I-pros and cons of the pill pilill
Kuyakumangalisa ukuba bambalwa ukuba inani le-HIV elitsha kubantu abadala abangaphezu kweminyaka engama-50 luphawuleka kwaye lukhula. Namhlanje ama-21 ekhulwini kubo bonke abatsha baxilongo be-HIV baphakathi kwabantu abadala, apho iinekota zazo ziphakathi kwabadala abaneminyaka engama-60 nangaphezulu.
Nangona umntu unokucinga ukuba ukuthandwa kwezidakamizwa ze-erectile ezifana ne-Viagra okanye i-Cialis kubangela ukuba kubekho amazinga atshintsho aphezulu, into elula kukuba thina, njengentlalo, sinokucinga ukuba abantu abangaphezu kweminyaka engama-60 no-70 abanakho impilo , kunye nokuphila okunesondo,
Kwaye akucaci ukuba kunjalo.
Ngaloo ndlela, oogqirha bahlala behluleka ukuxoxa ngesondo ngokukhuselekileyo kunye nezigulane zabo ezikhulileyo okanye baze bazibuze ngezinto zabo zesondo. Umncedisi ongenakulinganiswa kunye neengcamango ezingalunganga malunga nomngcipheko we-HIV kubantu abadala abadala baphela ekuphumeni okukhulu.
Kwiminyaka yakutshanje, ukufumaneka kwe- HIV ngaphambi kokusasazeka kweprophylaxis (i-PrEP) kuye kwanikezela umngcipheko abantu ithuba lokuzikhusela kangcono kwi-HIV. Ukuvunyelwa yi-US Food Administration and Drug Administration ngo-2012, isicwangciso sepilisi esisodwa sosuku luye lwaboniswa ukunciphisa umngcipheko we-HIV ngama-96 ekhulwini kwiphepha elithile labakho bungozi.
Ngokusekelwe kulo, ukhokelo olukhoyo oluvela kwiiNkonzo zoLuntu zezeMpilo zase-US (USPHS) lincoma ukuba nayiphi na umntu "onobungozi obukhulu bokungenwa sulelo" anikezelwe i-PrEP njengenxalenye yesicwangciso esiphezulu sokukhusela i-HIV. Kwaye kubandakanya abantu abadala, nokuba ngabafazi besini, abantu besini okanye abantu besini.
Nangona naphezu kwemizamo karhulumente yokwandisa iPEPEP, abaninzi abantu abadala abadala bayahlala beqiniseke ukuba ngaba kunjalo, bahlala bekhankanya iindleko zonyango okanye umthwalo wokunyanzelisa iziyobisi njengemiqobo ebalulekileyo. Abanye, okwangoku, bakholelwa ngokwabo ngokwaneleyo ngokukhuselwa ngamakhondom okanye ngemisebenzi yezesondo ebonwa njengengozi ephantsi.
Kwabanye banjalo, i-PrEP iyona khetho abakholelwa ukuba kufuneka ilinganwe ngokuchanekileyo nangomntu ngamnye, ukulinganisa izibonelelo ezinokubakho kwimiphumo emihle.
Ummeli weNtsholongwane kaGawulayo Imibuzo PrEP Ukusetyenziswa kwabasebekhulile
Ngomxholo weMeyi 2016 ummeli we- Advocate , uStuart Sokol, oneminyaka engama-71 ubudala, ongu-gay indoda engumntu ongeNtsholongwane kaGawulayo owayengumgadi wesibini kwi-National AIDS Hotline kunye neKhomishini yaseLos Angeles County kwiNkonzo zezeMpilo ze-HIV. ukuba ngaba abadala kunye ne-PrEP bafanelekile umxube njengoko amanye amagosa ezempilo atyhola.
"Nangona uqeqesho lwangoku ufumana unyango olutsha," wathi uSokol, "siyazi ukuba kuthatha iminyaka ukususela ekuqaleni kokungena kwi-HIV kude kube yilapho iimpawu zokuqala zenza ukuba ziziwe. okanye 15. "
"Le mihla iya kundibeka kuma-80s," u-Sokol waqhubeka, wongezelela esithi, "Ngokuqinisekileyo, ukuba ndibe ngama-20s, i-30s, i-40s, i-50 okanye i-60, ndiza kugxuma ngeli thuba, qi niseka. "
U-Sokol waphinde wabuza ukuba ngaba abantu beqela lakhe elidala, abanokuthi babe neengxaki zezokwelapha ezifuna ukuhlolwa rhoqo kunye neemvavanyo zelabhu, baya kukulungele ukungenisa iimvavanyo zegazi ezongezelelweyo ukubeka esweni isimo sabo se-HIV kunye nemiphumo emibi yeziyobisi.
