Umbuzo wokubuza umxhumanisi oqondile futhi uphakamise ukuhlangana nobungozi obuphezulu obungozi
Kukhona iziphakamiso ezinde ukuthi umkhuba wokuwazisa ama-vaginal, uhlangothi lwama- vaginal, ungandisa ingozi ye-HIV ngokususa amabhaktheriya okuthiwa "amahle" avela ku-flint / rectal flora ngenkathi ebangela ukucindezeleka kumathiski amancane angama-mucosal afaka lezi zitho.
Ingabe lokhu kungaba yiqiniso? Kungenzeka ukuthi imikhuba ingacabangela ukuthuthukisa impilo kanye nokuhlanzeka komuntu siqu ngokungenakuqhathanisa ukwandisa ingozi yegciwane lesandulela ngculaza ngaphandle kwethu ngisho nokwazi?
Izifundo Zokuqala Ukuphikisana Okuphambene Nokudideka
Kusukela ngasekupheleni kwawo-1990, izifundo eziningana zahlanganiswa ngokungathí sina i-douching ne-HIV nezinye izifo ezithathelwana ngocansi (STIs) . Eziningi zalezi zifundo zaqhutshwa e-Afrika, lapho kwaphakanyiswa khona ukuthi ukusabalala kwamasini akukona nje ukwandisa ingozi ye- bacterial vaginosis ngamaphesenti angu-60 kodwa okwenze njalo kubesifazane abane-HIV. Ngesikhathi abacwaningi behluleka ukusungula isixhumanisi esicacile phakathi kwe-HIV kanye ne-douching, basikisela ngokuqinile ukuthi kungenzeka ukuthi ukudluliselwa kuphakeme.
Kodwa-ke, kwakukhona izici eziningi ezenza isixhumanisi esicacile sikwazi ukusungula. Phakathi kwalezi zinto kwakuyiziningi zezifundo zakuqala ezenziwa ngezilungiselelo ezinganiselwe, ezifana ne-Afrika, lapho impilo jikelele kanye nokufinyelela ekunakekelweni kuvame ukutshela imiphumela. Iningi locwaningo luye lwaqhutshwa phakathi kwabasebenzi bezocansi bezohwebo (CSWs) , lapho inhlangano ephakathi kwe-HIV neminye imikhuba (njengokusebenzisa ikhondomu , isandulela ngculazi, ukusetshenziswa kwezidakamizwa ) ngokungahle kube nomthelela omkhulu ekungeneni kokutheleleka kunokuba ihlanganise ne-douching.
Ngaphezu kwalokho, imiphumela evela ezilingo zazivame ukuphikisana. Ucwaningo oluthile eKenya, luphetha ngokuthi ukungena kwesinye sangasese kuhlotshaniswa nokusetshenziswa kwamakhondomu okuba ngu-1.5 kuya kwezingu-2,5 ngaphezulu uma kuqhathaniswa nabalingani babo abangafani. Isifundo samaShayina eminyakeni embalwa kamuva kamuva sabonisa okuphambene nalokho, nge-vaginous douching ehambisana nokusetshenziswa kakhudlwana okuncane kakhulu.
Imvelo ephikisanayo yocwaningo yenza kuphela ukuphikisana nenkulumo-mpikiswano eqhubekayo, abaningi bebheka ukuthi kunamathuba amaningi kakhulu abaphangi abangase bakwazi ukubeka isixhumanisi esicacile phakathi kwemikhuba ye-HIV kanye ne-douching.
Izifundo Zamuva Zinikezela Ngokucacile
Ngonyaka wezi-2012, izifundo eziningi eziningana zanikeza ulwazi olucacile lokuthi kungenzeka yini ukutheleleka ngegciwane lesandulela ngculazi kulabo abavame ukugeza.
