Ukwedlulisa kungenzeka ngisho noma negciwane elingatholakali
Uma unesandulela ngculaza futhi uthatha izidakamizwa zakho njengoba kunqunyiwe, ungacabanga ukuthi ingozi yakho yokudlulisela igciwane kwabanye izobe iphansi, akunjalo?
Ezimweni eziningi, uzobe ulungile, kodwa zikhona izimo lapho abantu abanomthamo wegciwane elingenakutholakali egazini labo ngokuzumayo banegciwane elitholakalayo emzimbeni wabo noma emicimbini yomzimba. Lokhu kuyinto eyaziwa ngokuthi ukuchithwa kwegciwane.
Ngenkathi ikakhulukazi sibhekisela ekuchithweni uma kwenzeka emgodini wesilisa noma wesifazane (ukuchithwa komzimba), kungenzeka futhi emlonyeni (ukuchithwa komlomo).
Ukwenyuka komsebenzi wegciwane-ikakhulukazi ku-semen noma ukuvinjelwa kwamasendlini-kuhumusha ekutheleleni okukhulu kwegciwane lesandulela ngculazi kumlingani ongathintekile.
Indlela Ukukhishwa Kwezindlela Ze-Genital Kuqala
Ngokwesayensi, igama elithi "ukuchithwa" libhekisela enqubo lapho igciwane likhishwa, noma lichithekile, kusuka esitokisini esithintekayo eselilele. Izindlela ezimbili lokhu kungenzeka yizinqubo ezaziwa ngokuthi ukuqhuma kanye ne- apoptosis:
- Ukubheja kubhekisela esiteji emjikelezweni wokuphila nge - HIV lapho igciwane lithengisa i-membrane kusuka esitokisini elithelele ukudala igobolondo langaphandle. Kungase kuhlume kusuka kumlindi njengesifo se-free-circulating.
- I-apoptosis , eyaziwa nangokuthi ukuzibulala nge-cell, yinkqubo lapho i-cell izozibulala khona lapho ibeka ngaphansi kokucindezeleka. Ngesikhathi sokutheleleka okujwayelekile, i-apoptosis izobhubhisa igciwane elihlaselayo kanye neseli lemphathi ngokwayo. Kodwa ngegciwane lesandulela ngculazi, noma kunjalo, igciwane liyophoqa iseli libe yi-apoptosis ukuze likhulule inzalo yalo ukuba isakazwe.
Yikuphi okunye okuchazwayo ukuthi kungani ukuchithwa kwegciwane lesandulela ngculaza kungahle kwenzeke emgqeni wesisu kepha hhayi egazini lapho kungenakwenzeka khona ukuthi kungabonakali ngokuphelele.
Ubufakazi manje bubonisa ukuthi izici ezimbili zingase zibe nomthelela kulokhu: ukuhlukahluka kwegciwane lesandulela ngculaza ngaphakathi kwamaseli omzimba wethu kanye nokuhlukahluka kwezingculaza ezibhekene nezidakamizwa ngaphakathi kwezingcubu zomzimba wethu.
Ukukhishwa Kwezindlela Zokuhlukana Kwegciwane kanye neHIV
Enye yezimbulo zokuqala ezenzeka ngo-2000 lapho kutholakala ukuthi uhlobo lwe-HIV lungashintsha kusuka kwenye ingxenye yomzimba kuya kwesilandelayo. Ngokusho kocwaningo oluvela ku-Multicenter AIDS Cohort Study (MACS) eside, abanye abantu abanesandulela ngculazi baboniswe ukuthi banezifo ezihlukahlukene zegciwane egazini labo kanti omunye emaseni abo.
Ucwaningo lwaqhubeka lubheke emaphethweni okuchitha phakathi kwabahlanganyeli bezocwaningo. Kwezinye izimo, ukuchithwa kwakuyinkambiso eqhubekayo eyenzeka kokubili igazi negazi. Kwabanye, kwakungaphakathi futhi kwenzeka ngokuyinhloko emaphethelweni okuzala. Kwamanye namanje, kwakungekho ukuchithwa nhlobo.
