3 kwi-5 Izifo ezithintekayo kwizigulane ezingabonakaliyo
Kwimeko ye-case-by-case basis, oogqirha bavame ukuvavanya ukuba ubani osemngciphekweni omkhulu wokudlulisa i-HIV ngokubhekiselele kwizinto ezinjengomthamo wentsholongwane yomntu, ukuziphatha kweengozi , ukusetyenziswa kweziyobisi ezingekho mthethweni, njl. Ngokujongana nokujongana nale miba, ingozi kumntu unokunciphisa kakhulu.
Ukususela kwimibono esekelwe ngabantu, abaphandi banako ukukwazi ukwenza okufanayo ngokulinganisa ingozi yokudlulisela kwi-real-world, epidemiological data.
Into abayifumene kukuba enye into eyona nto, ngaphezu kwayo nayiphi na enye into, inxulumene nomngcipheko omncinci wokuhambisa : ukuhlala kunye nokuhlala kwinyango.
Enyanisweni, nangona kungekho unyango lwe-antiretroviral (ART) , ngokubona rhoqo ugqirha ngaphezu kokuqingatha umngcipheko wokudlulisa i-HIV xa kuthelekiswa nomntu ofunyaniswayo.
Ingozi yokuThumela iHIV ngeNqanaba loLondolozo
Abaphandi abavela kwiZiko loLawulo lweZifo kunye nokuVikela (i-CDC) e-Atlanta kutshanje benza imodeli yeemathematika basebenzisa idatha esuka kwiNkqubo yoLondolozo lweNtsholongwane kaGawulayo kunye neProjekthi yokuLawulwa kweMpilo (MMP).
Uhlolisiso lujolise ekunqunyeni amazinga okudlulisela esekelwe kokubili apho umntu emele khona ekuthiwa yi- HIV Care Continuum (oko kukuthi, ingaba bavavanyelwe, bekhathalele, kunyango, njl) kunye nemiba emingciphekweni enokummisela loo mntu umngcipheko ophezulu okanye ophantsi wokudluliselwa.
Kulinganiselwa ukuba abantu abayi-1,150,000 abane-HIV bahlala e-US namhlanje.
Kuzo, malunga:
- Iipesenti ezingama-82 ziyafunyanwa
- Iipesenti ezingama-37 zidibaniswe kwaye zigcinwa ngononophelo
- Iipesenti ezingama-33 zi-ART
- Iipesenti ezingama-25 zikhutshwe ngentsholongwane kunye nomthwalo ongenakubonakali wentsholongwane
Ngokubhekisela kula manani ngokulandelelana kwedatha kunye neenkampu ze-MMP, abaphandi be-CDC bakwazi ukubonisa ukuba izinga lokudlulisa i-US ngalinye li-3.9 ezithunyelwe ngabantu abayi-100 ngonyaka (100PYs).
Ukuphula eso sibalo phantsi kwinqanaba lokunyamekela, abaphandi bakwazi ukugqiba ukuba:
- Abantu abangafumanekiyo nge-HIV banesifo sokusasazwa kwezi-6.6 kwizifo ezingama-100 ze-PYs (phantse i-average average).
- Abantu abaye bafumanisa ukuba ngubani-owaziyo nje isimo sakhe, kungakhathaliseki ukuba ngu-5.3 usulelo lwe-ART nge-100PYs.
- Abantu abafumene unyango kwaye bagcinwe ekunyamekelweni kudluliselwe 2.6 ukusulela kwi-100PYs.
- Abantu baxhomekeke kwi-ART abangazange baphuculwe ngokupheleleyo 1.8 izifo kwi-100PYs.
- Abantu bachaza i-ART abaye bathatyathwa ngokugqithiseleyo nge-0.4 izifo kwi-100PYs kuphela.
Ukusuka kwimbono yabantu, ubuninzi bezithunyelwa (ama-58 ekhulwini) babonwe kumadoda alala ngesondo kunye namadoda (MSM) . Yaye ngoxa abantu abadala abaneminyaka engama-35 ukuya ku-44 bafumana ama-34 ekhulwini kuwo onke ama-transmissions, inani eliphezulu lokusasazeka (6.2 ukusuleleka kwi-100PYs) kwenzeka kubantu abadala 25-34 .