Nangona i-Medicaid kunye nemigaqo-nkqubo ye-inshorensi yempilo yayiza kubandakanya i-PrEP kwiimfomula zamachiza, iintlawulo zentsebenziswano kunye nezithintelo zodwa zingavumelekanga kwabanye.
U-Sokol uphinde uchaze ukungabikho kolwazi phakathi kweekliniki njengeengxaki ezijongene nabaninzi abaneemfuno malunga neenzuzo ze-PrEP kunye neengxaki.
"Andiyena ugqirha wam osisiseko kunye ne-urologist yam ezayo malunga neengcamango zabo (malunga ne-PrEP)," watsho uSokol. "Baye balumkisa malunga nemiphumo emibi okanye bacetyiswa ngekliniki ye-HIV."
Uphando luya kuxhasa inkxaso kaSokol. Ngo-2015, amaziko okuLawula nokuVikela (iCCDC) athi ama-34 ekhulwini labanikezeli bempilo bonyango base-US babengakaze bave nge-PrEP.
Kulabo babenzayo, abaninzi babhekisela kwizigulane kwiingcali zonyango nangona zinzame zeCDC kunye ne-USPHS ukuqinisekisa oogqirha ukuba ukunakekelwa kwe-PrEP-kwaye kufuneka kulawulwe ngaphaya kwexesha lokunakekelwa kweprayimari.
Ngaphandle kwezenzo ezithile zentsholongwane kaGawulayo, kusekho ukusabalalisa ukuphumeza i-PrEP kwizigulane, kunye neepesenti ezingama-17 kuphela ezichazwe ngaphambili kokuba zibekwe izilwanyana.
(Ngokubanzi, abathengi abasuka e-US bahlala bezithobekileyo, ngezinye izifundo ezibonisa ukuba phakathi kwama-22,000 kunye nama-25,000 aseMelika angakhona kwi-PrEP njengamanje.)
Iziphakamiso kwiNkxaso ye-PrEP kwi-Older
Ngaphandle kokubalwa kwamanani, ukusetyenziswa kwe-PrEP bekuphantse kwaphindwe kane kumazwe phakathi kwabo bafikelela kwiminyaka engama-40 ukuya kweye-40s, kubonisa ukuba ukuguga (kunye nemali engenayo, isimo sengqondo kunye nolwazi olubanzi malunga nempilo yokukhusela ngokubanzi) imithintelo embalwa kunyango.
Abaxhasayo be-PrEP baqhubela phambili ukujonga iingcinga zesini kunye nezenzo ezinokubeka abaninzi abantu abadala kwiingozi eziphezulu zokusuleleka. Phakathi kwezi nkxalabo:
- Uphando lubonisa ukuba abaninzi abantu abadala abaneminyaka engama-50 abaneminyaka engaphezu kwama-50 bafaka ingozi yokufaka ingozi enkulu , nokuba ingaba isilwanyana okanye isisu.
- Ukusetyenziswa kwekhondom kuncipha ukunciphisa xa umntu ekhula, ukususela kuma-24 ekhulwini kubantu abaneminyaka engama-50 ukuya ku-59 ukuya kwi-17 kwipesenti kubantu abaneminyaka engama-60 ukuya kuma-69.
- Amaphesenti angama-62 amadoda kunye nama-78 ekhulwini kwabasetyhini akakaze axubushe ngempilo yabo yesondo kunye nogqirha ukususela ngo-50.
- Izifundo ezininzi ziye zabonisa ukuba amadoda asele badala awakasebenzisi iikhondom ngenxa yokungakwazi ukugcina ukulungiswa.
- Ukongezelela, abaninzi abafazi abakhulileyo abanentsholongwane kaGawulayo bakholelwa ukuba bona kunye neqabane labo elingenayo igciwane le-HIV badinga ikhondom ngenxa yokuba i-post-menopausal.