Lokho okutholakele okuphakanyisiwe kwakungukuthi:
- Ukuhluka kwe-HIV kungahumusha izimpendulo ezihlukile kokwelapha.
- Ukuchithwa kwe-HIV kungase kube yisimo lapho umuntu ehlelwa khona ngokofuzo.
Kulabo bantu ababhekene nokuchitha okwesikhashana, okutholakele kwakunzima nakakhulu. Kula madoda, abaphenyi be-MACS baphawula ukuthi ukutheleleka kwama-bacterial of the prostate gland kwakusondelene ngokuqondile nama-spikes emisebenzini yegciwane emzimbeni. Bakholelwa ukuthi ukuvuvukala kwendawo ye-prostate (isitho esikhiqiza isilwane) kwaqeda ukuchitha ngokusebenzisa ama-virus ahlale ehlanganisiwe emaseli we-prostate gland kanye nama-vesicles okugcoba.
Ucwaningo oluqhubekayo luye lwasekela kakhulu lokhu okutholwe futhi luye lwabonisa ukuthi ukuchithwa kungenziwa njengomphumela oqondile wezifo ezithathelwana ngocansi (STIs) , izifo ezihlala ndawonye, ngisho nokuya esikhathini .
Ukuphumelela kwezidakamizwa ze-HIV kungadlulela egazini, ama-Tissues
Sihlola igazi nge-HIV hhayi ngoba kuyindlela engcono kakhulu yokutheleleka kodwa ngoba inikeza ukufinyelela okulula uma kuqhathaniswa nalokho, ukuthi, umnkantsha noma amasampuli amathishu. Lokhu akusho ukuthi akuyona isilinganiso esiqine kakhulu-kodwa-ke asisiphi isithombe esiphelele ukuthi izidakamizwa ezithinta izidambisigciwane zingena kanjani emaqenjini namathisini ahlukene emzimbeni wethu.
Sekuyisikhathi eside sesazi ukuthi izidakamizwa ezifana ne-zidovudine (AZT) zikwazi ukungenelela ubuchopho namaseli omgogodla ngokuphumelelayo nangokwakheka okuphezulu kunokuba yonke imithi ye-HIV. Yingakho kwase kuyisikhathi eside isetshenziswe kubantu abanenkinga yokunciphisa ingculaza njengendlela yokuqhubekela phambili kancane kwesifo.
Ngokufanayo, kukhona ubufakazi obukhulayo umuthi weTruvada, lapho usetshenziswa njengesifo sokuvimbela ( owaziwa ngokuthi i-PrEP ), awufaki emathisini asiswini ngendlela efanayo.
Ucwaningo oluvela eNyuvesi yaseNorth Carolina e-Chapel Hill lubonise ukuthi ukuhlushwa kweTruvada emathisini angama-rectal kunganikeza ukuvikeleka okungaphezulu kwamaphesenti angama-90 nje kuphela ngamanani ama-PrEP amabili noma amathathu ngesonto . Ngokuphambene nalokho, ukuhlushwa kweTruvada ezithombeni zangasese kwakuphansi kakhulu, kuhlinzeka kuphela ukuvikelwa kwamaphesenti angu-70 ngisho nokunamathela okuphelele kwansuku zonke.
Okufanayo kungasebenzisa kahle kakhulu isici sobulili besilisa. Uma kunjalo, kungenzeka ukuthi ukwelashwa kwegciwane lesandulela ngculaza kungalimaza igciwane kwenye indawo emzimbeni kodwa kungaphumeleli emgqeni wokubeletha uma kukhona ukutheleleka.
Kulokho, kukholelwa ukuthi isimiso somzimba sokuzivikela singase sibe yimbangela enkulu eyenza ukuba abantu besilisa nabesifazane bahlasele.
