Isizathu Sokuba Sisebenzise Ithemu nokuthi Siqondisa kanjani Imizamo Yokuvimbela
Amadoda abe nobulili namadoda (MSM) igama elisetshenziselwa ukuhlukanisa abantu abesilisa abenza umsebenzi wocansi nabanye abesilisa, kungakhathaliseki ukuthi bazikhomba kanjani. Leli gama lakhiwa ngawo-1990 ngama-epidemiologists njengethuluzi lokubheka ukukhomba kangcono umzila wokudluliswa kwe-HIV nokusabalala kwesifo ngokusebenzisa umsebenzi wesilisa ocansini wesilisa.
Ngaphambi kwalokhu, abacwaningi babekuncishiswe ukuhlaziywa okusekelwe ekuziboleni-lapho abantu abathintekayo ngokuthi "gay" noma "abesilisa nabesifazane ngokobulili" bebengacabangi ngokocansi, kanti labo ababhekwa ngokuthi "baqonde" bangase bahlanganyele ngokobulili namanye amadoda.
I-MSM esikhundleni sayo igxile ekuziphatheni kunokuba kube nokuzibandakanya kwamasiko noma kwezenhlalakahle ngaleyo ndlela kuhlinzeke isithombe esicacile sezinga lokutheleleka nge-HIV . Lokho, ngokulandelana, kusinikeza ukuqonda okungcono okushiwo ukuvinjelwa kwegciwane lesandulela ngculaza, kufaka phakathi ukuthi yiziphi amathuluzi okuvimbela okuzosetshenziswa kuwo.
Izifundo ziyahlukahluka emphakathini nasesiko, kodwa ucwaningo oluqhutshwa nguMnyango WezeMpilo Nengqondo E-New York City lwembula ukuthi kulaba bantu abangu-4 200 abaxoxwa ngocingo:
- Cishe umuntu oyedwa kwabayishumi owaziwa ukuthi ulala ngokuqondile nabanye abantu.
- Amaphesenti angama-70 amadoda ashadile abhekwa ngokuqondile ekusebenzeni ngokobulili besilisa ngesikhathi esisodwa.
- Amaphesenti angu-10 amadoda ashadile abhekwa njengamacala ayebikezele ukuziphatha ngokobulili obufanayo phakathi nezinyanga ezingu-12 ezedlule
Izibalo ze-HIV Phakathi kwe-MSM e-US
Ngenkathi i-MSM imelela kuphela amaphesenti amabili okubalwa kwabantu base-US, njengabantu abenza amaphesenti angu-55 azo zonke izifo ze-HIV.
NgokweSikhungo Sokulawula Nokuvimbela Izifo (CDC), uma umkhuba wamanje uqhubeka njalo ku-MSM oyedwa uzokwethelelwa nge-HIV esikhathini sokuphila. Amathemba abonakala ahlukumeze kakhulu ama-MSM ase-Afrika aseMelika, kanti ukubonakala kwamanje kubonisa ukuthi ama- 50% engozini yokuphila engozini yokuthola i-HIV .
Ekuhlolweni kwabo kuka-2014, i-CDC yaqhubeka yabona ukungalingani okuyinhloko ekutheleleni kwe-HIV phakathi kwe-MSM:
- I-MSM imele amaphesenti angama-67 azo zonke izifo zokuthola i-HIV ezintsha kanye namaphesenti angu-83 okuxilongwa okusha phakathi kwamadoda angu-13 nangaphezulu.
- I-MSM encane ephakathi kweminyaka engu-13 no-24 engozini enkulu kakhulu, iphethe amaphesenti angu-92 zonke izifo ezintsha emadodeni.
- Izinga le-HIV phakathi kwe-Hispanics / Latinos liyakhathazeka kakhulu. Ngenkathi ukuhlolwa okusha kwe-HIV phakathi kwe-white and African MSM yaseMelika sekuyeke kakhulu (phansi ngamaphesenti ayisithupha namaphesenti amabili, ngokulandelana, kusukela ngo-2010), inani lamaSpanishi / Latino MSM lenyuke ngamaphesenti angu-13.
- Namuhla, kubalwa ama-MSM angu-687,000 e-US Kulawa, amaphesenti angu-15 ahlala angaziwa.
- Phakathi kwalabo abathintekayo abanesandulela ngculaza, kuphela amaphesenti angu-57 ahlala ehlotshaniswa nokunakekelwa okukhethekile kwe-HIV okungaphezu konyaka ngemva kokuxilongwa, kuyilapho amaphesenti angu-58 kuphela okwelashwa ngegciwane lesandulela ngculaza ayekwazi ukusekela imithwalo engavamile engavamile yokukhombisa ukwelashwa.