Ukukhusela i-HIV kubaluleke nakakhulu kubantu abadala asebekhulile banikezela ukuba iziganeko eziphezulu zezolimo zikhona xa kuthelekiswa nabantu abancinci. Ukongezelela koko, abantu abadala abasanda kugulelwa banamaqondo angaphantsi kwe- CD4 ngexesha lokuxilongwa, kunye nokuhla kwe-CD4 ehamba phambili-ebonisa ukuqhubela phambili kwezifo ngokukhawuleza.
Ulwaphulo lwe-HIV lunokuba nzima nakumntu omdala njengokuba banakho ukuphathwa ngezinye iimeko ezifana nokunyuka kwengcinezelo yegazi, isifo senhliziyo, izifo zentlungu kunye nesifo sikashukela. Oku kuguqulela umngcipheko ophezulu wokusebenzisana kweziyobisi , kunye neengxaki ezinxulumene neeshedyuli zokulandelela kunye nokunamathela kweziyobisi.
Ngokubambisana, yonke le micimbi ixhasa ukusetyenziswa kwe-PrEP, ukuba kuphela ukuphepha iingxaki zentsholongwane kunye nonyango kubantu abadala.
Ukwenza Okulungileyo
Ingaba i-PrEP iyilungele wena kwaye ugqirha wakho ufuna ukugqiba kwisigqibo somntu ngamnye, ngokubhengezwa ngokugcwele kwezinto zombini kunye nenkunkuma yokusetyenziswa kusekelwe kwiimeko zakho kunye nobungozi. Oko ngokuqinisekileyo akunjalo isisombululo esisodwa-esifanelekileyo-sonke isisombululo.
Kufuneka kwakhona kukhunjulwe ukuba i-PrEP ayifuni ukuba yinto emele yedwa. Iikhondom, ukunciphisa inani lamalungu ezesini, kunye nokusetyenziswa kweyeza-antiretroviral kwiqabane elijongene ne-HIV kufuneka lihlolisiswe njengenxalenye yesicwangciso sokukhusela esihlangeneyo.
"Ndiyayithanda imbono yokuba kukho izisombululo ezinokusebenza," watsho uSokol. "Ndiyi-100 ekhulwini kuyo, kodwa kufuneka ndiqwalasele ukuba (PrEP) ndilungile."
Ekugqibeleni, ukhetho olwenziwe-olwenziwe ngolwazi olupheleleyo, olungenamkhethe-oluya kugqiba ukuba i-PrEP yinto efanelekileyo kuwe. Thetha nogqirha wakho okanye qhagamshelana nomnxeba we -AIDS wengingqi ukuze uthole ulwazi oluninzi okanye uhanjiswe kwingcali efuphi kuwe.
Imithombo:
Isibonelelo, R. "Ukusasazwa kwe-PrEP Innovations." INgqungquthela yeSizwe ye-10 kwiNtsholongwane kaGawulayo kunye noKhuselo lokuThinteka. EParis, eFransi; Oktobha 2015; islayidi.
IiNkonzo zeMpilo zikaRhulumente zase-US (PHS). "I-Preexposure Prophylaxis yokuNqanda iNtsholongwane kaGawulayo e-United States - 2014: Isikhokelo seNkcubeko." EWashington, DC; papashwe ngoMeyi 14, 2014;
Castel, A .; Ukukhawuleza, iD .; Tang, W .; okqhubekayo. "Ukuqonda indlela yokubonelela ngeNtsholongwane kaGawulayo malunga neNjongo yokuBhala iPEP." I-Journal ye-Immune Deficiency Syndrome. 2015; 70 (5): 520-528.
I-Pillowsky, D. kunye noWu, L. "Ukuziphatha komngcipheko wesondo kunye ne-HIV kubahlali baseMelika abaneminyaka engama-50 ubudala nangaphezulu: ukuhlaziywa." Ukusetyenziswa kakubi kweziyobisi. 2015; 6: 51-60.
Guaraldi, G; Zona S, Bazalwana, T .; Stentarelli C, et al. "Ukuguga ne-HIV kunye nesifo sengculaza kwi-HIV yobudala ngexesha elidala: uluntu oluninzi olunamaqela ahlukeneyo." PLoS One. Epreli 2015; 10: e0118531.