Okokuqala, okwenziwe njengengxenye yezilingo ze-HPTN 035 ze- HIV microbicide , kuhlanganisa nabesifazane abangu-3,099 abasebenza ngokocansi, abesifazane abangenayo i-HIV eMalawi, eNingizimu Afrika, Zambia, Zimbabwe naseFiladelphia. Ngokusho kocwaningo, abangaphezu kwesithathu kwabahlanganyeli babe ne-bacterial vaginosis ekuqaleni kokuqulwa kwecala, inani lalo alizange lishintshe kulo lonke izifundo zeminyaka emithathu, kungaba phakathi kwabesifazane abenza ukuhlanza kwesisu noma labo abangazange bawasebenzise.
Kubhekwe njengesibalo esifanele, imiphumela ye-HPTN 035 ngokuphambene ngokuphikisana nayo eminingi yezifundo zangaphambili eziye zaphakamisa ukuthi ibhaktheriya vaginosis-ngokwayo ehlotshaniswa nokwanda kwegciwane lesandulela ngculazi-ingase ivuselelwe ukugubha kwesisu.
Ucwaningo lwesibili oluqhutshwa eLos Angeles alukhombisi ukuxhumana phakathi kwe-vaginal noma i-rectal douching ne-HIV kwabesifazane. Ucwaningo lwalokhu ikakhulukazi njengoba abangu-71% babahlanganyeli babika ukuthi babe nobulili obufanayo, kanti abangu-18% babika oxhumana nabo ngale nyanga edlule.
( Ubulili obunayo bokutholwa buhlala buningi obungozi obukhulu obuhlobene nokutholakala kwe-HIV, okungaphezu kwezikhathi ezingu-18 kunomzimba wesitho sangasese.)
I-HIV ne-Rectal Douching kubantu
Ucwaningo lokugcina, uphenyo ngokuxhumanisa phakathi kwe-HIV kanye ne-rectal douching emadodeni abelana ngesondo namadoda (MSM) , abhale isithombe esinkimbinkimbi kakhulu. Kwama-MSM angu-413 abenza ama-douching ama-rectal, 44% banesandulela-ngculazi ne-18% kuphela kwalabo abangazange bafeze. Ukubukwa kwe-Douching kwahlanganiswa cishe kabili inani lama-STIs phakathi kwabahlanganyeli bokucwaninga (21% kuya kwe-11%).
Ngenkathi, ebusweni, lokho okutholakala kuvele ngokuphathelene nabo, abacwaningi basheshe baphowule ukuthi i-douching rectal, ngaphakathi kwayo, ayingeyona imbangela yamanani akhule.
Esikhundleni salokho, ukunambitheka kwama-rectal kwahlanganiswa kalula nemikhuba eyaziwayo yokwandisa ingozi ye-HIV, okungukuthi umlingani ocansini ocansini nokusetshenziswa kwezidakamizwa zokuzilibazisa.
Ngokucacile, phakathi kwe-MSM kulolu cwaningo, labo abathintekayo babeneminyaka engama-5 abalingani bezocansi ezinhlanu kulezi zinyanga ezintathu ezedlule ngokubhekene nabangewona amabheji abanobabili. Ukusetshenziswa kwezidakamizwa zokungcebeleka kubonakala sengathi kunomthelela ekunyuseni kokuphindwe kane kwezingculazi uma kuqhathaniswa ne-MSM engasebenzisi izidakamizwa.
Ngokusekelwe kwedatha, abacwaningi baphetha ngokuthi ukukhwa kwe-rectal kwakungumkhuba owodwa ohambisana nemisebenzi engozini enkulu kunokuba yi-stand-alone factor nokuthi ekugcineni kwaba nenani labalingani bobulili abadlala indima enkulu kunazo zonke emazingeni amanani. Eqinisweni, ucwaningi oluningi namuhla lubonisa ukuthi i-MSM abanezinsizakalo ezine zobulili ezingaphezu kwenyanga eziyisithupha ine-32.3% engozini enkulu ye-HIV kungakhathaliseki ukuthi yiziphi ezinye izici zokuziphatha, kuhlanganise nokusetshenziswa kotshwala / izidakamizwa kanye nobulili obuncane .
Abacwaningi baphetha ngokuthi imikhuba yokuhlanzeka kwe-rectal isivele ivamile, ikakhulukazi phakathi kwe-MSM, futhi cishe ayihlotshaniswa nengozi ye-STI.
Imithombo:
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