Ngoko Yintoni Eyasitsho Kona?
Ukususela kwimibono yehlabathi ngokwenene, la manani aqinisekisa ukuba izigulane ezinokunyamekela, ezinokungabonakali kwintsholongwane ye-viral ziyakwazi ukunciphisa ama-94 ekhulwini kwiimeko zokuhamba ngokuthelekiswa kunye nabangenayo. [Ukubeka iqabane elingakhuselekanga kwi- HIV ngaphambi kokuba i-prophylaxis (PrEP) isenokunciphisa ngakumbi loo mngcipheko.]
Kwiphepha le-flip, amanani acacisa ukuba, ngelixa izigulane ezingafumaneki zimelele iipesenti ezili-18 zabantu bonke abane-HIV kwi-US, ziphendula malunga neepesenti ezingama-30 zazo zonke izifo. Okubi nakakhulu, abantu abazi kakuhle isimo sabo kodwa bahlala bexilisekile ukuba banakekele i-akhawunti ngenxa yezifo ezithintekayo ezintathu kuzo zonke iintsholongwane ezinhlanu .
Imodeli ye-MMP iyaqhubeka isekela ezi zibalo ngokugqiba ukuba amaphesenti angama-62 alabo abangakhange bahlolwe rhoqo babandakanye ngesondo esingaphantsi kwesini . Ngokwahlukileyo, iipesenti ezili-16 kuphela zabantu abakwi-ART babecala ngesondo elingaphantsi kwesini, ngelixa bebancinci (iipesenti ezili-10,5) baye bagwema iikhondom ukuba bekungabonakali ngokupheleleyo.
Ngokufanayo, izigulane ekunyamekeleni kunye nakwii-ART zibikwe ukuba zibambisene ezimbini kunye neentathu zentsebenziswano zesondo kunyaka owedlule, ngokulandelanayo, xa kuthelekiswa nalabo abangafunyaniswayo okanye abathatyathwa ngaphandle kokunyamekela (abalingani 8 ukuya ku-8.8). Iziphumo ezifanayo zibonwe kwizigulane ezilaliswe ngamachiza, kunye neepesenti ezingama-0.9 kuphela zezo zonyango zokusetyenziswa kweziyobisi ze-ART ngokuthelekiswa nama-6.3 eepesenti abangafunyanwanga.
Ekugqibeleni, umyalezo wokuya ekhaya ulula: ukuhlala kunye nokuhlala ekunyamekelweni kubonisa ukunciphisa kakhulu kunomngcipheko we-HIV, ngaphezu kokunciphisa amathuba okudluliselwa kwexesha xa uthatha unyango lwe-HIV , kungakhathaliseki ukuba ngumthamo wentsholongwane okanye uhlobo lwe-regimen , kunciphisa umngcipheko ngokuqhubekayo 30 ekhulwini.
Enyanisweni, ukuvavanya nje i-HIV kunokunciphisa umngcipheko womntu ngamaphesenti angama-19, ebonisa ukuba ukuqonda ngokwabo kunokuthi, kwinqanaba elithile, litshintshe ukuziphatha komngcipheko womntu. Ngokuqinisekileyo indawo efanelekileyo yokuqala.
Ukufumana indawo yokuhlola i-HIV okanye ukufikelela kwiinkonzo zonyango lwe-HIV eziseduze nawe, tyelela indawo ye-AIDSVu indawo yokuhlala eqhutywe yiSikolo se-Rollins yeMpilo kaRhulumente kwi-University yase-Emory, okanye uqhagamshelane nomnxeba we-HIV / AIDS kwindawo yakho, ezininzi zazo zifumaneka iiyure ezingama-24 usuku.
Imithombo:
Skarbinski J, Rosenberg E, Paz-Bailey G, et al. I-Virus Immunodeficiency Virus Transmissions kwiNqanaba ngalinye leContinuum Care eMelika. Umbhalo we-American Medical Association Internal Medicine. 2015; 175 (4): 588-596.