Inyaniso ehlukileyo ukusuka kubuxoki
Ukusetyenziswa kolwaphulo lwendoda ngokuzithandela (VMMC) ukunciphisa umngcipheko wokudluliselwa nge-HIV kumadoda angatshatanga. Nangona kukho ubungqina obuqinileyo bokuba amadoda angalukileyo aphethwe yintsholongwane yokusuleleka kwi-HIV ngokulala ngokwesondo kunamadoda angabalukanga, umkhuba udla ukugxeka ngokugqithiseleyo kwabo bonke abangafuni ukusoka okanye ukubuza umbuzo wobugcisa bokuqala.
Uchungechunge lwezilingo ezilawulwa ngononophelo oluqhutywe eAfrika ukususela ngo-2005 ukuya ku-2007 lubonise ukuba i-VMMC inokunciphisa umngcipheko wokutshintshwa kwe-vaginal-to-penile naphi na kwi-51% ukuya kwi-60%.
Ngokusekelwe ekuqinisweni kwezi zilingo, i-World Health Organisation (WHO) kunye neNkqubo yeZizwe eziManyeneyo kwi-HIV / AIDS (i-UNAIDS) ikhuphe iingcebiso ngo-2007 ithi:
"Ulwaluko lwamadoda lufanele lubonwe njengesicwangciso esongezelelweyo, esibalulekileyo sokuthintela ulwaphulo lwe-HIV oluxhatshazwa ngamadoda ... (kodwa) akufanele sithathe iindawo zokuzikhusela nge-HIV."
Ngo-2011, i-VMMC engaphezu kwesigidi se-1.3 yenziwe, ikakhulukazi eMntla naseMzantsi Afrika apho amazinga omntu omdala angama-26%. UMongameli Obama uzimisele ngakumbi ukuxhasa ukusoka kwezigidi ezi-4.7 ngasekupheleni kuka-2013.
Ulwaluko njengoNqande: I-One-Way Street?
Kwiphepha le-flip le mbambano, uphando oluninzi olufanayo lubonisa ukuba ulwaluko lwendoda alunikeli inzuzo efanayo yokukhusela kumlingani osetyhini ongakhange ujongene nobuhlobo be-serodiscordant .
Kukho izimbalwa ezinokubangela ukuba le nto ingabonakali-kubandakanywa nokukhuseleka kwezinto eziphilayo zezilwanyana kunye, kwezinye iimeko, ukuqala kwangaphambi kwesondo phambi kokuba isilonda sokusoka siphulukiswe ngokupheleleyo.
Akunakho ubungqina bokuthi ulwaluko luya kunciphisa umngcipheko wokusuleleka kumadoda abelana ngesondo kunye nabesilisa (MSM) , apho indlela eyintloko yokusuleleka isondo sesondo .
Ingaba ukusoka kunokunika uncedo olukhuselekileyo kumadoda asebenzisana ngesondo esifanelekileyo kunye nomlingani wesetyhini uhlala engalingani.
Ingxoxo eqhubekayo yokukhupha ingqalelo ukuba ukusoka akubonakali kuthintela amazinga okuthunyelwa kwe-HIV kumazwe athuthukileyo njengoko enza kwiindawo eziqhelekileyo, eziphakamileyo ezibonakalayo njenge-Afrika yase-Sahara.
Ngokusekelwe kubuninzi bobubungqina, i-WHO / i-UNAIDS yenze indlela yokucwangcisa ngokuthi:
Impembelelo enkulu yempilo yoluntu iya kuba kwisistim apho iHIV ixhomekeke khona (ukusukela kwintsholongwane kaGawulayo kuluntu jikelele kubangaphezu kwe-15%), isasazeka kakhulu ngokudluliselwa kwesondo, kwaye apho inani elincinci lamadoda (umz. . "
Ngo-2011, i-UNAIDS ibike ukuba izinga lokukhula kwabantu abadala eliphakathi kwe-Sahara lase-Afrika liphakathi kwe-10% (eMalawi) kunye nama-26% (eSwazini). Ngokuthelekiswa, izinga lokukhula kwabantu abadala labantu base-US bahamba malunga ne-0.6%.