Indlela Umzimba Wakho Wokuzivikela Ngayo Uvuselela Ukukhishwa
Ukuba khona kwanoma yikuphi ukutheleleka kuzokwenza kusebenze amasosha omzimba. Uma lokhu kwenzeka, umzimba uzophendula ngokukhulula izinto emzimbeni obizwa ngokuthi i- cytokines ekhombisa ukuthi iqondise futhi iqondise amangqamuzana omzimba emthonjeni wokutheleleka. Nakuba amanye ala ma-cytokines esiza ukulwa nezifo, ezinye zinomphumela ophikisanayo ngokuthi "ukuvusa" i-HIV encane efihliwe emaqenjini ahlukene namathisini omzimba.
Eyaziwa njengezindawo zokugcina ezigciniwe , lezi zindawo zamaselula zivikela ngempumelelo i-HIV emzimbeni wokuvikela omzimba. Ngokuvamile ngesikhathi sokugula okunzima, lapho isimiso somzimba sokuzivikela sisasebenza, ukuthi igciwane lizovela ngokungazelelwe. Yingakho abanye abantu behamba iminyaka bengenawo ukwelashwa bese ngokungazelelwe babe nokugula okukhulu okuhambisana ne-spike enkulu emisebenzini yegciwane.
Iphethini efanayo ibonakala isebenza ekusatsheni kwegciwane lesandulela ngculaza. Ngaphambi kokutheleleka, tshela i-STI noma i- prostatitis , isimiso somzimba sokuvikela omzimba sizokhipha uhlu oluhlukile lwe-cytokines engenazifo (uhlobo oluhambisana nokuvuvukala). Ukuqhuma okungazelelwe kokuvuvukala kwendawo kuhlobene ngokuqondile nokunyuka kokuchithwa kwegciwane.
Uma lokhu kwenzeka, amangqamuzana egazi amhlophe avikela (i-leukocytes) ngokuzumayo azokhukhula isayithi lokutheleleka. Enye i-leukocyte enjalo, ebizwa ngokuthi i- CD4 T-cell , iyona njongo enkulu ye-HIV. Njengoba lezi T-seli zitheleleke ekuhlaselweni kokuqala, izinamba zamagciwane zikhuphuka kuze kube yilapho isikhathi sokutheleleka kwangasese senziwa ngaphansi kokulawula.
Kulolu hlelo lokuqhuma komzimba ukuthi umuntu onokwelashwa kwe-HIV angase adlulisele igciwane kwabanye. Ngenkathi umthamo wegciwane kungakhula ngegijimi eyodwa noma ngaphezulu (ukuxhuma kusuka, uthi, 100 kuya ku-1,000), kungase kube okwanele ukwenza lula ukutheleleka.
Ukwethula i-HIV Ngesikhathi sokuya esikhathini
Ukuchithwa kwegciwane lesandulela ngculaza kungenzeka ngenxa yesikhombisa. Ngesikhathi ukuchithwa kungase kungabi kakhulu ukwandisa ingozi yokudlulisela kubantu besifazane ekwelashweni kwe-HIV, kungaba kulabo abangabazi isimo sabo noma abazange baphathwe.
Ucwaningo oluvela e-Oregon Health and Science University (OSHU) luhlolisise iqembu labesifazane ababethelwa ekuzaleni ngokocansi ngenxa yokutheleleka kwe- herpes simplex (HSV-2) ekhona. (I-HSV-2, igciwane elichaphazela amaphesenti angu-67 womphakathi womhlaba, liyaziwa ngokubangela ukugcoba kwamagciwane kokubili abesifazane abanobuhlungu nabangenakuqhathaniswa .)
Phakathi kwaleli qembu labesifazane, ukuchitha i-HIV kwavame ukuhamba ngesikhathi sokuya esikhathini nokukhula okwezingxenye eziyisishiyagalombili kumthamo wegciwane uma kuqhathaniswa nomjikelezo wokuqala. Lokhu kwenzeke ukuthi owesifazane wayenezimpawu ze-HSV-2 noma cha. Nakuba lokhu kwanda kungase kungabonakali kakhulu kwabesifazane abanomsebenzi wegciwane ocindezelweyo, kwakubhekwa njengabalulekile kulabo abanemithwalo ephezulu yegciwane lesandulela ngculazi.
