakaliyo. Isicwangciso, esaziwa ngokuba yiNyango njengoThintelo (iTraP) , siye saboniswa ukunciphisa umngcipheko we-HIV malunga no-96% ekwakheni ubuhlobo obuxubileyo (ubudlelwane).
Okwangoku, ukusetyenziswa kwe- pre-exposure prophylaxis (PrEP) -ngokuba umlingani ongakhuselekanga umiselwe umthamo wansuku zonke we-HIV drug Truvada- eyaziwayo ukunciphisa umngcipheko phakathi naphakathi kwama-44 ekhulwini kunye nama-75 ekhulwini.
Ukusetyenziswa ngokufanelekileyo nokufanelekileyo kweikhondom kubonakala kubalulekile ekukhuseleni intsholongwane kaGawulayo, kunye namaziko ase-United States okuLawula ukuLawula nokuKhusela ingxelo ukuba ukusetyenziswa rhoqo kweikhondom kunokuthintela ukuthunyelwa kwabangama-7 kwabangama-10. (Le ngxelo enye yagqitywa ukuba kuphela i-MSM enye-ezintandathu ivakalise ukusetshenziswa kwekhondomu.)
Idata ngokubanzi isekela ukusetyenziswa okuhlangeneyo kwe-TasP, PrEP, kunye neikhondom njengendlela efanelekileyo yokunciphisa ingozi ye-HIV, kubini abalingani bobulili obufanayo kunye nabakwa-MSM bahlanganyela kwisini esasinileyo.
Ngokwahlukileyo, ubulili obungaphantsi kwekhondom abukacetyiswa, nangona ukuba zombini i-TasP kunye ne-PrEP zisetyenziselwa, njengoko kunokubakho ubuncipheko bexesha elide kwizibini ezitshatileyo.
UkuLawulwa ngengozi kunye noTyala loSondo
Ukuba ukholelwa ukuba uye waveleleka kwi-HIV, mhlawumbi ngokusebenzisa ikhondom yokuqhawula ngesondo ngokungathandanga, kukho imishanguzo enokunciphisa kakhulu ingozi yokusuleleka ekuthiwa yi-post-exposure prophylaxis (PEP).
I-PEP iqukethe iikhosi ezingama-28 zezidakamizwa zokulwa ne-antiretroviral, ekufuneka zithathwe ngokupheleleyo kwaye zingaphazamiseki. Ukuze kunciphise umngcipheko wosulelo, i-PEP kufuneka iqaliswe ngokukhawuleza kunokwenzeka - ngokufanelekileyo kwiiyure ezingama-36 ukuya kufumaneka .
Imithombo:
Baggaley, R .; White, R .; kunye noBuily, C. "Ukutshatyalaliswa kweengcipheko ngeHIV nge-intercours ye-anal e: ukuhlaziywa ngendlela echanekileyo, ukuhlaziywa kwemeta kunye nefuthe lokukhusela i-HIV." International Journal of Epidemiology . Agasti 2010; 39 (4): 1048-1063.
Cohen, M .; Chen, Y; McCauley, M .; okqhubekayo. "Ukuthintela usulelo lwe-HIV-1 ngonyango lokuqala lwe-antiretroviral." I-New England Journal of Medicine. Agasti 11, 2011; 365 (6): 493-505.
Isibonelelo, uR .; Lama, J; Anderson, P .; okqhubekayo. "I-Preexposure Chemoprophylaxis yokukhusela i-HIV kubantu abalala ngesondo nabantu." I-New England Journal of Medicine. Disemba 30, 2010; 363 (27): 2587-2599.
Baeten, J; Donnell, D .; Ndase, P .; okqhubekayo. "I-Antiretroviral Prophylaxis yokukhusela i-HIV kuMadoda kunye nabasetyhini." I-New England Journal of Medicine. Agasti 2, 2012; 367 (5): 399-410.
Supervie, V .; Viard, J; Costagliola, D .; okqhubekayo. "Umngcipheko wokuxhatshazwa ngentsholongwane kaGawulayo ngokwesenzo ngasinye ngokwesondo phantsi kwe-antiretroviral yiphilisi yokhuphayo: ukuhlaziywa kwesistim kunye ne-Bayesian modeling". Izifo ezithathelwanayo zonyango. Epreli 19, 2014; pii: ciu223 [i-Epub ngaphambi kokuprinta].