Icala eliqinisekisiwe le-HIV lifakazela ukucabangela nokugqamisa izingozi
Ingozi ye- HIV phakathi kwama-lesbians (okubizwa nangokuthi abesifazane abalala nabo besifazane) sekuyisikhathi eside ibhekwa njengephansi. Kodwa njengoba kwakamuva nje ngo-2014, kube khona amacala okudluliswa ngokocansi phakathi kwabesifazane ababili lapho kungekho khona enye indlela engenzeka yokutheleleka.
Ingabe lokhu kusho ukuthi ukudluliselwa ngokocansi kwebesifazane-kuya-wesifazane ngeke kusabhekwa njengokungajwayelekile? Noma ingabe zikhona izici ezicacile ezandisa ukwenzeka kokutheleleka okungase kwazise amasu okuvimbela phambili?
Kungani "Abesifazane Abalala Nabafazi?"
Abesifazane abalala nabesifazane (i-WSW) igama elisetshenziselwa ukuhlukanisa abesifazane abenza umsebenzi wocansi nabanye besifazane, kungakhathaliseki ukuthi bazikhomba kanjani. Leli gama lakhiwa ngawo-1990 ngama-epidemiologists njengethuluzi lokubheka ukukhomba kangcono umzila wokudluliswa kwe-HIV nokusabalala kwesifo ngokusebenzisa umsebenzi wesifazane ocansini wesifazane.
Ngaphambi kwalokhu, abacwaningi babekuncishiswe ukuhlaziywa okusekelwe kulo, lapho abesifazane abathintekayo njengabesilisa abesilisa ocansini noma abesilisa nabesilisa noma abesilisa nabesifazane ababesithandana nabo ngokobulili, kanti labo abathintekayo bangase bahlanganyele ngokocansi nabanye besifazane.
Igama elithi WSW kunalokho ligxila ekuziphatheni kunokuba kube nokuzimela komphakathi noma kwezenhlalakahle, ngaleyo ndlela kuhlinzeke isithombe esicacile sokusakazeka kwegciwane lesandulela ngculazi futhi, futhi, ukuqonda kangcono impendulo ehlobene nokuvimbela i-HIV.
Izinga lokutheleleka nge-HIV Phakathi kwe-WSW
Esikhathini somlando we-HIV, iningi lokugxila kwezempilo lomphakathi liye lafakwa ekudluliseni i-HIV phakathi kwamadoda alala namadoda (MSM) , namanje kucatshangwa phakathi kwesigaba esingozi kakhulu emazweni amaningi.
Ngokuphambene nalokho, i-HIV phakathi kwe-WSW iye yakhathalela kakhulu, futhi inkolelo evamile yokuthi, njengeqembu, ingengozi yokutheleleka.
Izibalo zisekela ngokuyinhloko leyo nkolelo. Ngokusho kwe-US Centers for Disease Control and Prevention (CDC), kwabangu-246 461 baseMelika abanesandulela ngculaza ngo-2004, kuphela abangu-534 ababika ukuthi balala nobulili kuphela nabesifazane.
Kulezi, 91% kwakunenani elilodwa eliyinhloko engozini, ikakhulukazi ukujova ukusetshenziswa kwezidakamizwa . Ucwaningo olunjalo lufumene ukuthi ngaphandle kwabanikeli begazi besifazane abayizigidi, akekho owodwa ohlonzwe ngegciwane lesandulela ngculaza obike ucansi nomunye owesifazane njengengxenye yengozi kuphela.
Amacala amaningi aphethwe awakungekho kwabesifazane ababesifazane kuphela ababesifazane ocansini kodwa phakathi kwalabo abathintekile ngokusebenzisa eminye imisebenzi engozini enkulu, njengokwesilisa nomlingani wesilisa ocansini. Ucwaningo lwe-2003 oluqhutshwa yi-CDC lubonise ukuthi phakathi kwabesifazane abangu-3 139 ababhekene ne-HIV, abangu-14% wabesifazane abamhlophe, abesifazane abangu-6% abamnyama, nabesifazane abangu-6% baseSpanishi bavuma ukuthi balala nobuhlobo bobulili obuhlukile.
Ukwengeza, ukujova ukusetshenziswa kwezidakamizwa phakathi kwabesifazane abanegciwane lesandulela ngculaza kubonakala sengathi kuyindlela yokuqala yokutheleleka phakathi kwama-24% kuya kuma-33% amacala.
Amacala okudluliswa kwe-HIV Phakathi kwe-WSW
Kuze kube manje, kube khona amacala ayisithupha kuphela okudluliselwa kwe-HIV phakathi kwe-WSW lapho ezinye izinto ezibeka engozini eziphezulu zingabonakali kalula.
Ngo-2003, kubikwa ukuthi owesifazane wase-Afrika waseMelika uthola i-HIV kumlingani wakhe wesifazane ngemuva kocansi olunamandla esebenzisa amathoyizi abelana ngesondo. Ukuhlolwa kwe-Genotypic kuqinisekisile imidwebo yezakhi zofuzo lomlingani. Bobabili besifazane babike ukuthi ubudlelwane babo bebuhlobo obulodwa futhi abuzange bahlanganyele ocansini nendoda.
Njengoba kwakungekho bufakazi bokusebenzisa injini yezidakamizwa, kwaqedelwa ukuthi ukusetshenziswa okukhulu kwamathoyizi okulwa nobulili kwaholela ekutheni kuhanjiswe ngamanzi omzimba okhethwe igazi.
