Ukuchonga izithintelo zokusetyenziswa kwe-PrEP
Kuye waboniswa ukuba ukusetyenziswa kwansuku zonke kweyeza-antiretroviral, iTruvada , kunokunciphisa kakhulu umngcipheko wokusuleleka kubantu abanentsholongwane kaGawulayo kwimeko enobudlelwane be-serodiscordant (okt, apho iqabane elinye linentsholongwane kaGawulayo kwaye enye ingenayo i-HIV). Isicwangciso, esibizwa ngokuba yi- pre-exposure prophylaxis (okanye i-PrEP) , siye saboniswa ukunciphisa umngcipheko wokusasazeka ngamanye amaphesenti angama-62 ukuya kuma-75 ekhulwini xa kuthathwa ngokunamathela ngokungaguqukiyo.
Ukusuka kwimbono yokubala, amanani axhasa ngokusetyenziswa kwe-PrEP njengenxalenye yesicwangciso sokukhusela i-HIV. Nangona kunjalo, ukusuka kwindlela yokuphila kwangempela, amanani angenakho konke okukholisayo, ngamagama athi "ahambelanayo" kwaye "angaphazamiseki" abonisa iingxaki ezinokuthi bangabhalela.
Enyanisweni, ngokubhekiselele kuphando lwezoshishino, abantu aba-1 774 kuphela baseU.S. bazalise imiyalelo yeTruvada ye-PrEP phakathi kukaJanuwari 2011 no-Matshi 2013. NgoJulayi 2016, elo nani lakhulile lifikelela kuma-76,000. Lo usengumntu othobekileyo othobekileyo wanikezelwa ukuba izifo ezingama-50 ezintsha ze-HIV ziqikelelwa ukuba zenzeke e-US njalo ngonyaka.
Amanani abangela ukukhanya kwimiba emininzi eyenza i-PrEP ibe yindawo ekucwangciseni uphando, kodwa kuncinci xa ifakwa kwiimeko zehlabathi langempela. Kwaye akukona nje umcimbi wemfundo okanye ukuqonda (nangona ezi zinto ziphambili). Kucacile ukuba kukho enye into eyenziwa.
Impembelelo yexabiso kunye nokuxhomekeka
Uphando olwenziwe ngo-2012 olwenziwa ngamaziko e-United States for Control and Prevention (CDC) e-United States lugqiba ukuba ngaphezu kweyesithathu kwabemi baseMerika kwi- antiretroviral therapy (ART) abakwazi ukugcina ukunyanzeliswa kwezidakamizwa rhoqo- kwaye oku kubantu abanentsholongwane kaGawulayo apho kubambelela khona ihambelana ngqo nomyinge kunye nomgangatho wobomi.
Ngaba sinokulindela ukuba izithintelo zingabi ngaphantsi kubantu abathatha i-ART kungekhona "ukusinda" ngeyona, kodwa ukukhusela i-HIV? Emva koko, ngelixa iikhondom ziyaziwa ngokubonelela ngokukhuseleka ngakumbi, amanani abonisa ukuba asetyenziswe kwizinto ezimbini zesini kuphela.
Ngoko xa abanye bebuza, "Kunzima kangakanani ukuthatha ipilisi encinane ngosuku?", Uphando oluninzi lubonisa ukuba ukunamathela kwimihla ngemihla kungabangela ukukhawuleza. Cinga ukuba imithi engapheliyo yesifo sikashukela okanye isifo senhliziyo sidinga ukuthobela i-70 ekhulwini (okanye ukulingana kwezilwanyana ezithandathu ezingekhoyo ngenyanga). Ngokwahlukileyo, i-PrEP ifuna ukulandelelana ngokugqibeleleyo ukwenzela ukufezekisa iinjongo zokukhusela.