Ukulinganisa Ubungqina
Phakathi kuka-1989 kunye no-2005, izifundo ezininzi zokuqwalasela i-Afrika zaphawula ubudlelwane obuphakathi kwepesenti yabantu abalukileyo kwindawo ephezulu yobuncipheko kunye namazinga aphantsi okusuleleka ngoGawulayo. Nangona ezinye zeziphumo zaphoqeleka-kubandakanywa nokufundiswa kwamanye amaqela ase-Uganda okubonisa ukuba iingxaki zokusuleleka zingama-42% ngaphantsi kwamadoda alukileyo-kwakukho izifundo eziphantse zinokuphikisana neziphumo okanye ukubuza umbuzo umbhali izigqibo.
Ngo-2005, ukuphononongwa ngokuchanekileyo kwezifundo ezingama-35 zokuqinisekisa ukuba umbutho phakathi kokunyuka kwamazinga okusoka kunye nokunciphisa amazinga okudlulisela abantu besifazane. Sekunjalo, ubungqina babuthatyathwa bengenelisekanga ukuba bavume ukusetyenziswa kolwaluko njengethuluzi lokukhusela abantu.
Ukususela ngo-2005 ukuya ku-2007, uluhlu lwezilingo ezilawulwe ngokungapheliyo oluqhutywa kumazwe amathathu ase-Afrika ngokugqibeleni lanikezela ubungqina obuninzi bokuxhasa ukusetyenziswa kwalo.
- EKenya , amadoda angama-2,784 aphakathi kweminyaka eyi-18 no-24 ayetyenyelwa kwisifundo esikhokelwa yiYunivesithi yase-Illinois. Icaleni lapheliswa ngaphambi kwesikhathi xa ukusoka kwaboniswa ukuba kuphumelele u-53% ekukhuselweni kwe-HIV.
- Emazantsi Afrika , amadoda angama-3 273 phakathi kwe-16 no-24 abanjwe kwilingo elixhaswa ngu-Agence Nationale de Recherches sur la SIDA (ANRS). Icaleni lapheliswa emva kweenyanga ezili-17 emva kokuba iziphumo zesikhashana zibonise ama-60% abantu abancinci kwiintsholongwane.
- E- Uganda , amadoda angama-4996 aphakathi kwe-15 no-49 atyunjwa ukuvavanywa yi-John Hopkins Bloomberg School of Health Public. Ulingo lwaye lwapheliswa ngaphambi kokuba lubonise ukusebenza kwe-51%.
Nangona i-meta-analysis ixhase ngokubanzi ukufunyaniswa kwimeko yesifo sengqungquthela yaseAfrika, abanye baye babuza ukuba ingxaki yokuphumeza-kuquka ukusetyenziswa kwekhondom kunye nokukhubazeka kokuziphatha-akukaze kulungiswe ngokupheleleyo.
Iinkqubo zeZibalo ezenzekayo zokunciphisa ukuthunyelwa
Uninzi lwezifundo kwiminyaka yamuva zicebise ukuba i-bacterial biome ngaphantsi kwesibindi ingaba yimbangela yokwanda komngcipheko kumadoda angaselwanga. Uphando lubonisa ukuba isibalo sabantu abathintekayo bentsholongwane banokujika ii-Langerhans zeeseli phezu kwesikhumba ukuba zibe "ngabaculi" ekukhuseleni kwabo.
Ngokuqhelekileyo, iiseli zeLangerhans zisebenza ngokubamba nokuthutha ii-microbes ezihlasele kumaseli omzimba (kubandakanywa neeseli ze-CD4 ), apho zithandwa khona nge-neutralization. Nangona kunjalo, xa umthwalo webhakteria unyuka, njengoko kwenzeka phantsi kwebhunga, ukuphendula okuvuzayo kwenzeka kwaye iiseli zeLangerhans zithintela iiseli ngeempawu ezinokukhubeka kunokuba zivele nje.
Ngokusoka i-penis, ibhaktheriya e-anaerobic phantsi kweengqumbo ayinakukwazi ukukhula, ngaloo ndlela iyanciphisa impendulo yokuvuvukala. Uphando olongezelelweyo lunokubangela ukuphuhliswa kwee- microbicidal agents okanye ezinye izicwangciso zokungabikho zokucwangcisa ukuphucula umphumo.
Ukusebenza kweNkqubo eAfrika
Uhlobo lweMathematika nge-WHO, i-UNAIDS kunye neZiko leMzantsi Afrika le-Epidemiological Modeling and Analysis (SACEMA) lisikisela ukuba, kwindawo ephakamileyo yokusabalalisa apho ulwabelana ngesondo ngokobulili yindlela yokuqala yokuhambisa, isifo esisodwa sisitsha siya kupheliswa kuwo onke amadoda amahlanu asandul . Ngokwicatshulwa, ukuba i-90% yamadoda ayalukile ngaphakathi kwezi ndawo, kunokunciphisa ukunciphisa ama-infection angama-35% ukuya kwi-40% (ngenxa yezinga lokungenwa koluntu oluphantsi).
