Isikhokelo se-PrEP samanje kwiNkonzo yezeMpilo kaRhulumente yase-US
Ukusetyenziswa kwansuku zonke kweziyobisi iTruvada (tenofovir + emtricitabine) kubonisiwe ukunciphisa umngcipheko womntu we-HIV ngo-92%. Isicwangciso, esaziwa ngokuba yi- HIV ngaphambili-exposure prophylaxis (PrEP) , sithathwa njengendlela efanelekileyo yokunqanda ukusasazeka kwe-HIV kubantu abangakhuselekanga kunye nokukwazi ukuguqula amazinga okusuleleka kwiintsholongwane.
Njengamanje, kuwo onke amazwe aphezulu aphezulu kuMntla Melika naseYurophu, i-US inesisindo esiphezulu sentsholongwane kaGawulayo (ama-50,000 amatsha ngonyaka) kunye neyesibini kwizinga eliphezulu lokusasazeka kwe-HIV (0.6%, okanye abantu abayi-1.2 million abanesifo sengculaza) onke amazwe. Kuphela iLatvia, ilizwe elinabantu abangaphantsi kwezigidi ezi-2 kunye nezifo ezili-10 ezifunyanwe zifo, unesantya esiphezulu sezinga (0.7%).
Njengemiphumo yale manani, i-US Public Health Service (USPHS) ikhuphe izikhokelo zayo zokuhlaziywa kliniki ngomhla we-Meyi 14, 2014, ekubiza ukuba ukusetshenziswa kwansuku zonke kwe-PrEP kubantu abanentsholongwane kaGawulayo kumngcipheko omkhulu wokusuleleka, njengendlela elandelayo:
Amadoda avuthiweyo abelana ngesondo kunye nabesilisa (MSM) abangenabo ubudlelwane bomntu oyedwa osandul 'uvavanyo lwe-HIV, kwaye bahlangabezane neyodwa okanye ngaphezulu kweendlela ezilandelayo:
- Yenza isondo sesini esingaxilwanga ngesilwanyana (esamkelekileyo okanye sokufaka) .
- Unesifo sokudluliselwa ngesondo (STI) kwiinyanga ezintandathu ezidlulileyo.
- Ingaba kuse-serodiscordant (imeko edibeneyo) ubudlelwane kunye nomlingane we-HIV.
Amadoda abesondo ngokwesondo abesilisa kunye nabasetyhini (MSMW) abangenabo ubudlelwane bomntu oyedwa kunye ne-HIV-negative partner, kwaye bahlangabezane nenye okanye ngaphezulu kwezi zilandelayo:
- Yenza isondo sesini esingaxilwanga ngesilwanyana (esamkelekileyo okanye sokufaka).
- Unesifo sokudluliselwa ngesondo (STI) kwiinyanga ezintandathu ezidlulileyo.
- Ingaba kuse-serodiscordant (imeko edibeneyo) ubudlelwane kunye nomlingane we-HIV.
Amadoda abesilisa kunye nabesifazana abangabantu abesifazana abangabikho bobudlelwane bomntu oyedwa kunye nohlobo oluthile oluhlolwe i-HIV, kwaye bahlangabezane neyodwa okanye ngaphezulu kweendlela ezilandelayo:
- Ngokuqhelekileyo sebenzisa ikhondom ngomnye okanye amaqabane amaninzi engaziwa yi-HIV kunye nomngcipheko omkhulu we-HIV (injecting users users, MSMW).
- Ingaba kuse-serodiscordant (imeko edibeneyo) ubudlelwane kunye nomlingane we-HIV.
Abasebenzisi beziyobisi beziyobisi (ii-IDU) abadibeneyo baye bajoba izidakamizwa ezintandathu kwiinyanga ezidlulileyo, kwaye bahlangabezane nenye okanye ngaphezulu kwezi zilandelayo:
- Yabelana ngeesaliti okanye wabelane ngezilingo ezinyangeni ezintandathu ezidlulileyo.
- Beye kwi-methadone, buprenorphine okanye i-suboxoneprogram yokonyango kwiinyanga ezintandathu ezidlulileyo.
- Ngaba unayo nayiphi na ingozi ekhankanywe apha ngasentla yokufumana isondo.
Ukongeza, i-PrEP inokumiselwa kwiimeko ezixubekileyo (i-serodiscordant) ezithandwayo ezifuna ukukhulelwa okanye ezilindele. Zomibini izikhokelo ze-FDA kunye nezikhokelo zonyango lwe-antiretroviral zonyango zibonelela oku.
Kuthiwani Ukuba Andikho Kwiluhlu?
Ekugqibeleni, isigqibo sokumisela i-PrEP kufuneka senziwe kwimeko yimeko, ngenjongo yokuvavanya umngcipheko womntu ngamnye wokusuleleka kunye neendlela zokunciphisa ingozi.
Ukuba ukholelwa ukuba ufanelekile kwi-PrEP, kubalulekile ukuba usebenze nomcebisi oqeqeshwe okanye uqeqesho lwezempilo ukuze uqinisekise ukuba uyaqonda iingenelo kunye nemida yokunyanga .
I-PrEP ayifanele ithathelwe ingqalelo endaweni yekhondom okanye isetyenziswe kwindawo yokuzalisa ixesha elipheleleyo kunye nomlingane osuleleka ngu-HIV.
I-PrEP iyakunikwa kuphela ngugqirha kwaye idinga ukuvavanywa kwe-HIV phambi kokuqala kwonyango kunye neenyanga ezintathu emva koko. I-Medicaid kunye neenkqubo ezininzi ze-inshurensi zase-US zihlanganisa iindleko ze-PrEP, ngelixa uhlawule ngokukhawuleza uncedo lweziyobisi luzafumaneka kulabo abafanelekayo kwi-Truvada yaseGiliyadi ye-PrEP yeMicro Assistance Programme.
Imithombo:
Amaziko okuLawula nokuKhuselwa kwezifo (CDC). "Pre-Exposure Prophylaxis (PrEP)." E-Atlanta, eGeorgia; fi kelele ngoNovemba 6, 2014.
I-World Health Organization (WHO). "Ukunyuka kwe-HIV phakathi kwabantu abadala ukuya ku-49 - Idatha yelizwe." I-Geneva, eSwitzerland; fi kelele ngoNovemba 6, 2014.
Iqela leBhanki yehlabathi. "Izwe kunye nokuLungisa amaQela." IWashington, DC; fi kelele ngoNovemba 6, 2014.
IiNkonzo zeMpilo zikaRhulumente zase-US (PHS). "I- Preexposure Prophylaxis yokuNqanda iNtsholongwane kaGawulayo e-United States - 2014: Isikhokelo seNkcubeko." EWashington, DC; papashwe ngoMeyi 14, 2014; fi kelele ngoNovemba 6, 2014.
Iziko zeSizwe zezeMpilo (NIH). "Iziphakamiso zokusetyenziswa kwezidakamizwa zokulwa ne-antiretroviral kwiimali ezithintekayo ze-HIV-1 kwintsapho yabantwana kunye nokungenelela ekunciphiseni ukudluliselwa kwe-HIV e-United States." EBethesda, eMaryn; fi kelele ngoNovemba 6, 2014.