Izifundo eziliqela zakutshanje ziqinisekisa imingeni. Ngo-2013, iSifundo se-VOICE-esibheke ukusetyenziswa kwe-PrEP phakathi kwama-5,029, abasetyhini be-Afrika basetyhini-yabonakaliswa ngento engenamsebenzi xa kuboniswa ukuba iipesenti ezingama-30 kuphela zaziyokwazi ukugcina unyango lwemihla ngemihla. Iziphumo ezifanayo zibonwe kwi-FEM-PrEP Study, eye yacinywa ngenxa yezinga eliphantsi lokunamathela phakathi kwabo bathatha iTruvada imihla ngemihla.
Ngenxa yezi zifundo kunye namanani angaphantsi-okulindelekileyo kubhaliso be-PrEP, kugxininiswa ngakumbi kunokuba kufuneke ukuba kufakwe kwimfundo ejoliswe kuyo, apho abantu abasenkundleni ye-serodiscordant ( kubandakanywa nalabo abafuna ukukhulelwa ) bayacetyiswa malunga ne-PrEP njengenkqubo yentsapho jikelele ukuziqhelanisa, kungekhona nje kwiindawo ezikhethekileyo zeHIV.
Abenzi bomgaqo-nkqubo bangaphinda bafune ukuvavanya ukuba iindleko ze-PrEP, eziqikelelwa ukuba zijikeleze i-$ 12,000 ngonyaka, inokuba yinto enqandekayo kulabo abanezicwangciso ze-inshorensi ezingagqibekanga ngokupheleleyo ukusetyenziswa kwazo.
Kuphando lwe-2013 lweengcali ze-US kunye neCanada ezithathelwanayo, izifo ezingama-74 zaxhasa ukusetyenziswa kwe-PrEP ngokubanzi. Nangona kunjalo, kweli qela, kuphela i-9% kuphela eyayiyibeke kwizigulane.
Kuthemba ukuba iingcebiso ezenziwe yi-CDC ngo-Meyi 2014, ukubiza ukuba ukusetshenziswa kwe-PrEP kubantu abakujongene nomngcipheko ophezulu wokusuleleka, kuya kukwandisa ukubhaliswa kwamaqela e-US okujoliswe yiCDC kubandakanya:
- Amadoda abelana ngesondo kunye namadoda (MSM) abangasebenzisi iikhondom ;
- Abantu abangenayo i-HIV abahlala belala ngesondo nomntu onentsholongwane kaGawulayo;
- abasebenzisi beziyobisi (ii-IDU), kunye;
- abantu abalala ngesondo kunye nabalingani abasemngciphekweni.
Imithombo:
Rawlings K, Mera R, Pechonkina A, et al. "Isimo seTruvada ye-HIV ngaphambi kokusasazeka kweprophylaxis (PrEP) e-United States: uhlalutyo lokusetyenziswa kweziyobisi zangaphambili." INgqungquthela ye-ICAAC yeNkcazo ye-53 kwiNkundla ye-Antimicrobial Agents kunye ne-Chemotherapy; Denver, Colorado; NgoSeptemba 10-13, 2013; H-663a.
Amaziko e-US for Control and Prevention (CDC) yeZifo. "I-CDC Fact Sheet | I- HIV e-United States : Amanyathelo okuNakekela." Atlanta, Georgia; epapashwe ngoJulayi 2012.
Anderson, J. "Ukusetyenziswa kweCondom kunye neengozi zeHIV phakathi kwabantu base-US." I-American Journal yeMpilo kaRhulumente. Juni 2003; 93 (6): 912-914.
I-Microbicides Trial Network (MTN). Isitatimende se-MTN ngesigqibo sokuNqanda ukusetyenziswa kweziTemon ze-Tenofovir zomlomo kwi-VOICE, iSifundo esiKhulu sokuCandwa kweNtsholongwane ka-HIV. " Ukhuphelo olukhutshwa nguSeptemba 28, 2011.
Isiko seSizwe soMbane kunye nezifo ezithatheleneyo (iNIAID). "I-FEM-PrEP Ukhuselo lwe-HIV kunye neempembelelo zayo kwi-NIAID Research." EBethesda, eMaryn; ukukhutshwa kwenkxaso ekhutshwa ngo-Apreli 18, 2011