Ukuhlalutya kweendleko-mpembelelo kubonise ukuba, ngokuphelisa izifo, umthwalo kwiinkqubo zonyango lwezempilo unokuncitshiswa kakhulu. Uphando olunye lwePhondo leGauteng eMzantsi Afrika-apho izinga lokusuleleka lingaphezu kwama-15%-lubonakaliswe ukuba indleko ze-1 000 yolwaluko lwamadoda (malunga nama-$ 50,000) zingabangela ukugcinwa kweendleko ezingaphezulu kwe-$ 3.5 yezigidi kwiyeza-antiretroviral kuphela. iindleko zezokwelapha kunye / okanye izibhedlele.
Sekunjalo, abanye baye baxela ukuba izibalo zithembeke kakhulu, ngelixa enye (ekukhulumisana kakhulu) ifundisa ukuba ukuphunyezwa kweenkqubo zekhondom zamahhala zihlandlo ezili-95 ngaphezulu kweendleko ezingaphezu kokusoka ekukhuseleni intsholongwane kaGawulayo.
Ngo-2013, i-WHO ivume ukusetyenziswa kwePrepex, isisombululo sokuqala sokusokwa kwabantu besilisa. I-ring elastic flexible efuna i-anesthetic kwaye iqhotyoshelwe ngqo kwijwabu, ngaloo ndlela inqunyulwe igazi. Ngeveki, izicubu ezifayo ziyakususwa ngaphandle kwilonda elivulekileyo okanye izibonda. Le teknoloji entsha ithemba ukunyusa inani le-VMMC nge-27 yezigidi ngo-2020.
Ngaba Ulwaluko njengoNqandekayo e-US?
Ukusuka kwimbono yokunakekelwa kwempilo yoluntu, kubalulekile ukuqaphela ukuba akukho mhlaba wonke owake wakhuthaza ukusoka kwindoda njengendlela yokukhusela i-HIV. Ngokucacileyo, kukho ukungafani okubalulekileyo kwintlupheko ye-Afrika ngokubhekiselele kwilizwe eliphuhlisiweyo, ngokukodwa ukususela kwiminyaka engama-60% kwezifo ezitsha kwi-US ziphakathi kwe-MSM.
Ukongezelela, impembelelo embi kwabasetyhini-sele ikhuselekileyo ngenxa yezinto eziphilayo kunye nezoqoqosho-kubonakala ukuba ixhamle nayiphi na inzuzo enokwenzeka yokuphunyezwa ngokubanzi, nangakumbi kwimimandla engozini apho ukuhlaselwa kwabantu besini esithandanayo. Abanye bakholelwa ukuba imilayezo ejoliswe kuyo ngokusoka iya kuba nempembelelo engafanelekanga kwimimandla apho ukugxeka kusebenze ngokuphezulu kunye nokusetyenziswa kwekhondom ngokuhlala phantsi kwe-50%.
Nangona kunjalo, uphando oluthile lubonise ukuba ukusoka kwe-neonatal kunganciphisa umngcipheko we-US wengcinezelo yobomi be-HIV kunye ne-20%. Ngo-2012, i-American Academy ye-Pediatrics ikhishwe isitatimende somgaqo-nkqubo esilungisiweyo esibonisa ukuba "iingeniso zempilo zoluko lwendoda olusandul 'ukuzalwa luya ngaphezu kweengozi kwaye ukuba izinzuzo zenkqubo zilungele ukufikelela kule nkqubo kwiintsapho eziyikhethayo." Phakathi kwezibonelelo ezidwelisweyo kukuthintela ukusuleleka kwezifo zamanzi, umhlaza we-penile , kunye nokudluliselwa kwezifo ezithile ezithathelwana ngesondo , kuquka ne- HIV .
Uninzi oogqirha kunye namagunya ezempilo bathabatha indawo engabonakaliyo ngokumalunga nokusoka kwindoda ekhulile, egxininisa ukuba iyancipha kunokuba iphelise umngcipheko wokutshatyalaliswa kwentsholongwane kaGawulayo. Kukho akukho ngcebiso kwi-US ngokusetyenziswa kolwaluko lwendoda ngokuzithandela ukunciphisa umngcipheko wokudlulisela emadodeni.
Imithombo:
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