Umbuzo wovavanyo ohambelana ngqo kunye nokubonisa ukuba udibaniselwano kunye nobudlelwane obuphezulu bengozi
Kukho iingcebiso ezinde ukuba indlela yokwenza i-douching, zombini kunye neengxenyana, inokunyusa umngcipheko we-HIV ngokususa iintsholongwane ezibizwa ngokuthi "ezilungileyo" ezivela kwizityalo zangasese / i-vagina ngenkathi zibangela uxinzelelo kwizicubu ezinamaqabunga e-mucosal ezibeka ezi ziko.
Ngaba oku kunokwenzeka? Kungenzeka ukuba iinkqubo zicinga ukuphucula impilo kunye nococeko lwazo ngokungazi ngokunyusa ingozi ye-HIV ngaphandle kwethu nokuba sazi?
Iingxelo zokuQala kwiNgxaki kunye nokudideka
Ngasekupheleni kwee-1990s, iinjongo ezininzi zadibanisa ngokuthe ngqo ukungena kwi-HIV kunye nezinye izifo ezithathelwana ngocansi (STIs) . Zininzi zezi zifundo zaqhutyelwa eAfrika, apho bekucetyiswa ukuba ubuhlungu besisu abukhulanga nje kuphela umngcipheko we- bacterial vaginosis ngama-60% kodwa okwenzeka ngokuqhelekileyo kubasetyhini abane-HIV. Nangona abaphandi bengenakukwazi ukuqhagamshelanisa ubudlelwane obucacileyo phakathi kwe-HIV kunye ne-douching, bacetyiswa ngamandla ukuba ukuhanjiswa kwasemandleni kwakuphezulu.
Nangona kunjalo, kukho izinto ezininzi ezenza ukuba kube nzima ukuseka unxibelelwano. Phakathi kwezi zinto kwakukho ukuqhutywa kwezifundo zakuqala ezenziwe kwizicwangciso ezingenamlinganiselo, njengeAfrika, apho impilo jikelele yabemi kunye nokufikelela ekunyamekelweni kwazisa rhoqo iziphumo. Uninzi lwaphando luye lwaqhutyelwa phakathi kwabasebenzi bezesondo zorhwebo (ii-CSWs) , apho umbutho phakathi kwe-HIV kunye nezinye izinto (ezifana nokusetyenziswa kwekhondom , isondo lesandulela , ukusetyenziswa kweziyobisi ) ngokuqinisekileyo ziza kunika inxaxheba ngaphezulu kwengozi yokusuleleka kwintsholongwane kunokuzihlaziya.
Ngaphezu koko, iziphumo ezivela ezilingo zazivame ukuphikisana. Ucwaningo oluthile lwaseKenya, umzekelo, ugqithiso lwe-vaginal lwalunxulumene namaxesha aphindaphindiweyo okusetyenziswa kwekhondom phakathi kwama-1.5 ukuya kwe-2.5 xa kuthelekiswa nabalingani babo abangabonakali. Ukufunda isiTshayina kwiminyaka emininzi kamva kuboniswe ngokuchaseneyo, kunye ne-vaginal douching ehambelana nokusetyenziswa kwekhondom.
Ubume obuphambene noluphando luye lwabangela ukuba kube neengxoxo eziqhubekayo, abaninzi bebanga ukuba baninzi baninzi abaxhobayo ukuba baqulunqe unxibelelwano olucacileyo phakathi kweNTSHOLONGWANE KAGAWULAYO ne-douching.
Izifundo ezangoku zibonelela ngokucacileyo ngakumbi
Ngo-2012, inani elincinci lwezifundo lanikeza ingcaciso ecacileyo kwintsholongwane kaGawulayo phakathi kwalabo abahlala besondeza.
Eyokuqala, eqhutywe njengenxalenye ye-HPTN 035 i- HIV microbicide , iquka ama-3,099 asebenza ngokwesondo, abafazi abane-HIV eMalawi, eMzantsi Afrika, eZambia, eZimbabwe naseFiladelphia. Ngokomphando, ngaphezu kweyesithathu sabathathi-nxaxheba babe ne-bacterial vaginosis ekuqaleni kwetyala, inxalenye yawo engatshintshi kuwo wonke umkhosi weeminyaka emithathu, mhlawumbi phakathi kwabasetyhini abahlala behlamba ngamanzi okanye abo bangenalo.
Kucatshangelwa ukuba zichanekile, iziphumo ze-HPTN 035 zichasene ngokuthe ngqo kwiinkalo zangaphambili eziye zacetyiswa ukuba i-bacterial vaginosis-ngokwayo ehambelana nomngcipheko we-HIV-ingakhuthazwa yi-vaginal douching.
Uphando lwesibini oluqhutyelwa eLos Angeles alubonanga nxu lumano phakathi kwe-vaginal okanye i-rectal douching kunye ne-HIV kwabasetyhini. Uhlolisiso lubaluleke ngokumalunga ne-71% yabathathi-nxaxheba bachaza ukuba banezesondo zobundlobongela, kunye ne-18% yokunika ingxelo ezinjalo ezinyangeni ezedlulileyo.