Ngokusho kwabacwaningi, ukuchithwa kwamagciwane ngesikhathi sokuya esikhathini kungase kusho ukuthi ukwanda kwamaphesenti angu-65 kwengozi ye-HIV uma owesifazane engaphathwa kabi. Ngokuphambene, ukwelapha i-HIV kunganciphisa, nakuba kungenakuqedwa ngokuphelele, ingozi kumlingani wesilisa othelelekile.
Izwi elivela
Kusukela ukwethulwa kwe-PrEP, sibonile ukwehla okulinganiselwe ekusetshenzisweni kwamakhondomu. Esinye isifundo sesiFulentshi, eqinisweni, sabonisa ukuthi uma umuntu ethatha ngokuphindaphindiwe wathatha i-PrEP, cishe uzobe esebenzisa amakhondomu (amaphesenti angama-54 angeke abe khona).
Ngenkathi ukuphumelela kwe-PrEP ngokungangabazeki, ikakhulukazi emibhangqwaneni yokuxubana nabantu kanye nabantu abasengozini enkulu yokutheleleka, akufanele kubonise ukuthi amakhondomu ayabaluleki kangako kunabo bonke.
Ekugcineni, noma yikuphi ukutheleleka nge-HIV kubangelwa izici eziningi ezihlanganisa, phakathi kwezinye izinto, uhlobo lomsebenzi wocansi ohilelekile kanye nempilo ejwayelekile yabantu abangahlosiwe. Ngisho noma umthamo wegciwane lomuntu osulelekile uphansi, ezinye izici zingakwazi ukuphakamisa eyodwa phezulu kokuya kwandisa ingozi, ngezinye izikhathi ngokuphawulekayo.
I-STI engahlosiwe ihlanganiswe ne-bacterial vaginosis ehlanganiswe ne-spike ebizwa ngokuthi yi-viral activity ngezinye izikhathi konke kudingekile ukuguqula umsebenzi "wobucansi" ube yithuba lokutheleleka.
Uma ungabaza mayelana nomlingani wakho wezocansi, futhi uma unezihlobo eziningi zocansi, ungathathi ithuba. Sebenzisa amakhondomu nanoma yimaphi amanye amathuluzi okuvikela ukuze uzivikele wena nomlingani wakho.
> Imithombo:
> Gupta, P .; Leroux, C .; I-Patterson, B .; et al. "I-Human Immunodeficiency Virus I-Pattern 1 Shedding Pattern ku-Semen Correlates ne-Compartmentalization of Viral Quasi-Species phakathi kwegazi ne-Semen." Journal of Infectious Diseases. 2000: 182; 79-87.
> Patel, E .; Kirkpatrick, A .; Grabowski, M .; et al. Ukuvuselelwa kwe-Penile Immune and Risk of Shedding of HIV: A Study Out Cohort Study. " I-Dis Infect Dis. 2017; 64 (6): 776-784.
> Spencer, L .; Ama-Christiansen, iS .; U-Wang, C. "Ukuvuselelwa Kwamasosha Omzimba Nokuxilongwa Kwegciwane lesandulela ngculaza Emkhakheni WamaGenesti Womfazi." I-Journal ye-Immune Deficiency Deficiency Syndromes. 2016; 71 (2): 155-162.
> Cottrell, M .; I-Yang, K .; Prince, H .; et al. "Ukubikezela amaqhinga okubheka ama-Truvada PrEP esebenzayo ngesimo se-PK-PD esinoveli esihlanganisa izicubu ze-metabolites esebenzayo kanye ne-nucleotide engapheli (EN)." Ingqungquthela yokuCwaninga nge-HIV; EKapa, eNingizimu Afrika; Okthoba 28-31 2014; isicaciso somlomo 22.06 LB.
> Teyssier, L .; Suzan-Monti, M .; I-Castro, D. "I-PrEP nokusetshenziswa kweKomso ku-MSM High-Risk ku-ANRS IPERGAY Trial." Ingqungquthela yama-Retroviruses kanye nezifo ezithinta amathuba (CROI); IBoston, eMassachusetts; Februwari 22-25, 2016; abstract 887.