Lezi zibalo zivumelanisa, ngezinga elithile, ne-HIV ngezifo kwezinye izingxenye zomhlaba. Ngenkathi isifo se-HIV (isibalo sezifo ezenzeka esikhathini esithile) singase sibe ngaphezulu emazweni athile, ukukhula kwesandulela ngculazi (isabelo sabantu abathintekayo) cishe kuphakeme kakhulu phakathi kwe-MSM.
Ucwaningo lwe-Epidemiological luphakamisa ukuthi ukukhula kwegciwane lesandulela ngculazi phakathi kwe-MSM kuphakathi kwamakhulu amathathu nesithupha ngaphezulu eMpumalanga Ephakathi, eYurophu, eMpumalanga nase-Asia Ephakathi, nase-Oceanic esifundeni sase-Oceanic, futhi kunoma yikuphi okuvela kunamaphesenti angu-15 ukuya kwangu-25 ngaphezulu kwe-Afrika engaphansi kweSahara, e-Central America , ENingizimu Melika, naseNingizimu naseNingizimu-mpumalanga ye-Asia.
Ucwaningo lwe-Epidemiological Lunikeza ulwazi lokuvimbela i-HIV ku-MSM
Inhloso yokucwaninga kwe-epidemiological ukuhlinzeka ngokungaboni kahle ukuthi lesi sifo sidluliselwa kanjani futhi hhayi ukuthi ubani "ophethe" ukudluliselwa. Njengalokhu, kusenza sisebenzise amasu okuvimbela ngaphandle kokwahlulela futhi (ngokufanele) ngaphandle kwamathonya ezombusazwe noma okuziphatha.
Esinye isibonelo esinjalo ukusetshenziswa kwe- HIV pre-exposure prophylaxis (PrEP) ku-MSM. Isu, lapho ukusetshenziswa kwansuku zonke kwe- Truvada (tenofovir + emtricitabine) kunganciphisa ithuba lomuntu lokuthola i-HIV ngamaphesenti angu-90 noma ngaphezulu, liye lafundiswa kakhulu ku-MSM ukuze libone ukuthi lizophumelela kangakanani. Ngenxa yalokho, i-PrEP ayinconywa kuwo wonke ama-MSM kodwa kunabo abasengozini enkulu yokutheleleka.
Kungani? Njengendlela, i-PrEP idinga ukulinganisa nsuku zonke ukuthi amadoda amaningi akwazi ukuwagcina. Ngenxa yalokho, abacwaningi besaba ukuthi ukumelana nezidakamizwa kungakhula ngokungadingekile ku-MSM okungenzeka ukuthi kunezinye izindlela zokuzivikela. Lokhu, kanye nezindleko zokwelashwa kanye nomphumela ohlangothini olungenzeka, usungule i-PrEP njengethuluzi elibalulekile lamacembu amathuba okuba nezinye izindlela zokuzivikela.
Lezi zihlanganisa ama-gay noma ama-MSM abesilisa nabesilisa abesilisa abangase abanjwe emiphakathini yabo futhi besabe ukudalulwa kobulili babo. Kungabandakanya futhi i-MSM encane (kusukela intsha ngokujwayelekile ingasebenzisa amakhondomu) nabasebenzisi abangasebenzeli izidakamizwa ezingekho emthethweni abahlala besengozini yokutheleleka.
Ucwaningo lwe-PrEP engozini ephezulu ye-MSM seluthathe indlela "yezwe langempela", ukuhlola indlela amadoda angama-gay nabesilisa nabesifazane abaziphatha ngayo kunokuzama ukushintsha ukuziphatha kwabo kuphela. Ngokwenza kanjalo, amathuluzi okuvimbela afana ne-PrEP ayimvelo kakhulu. Lokhu, kuqinisekisa, ukuthi imizamo yokuvimbela ibhekwa lapho ikhona khona inzuzo enkulu kakhulu.
Imithombo:
> Pathela, P .; I-Hajat, A .; Schillinger, J .; et al. "Ukuhlukana phakathi kokuziphatha ngokocansi nokuzibiza ngokobulili okuzibizayo: Ukuhlolwa Kwabantu Okusekelwe eNew York City Men." Ama-Annal of Medicine yangaphakathi. Ngo-September 19, 2009; 145 (6): 416-425.
> Amasevisi Okulawula Nokuvimbela Izifo. "Ingozi yokuphila ngculaza e-United States." I-Atlanta, Georgia; enyatheliswa ngoFebhuwari 23, 2016.
> Umqashi, C .; I-Baral, iS .; van Griensven, F .; et al. "I-epidemiology yomhlaba wonke yokutheleleka ngegciwane lesandulela ngculazi kumadoda alala namadoda." I-Lancet. NgoJulayi 28, 2012; 380 (9839): 367-377.