(I- sexual anal sex reception isisona sengozi esiphezulu sokuthengwa kwe-HIV, ngokuphindaphindiweyo kwezihlandlo ezili-18 kunezo zesini.)
Intsholongwane kaGawulayo kunye ne-Rectal Douching kuMadoda
Uphando lokugqibela, uphando ngekhonkco phakathi kwe-HIV kunye ne-rectal douching kumadoda abelana ngesondo kunye namadoda (i-MSM) , yenziwe umfanekiso obunzima kakhulu. Kwama-MSM angama-413 ayenokwenza i-douching reching, 44% bane-HIV kunye ne-18% kuphela kwabangenayo i-shower. I-Douching nayo yadibaniswa phantse kabini inani le-STI phakathi kwabathathi-nxaxheba (21% ngokumalunga no-11%).
Ngexesha, ebusweni, ukufunyaniswa kwafunyanwa ngokuphathelele, abaphandi bakhawuleza ukubonisa ukuba ukutyhulwa kwamathambo, kunye kunye ngokwabo, kwakungekho yimbangela yokwanda kwamazinga.
Kunoko, i-douching rectal yayibandakanyeka ngokukhawuleza nezenzo ezaziwa ngokunyusa umngcipheko we-HIV, okuquka iqabane elithile lezesondo kunye nokusetyenziswa kweziyobisi zokuzonwabisa.
Ngokucacileyo, phakathi kwe-MSM kwiphando, abo bavakalisi banomyinge wamaqabane amahlanu eentlobano zesini kwiinyanga ezintathu ezidlulileyo kunye nabangewona amashishini ababini ababini. Ukusetyenziswa kwezidakamizwa zokuzonwabisa ngokubonakalayo kubonakala nokuba negalelo ekunyuseni kwenyuka kwe-HIV xa kuthelekiswa ne-MSM engeyiyo.
Ngokusekelwe kwidatha, abaphandi baphetha ukuba ukubethelwa kwamathambo kwakunomsebenzi osemgangathweni onxulumene nemisebenzi yengozi ephezulu kunokuba yimiba yedwa kunye nokuba ekugqibeleni inani labalingani bezesondo abadlala indima enkulu kwizinga lokunyuka. Enyanisweni, uphando oluninzi namhlanje lubonisa ukuba i-MSM eneenkwenkwezi ezine okanye ngaphezulu kwezesondo kwisithuba seenyanga ezintandathu sinomngcipheko omkhulu we-HIV engama-32.3% ngaphandle kwazo zonke ezinye izinto zokuziphatha, kubandakanywa ukusetyenziswa kotywala / ukusebenzisa iziyobisi kunye ne -sex-less sex .
Abaphengululi baphetha ukuba iindlela zokuhlambulula iindawo eziqhelekileyo sele ziqhelekileyo, ngokukodwa kwi-MSM, kwaye akunakwenzeka ukuba zibandakanyeke ne-STI ingozi.
Imithombo:
Fonck, A .; Kaul, R .; Keli, F .; okqhubekayo. Izifo ezithathelwana ngocansi kunye ne-vaginal douching kwinani labasebenzi besinikazi baseNairobi, eKenya. " Izifo ezithathelwana ngesondo . Agasti 2001, 77 (4): 271-275.
Wang, B .; Li, X; Stanton, B; okqhubekayo. "Ukusetyenziswa kwamakhondom, ukusetyenziswa kwamakhondomu kunye nokusuleleka ngocansi phakathi kwabaseTshayina abasebenza ngesondo." Izifo ezithathelwana ngesondo . NgoNovemba 2005, 32 (11): 696-702.
Kasaro, M .; okqhubekayo. "Impembelelo yococo lwengqondo lomfazi kwisalathisi se-microflora yangasese ngexesha lokuthatha inxaxheba kwi-trial ye-HIV Prevention Trials Network ye-microbicide trial HPTN 035." I-International Microbicides Conference; ESydney, eOstreliya; Epreli 17, 2012.
Brown, J .; okqhubekayo. "Ukuguquka kwamagagasi kunye namacangca kunye nokufakelwa kweemveliso ezingaphezulu kwezinto zokubala phakathi kwabasetyhini eLos Angeles." I-International Microbicides Conference; ESydney, eOstreliya; Epreli 17, 2012.
Javanbakht, M .; Stahlman, S; Picket, J; okqhubekayo. "Iipatheni ezinobunzima bokuthandana." XIX INgqungquthela ye-AIDS yehlabathi lonke EWashington, DC; 22-27 Matshi 2012.
Koblin, B; Husnik, M .; Colfax, G; okqhubekayo. "Izinto ezinobungozi bokusulelwa ngentsholongwane kaGawulayo phakathi kwamadoda alala namadoda." AIDS . Matshi 21, 2006; 20 (5): 731-739.