Ngenxa yokuthi umlingani olwa negciwane lesandulela ngculazi wayephethe ukwelashwa kwama-antiretroviral (ART) , labesifazane bakholelwa ukuthi kungenzeka ukuthi ingozi yokudluliselwa yayingenakwenzeka futhi akazange acabange ukusebenzisa izithiyo zokuvikela ezifana namadamu wamazinyo noma amakhondomu.
Ngo-Mashi 2014, icala elifanayo libikwa i-CDC lapho owesifazane oneminyaka engu-46 ubudala waseTexas "engase athole" i-HIV ngokusebenzisa ubulili nomlingani wakhe oneminyaka engu-43 ubudala, nomlingani wesifazane ongu-HIV. Ukuhlolwa kofuzo kuboniswe umdlalo we-98% kulelo gciwane lomlingani wakhe, kuyilapho izinkinga eziningi ezingabangela ukutheleleka zazingekho.
Njengasekuqaleni, bobabili besifazane bathi bavame ukusebenzisa izithiyo zokuzivikela ngesikhathi socansi nokuthi ukuxhumana kwabo ngokobulili "kwakunzima kakhulu ukuvimbela ukuphuma kwegazi." Ngaphezu kwalokho, kuthiwa abalingani babenezocansi ezingavimbelwe ngesikhathi sezinyanga.
Kodwa-ke, ngokungafani necala lika-2003, umlingani olwa negciwane lesandulela ngculazi wayeke wayeka ukuthola i-ART cishe eminyakeni emibili ngaphambili, ephakamisa ukuthi umthamo wakhe wegciwane ophakeme ungenza kube khona amathuba okudlulisela i-HIV. Ngaphezu kwalokho, lapho kuqala ukwelashwa, lo wesifazane wayenesisindo esikhulu sokulahlekelwa isisindo kanye ne- esophageal candidiasis , okuyiyona enye yezincazelo ze-AIDS ze- CDC .
Uma ubheka lezi zici ngokugcwele kwazo, kuyacaca ukuthi ukuhlanganiswa kwalezi zici kwakha okuthile "kwesiphepho esiphelele" sokutheleleka, lapho izinambuzane ze-genitalia noma i-rectum eziphazamisekile noma ezilimele zinganikeza ukufinyelela okulula kwe-HIV.
Ukuvimbela i-HIV phakathi kwe-WSW
Yize ubufakazi obukhona bubonisa ukuthi ingozi yokudlulisela i-WSW ingenasiphelo kakhulu ngaphandle kwezinye izici eziyingozi, ukuvimbela kubonakala kubalulekile. Lokhu kuyiqiniso ikakhulukazi kwabesifazane abalala naye nomlingani wesifazane ongu-HIV noma abaqiniseki mayelana nesimo somlingani womlingani. Izinto ezikhona ezingcupheni zibandakanya:
- Ukukwabelana ngamathoyizi wezocansi
- Ukushaya, ikakhulu uma kukhona ukuchayeka kwegazi
- Ucansi olwenziwa ngomlomo
Ukuze kuqinisekiswe ingozi encane, ukusetshenziswa kwamakhondomu, amadamu kanye namadamu wamazinyo kunconywa, ikakhulukazi ngesikhathi sokuya esikhathini.
Ukwengeza, umthamo ophezulu wegciwane lesandulela ngculazi kumlingani we-HIV, kungakhathaliseki ukuthi uphathwe noma ungatholakali, uhambisana nobungozi obuphezulu. Ngakho-ke, isidingo sokuhlolwa kokuqala kanye nokwelashwa kubhekwa njengesihluthulelo sokuvimbela. Lokhu kubaluleke kakhulu emibhangqweni ye-serodiscordant, lapho umlingani oyedwa enesandulela ngculazi kanti enye ingenayo i-HIV. Ucwaningo lwamanje lubonisa ukuthi abantu abanegciwane lesandulela ngculaza abanesifo esingenakutholakali segciwane lengculazi bangamaphesenti angama-96% okudlulisela i-HIV kumlingani ongathintekile, isu elibizwa ngokuthi ukwelashwa njengokuvimbela (i-TasP) .
Kunconywa ukuthi ukuhlolwa kwezifo ezithathelwana ngocansi kungenziwa ngoba lezo zifo zingakwazi ukwandisa ukuhlukunyezwa kwezicubu zomzimba zangasese.
Imithombo:
Amasevisi aseMelika okuLawula nokuvimbela izifo (CDC). "I-HIV / AIDS phakathi kwabesifazane." E-Atlanta, eGeorgia; ngo-Agasti 2008; kutholakala ngo-Ephreli 2, 2014.
U-Kwakwa, H. noGhobrial, H. "Ukwelashwa Kwesilisa Kwabesifazane Ye-Virus Human Immunodeficiency Virus." Izifo Ezithathelwanayo Emitholampilo. Ngo-September 24, 2002; 36 (3): e40-e41.
Chan, S .; Thornton, L .; Chronister, K .; et al. "Kungenzeka Ukuthunyelwa Kwesifazane Kwabesifazane Ukudluliswa Kwegciwane lesandulela ngculazi - eTexas, 2014.V Ukubika Kwamaviki Kanye Nokufa Kwamaviki onke (MMWR) ngoMashi 14, 2014; 63 (10): 209-212.
Cohen, M .; I-Chen, i-Y .; UMcCauley, uM .; et al. "Ukuvimbela ukutheleleka nge-HIV-1 nge-antiretroviral yokuqala yokwelapha." I-New England Journal of Medicine. Agasti 11, 2011; 365 (6): 493-505.