Ukukhubazeka okuningi kwandisa ingozi emadodeni nakwabesifazane
Ukulala ngokobulili kungenye yezindlela eziyinhloko umuntu angatheleleka nge-HIV. Lokhu kubangelwa ukutheleleka okusha okungaba ngu-7 500 phakathi kwabesifazane minyaka yonke e-US kanye nokutheleleka okusha okuba ngu-1 000 phakathi kwabantu abesilisa nabesifazane.
Emhlabeni wonke, lezi zibalo ziyakhathaza nakakhulu. Ngenkathi ukuhanjiswa kwe-HIV e-US kunomzimba ophezulu phakathi kwamadoda angama-gay nabesilisa nabesifazane (abamele amaphesenti angu-63 azo zonke izifo ezintsha), izihlobo zobulili obuhlukile zikhona kakhulu eqenjini elichaphazelekayo emhlabeni wonke.
Lokhu kuyiqiniso ikakhulukazi e-Afrika lapho iningi lazo zonke izifo ezine ezinhlanu noma ezinhlanu ziphakathi kwezihlobo zobungqingili. Kulezi zindawo, ubulili besifazane ngumzila omkhulu wokutheleleka.
Ingozi yeHIV ngomsebenzi wocansi
Lapho bekhuluma ngengozi ye-HIV, abantu bazama ukuhlola ukuthi yiliphi "uhlobo" lobulili obuyingozi; ubulili, isilwane, noma ngomlomo. Ngokombono obala, ubulili obudala bubhekwa njengengozi enkulu kakhulu engozini engozini enkulu engamashumi ayisishiyagalombili yokutheleleka uma kuqhathaniswa nobulili besifazane.
Kodwa loluhlolo luyiphutha, okungenani kusuka kumbono ngamunye. Ngesikhathi ubulili bungase kube "engezansi" engozini, izibalo azicabangi ngendlela isifo esakazwa ngayo phakathi kwamadoda nabesifazane noma ukukhubazeka okubeka abanye abantu engozini enkulu kakhulu yokutheleleka.
Ngokwesibonelo, cabanga ukuthi abesifazane basuka cishe kathathu kuya kwesine amathuba okuthola i-HIV emadodeni kunanoma iyiphi enye indlela.
Noma ukuthi abesifazane abasebasha banamathuba amaningi okuthola i-HIV ekuhlanganisweni kwakhe kocansi kokuqala kunomlingani wesilisa.
Ngakolunye uhlangothi, kunamadoda athile abakhulu kakhulu ukuthola i-HIV kunezinye. Ucwaningo luye lwabonisa ukuthi amadoda angasokile angaphezu kokuphindwe kabili ukuthola i-HIV ngemuva kobulili besifazane kunabesilisa abasokile.
Ukuhlukunyezwa kuyahlukahluka ngabanye, ngakho ukuhlola ukuthi ingozi yangempela yobulili besifazane kudingekile ukuqonda kangcono izici ezibeka abanye besifazane nabesilisa engozini enkulu kunezinye.
Ukulimala Okungahle Kukhulise Ingozi Yegciwane lesandulela Ngculaza Kwabesifazane
Ingozi yegciwane lesandulela ngculazi ekubhekaneni ngokobulili elingavimbelwe liphakeme phakathi kwabesifazane ngezizathu eziningana. Ngokombono womzimba, izicubu zesisu (i-epithelium) zitholakala kakhulu kunegciwane lesandulela ngculaza kunezidakamizwa.
I-HIV ikwazi ukudlula kulezi zinhlayiya uma isimiso somzimba sokuzivikela sesigciwane sesibona igciwane elihlasela futhi ithumele amangqamuzana avikelayo okuthiwa ama-macrophage namaseli e-dendritic ukuze "abambe futhi abahudule" emgodini ozobhujiswa. Esikhundleni salokho, i-HIV ijika itafula futhi ihlasele amaseli (abizwa ngokuthi ama- CD4 T-cells ) ahlose ukuwasiza. Ngokwenza kanjalo, umzimba usiza ukusiza ukutheleleka kwawo.
Futhi, ngoba indawo ebusweni ye-epithelium yangasese ikhulu kakhulu kunaleyo ye-urethra yesilisa, ithuba lokutheleleka likhuphuka, ngokuvamile livele ngokucacile.
Okunye ukuhlukumeza ngokomzimba kubandakanya:
- Amaseli angaphansi komlomo wesibeletho asengozini ikakhulukazi e-HIV, ikakhulukazi ngesikhathi sobusha, ukukhulelwa kokuqala komfazi, noma ngaphambi kokutheleleka ngokocansi (i-STI) njenge-chlamydia noma i- papillomavirus yabantu (HPV) .
- Abesifazane abanesifo sofuba, kungakhathaliseki ukuthi ama-bacterial, viral, noma fungal, basengozini enkulu. Ucwaningo oluthile luphakamisa ukuthi i-bacterial vaginosis ihlotshaniswa nokukhushulwa kowesishiyagalombili engozini. Lokhu kuhumusha ibe yithuba elilodwa lokuthola i-HIV ngesikhathi socansi.
- Isikhathi sokuchayeka kanye nomthamo we-fluid onegciwane kukhona izici eziyinhloko ekunqumeni ukuthi umuntu uthola igciwane noma cha. Ngakho-ke, ucansi oluvikelekile lungakhuphula ingozi ye-HIV kumuntu wesifazane uma le ndoda ingena emzimbeni wayo.
- Izilonda ezivulekile noma izilonda ezivela kuma-STIs njenge-syphilis zingandisa ingozi kulaba besilisa besifazane. Kulaba besifazane, kepha izilonda zivame ukungena ngaphakathi futhi zingabonakali.
- Nakuba ukusetshenziswa kwansuku zonke kwegciwane lesandulela ngculazi okuthiwa i- pre-exposure prophylaxis (i-PrEP) kunganciphisa kakhulu ingozi ye-HIV kumlingani ongathintekile, kukhona ubufakazi obusebenza kahle kakhulu kwabesifazane. Ukucwaninga kusikisela izinga le-molecule yesikhumba esebenzayo emathisini wesisindo asisondelene kakhulu nasemathangeni angama-rectal.
- Imikhuba ye-Douching ingabuye ishintshe isitshalo se-"good" sesibindi, nakuba lokhu kusengaphansi kwengxabano .
Ayikho into yalokhu okucatshangelwayo ekucatshangeni noma yikuphi ukuhlukunyezwa kwezenhlalakahle okungabangela abesifazane ukuba bangene engozini. Lokhu kufaka phakathi ubudlova bezocansi ebuhlotsheni obungagcini nje ithuba lomfazi lokuzivikela kodwa kungabangela ukulimala kwezicubu ezincibilikile zesisu.
Ubumpofu, imigomo yezenhlalakahle, nokungalingani ngokobulili kuqinisekisa ukuthi noma yikuphi ukubusa umuntu angase abe nakho ngaphandle kwekamelo lokulala kuzokwengeza ekamelweni lokulala. Zonke lezi zifaka amazinga aphezulu e-HIV kwabesifazane.
Ukulimala Okukhulisa Ingozi Yegciwane lesandulela Ngculaza Kwabesilisa
Iqiniso lokuthi amadoda angatholakali negciwane lesandulela ngculazi kunabesifazane akufanele bahlaselele iqiniso lokuthi nabo banokukhubazeka okungakhuphula ingozi yabo yokutheleleka.
Siyazi, isibonelo, ukuthi i-penis engasokile ingenza kube lula ukutheleleka ngenxa yemvelo ebuthakathaka ngaphansi kwejwabu. Ekuphenduleni, umzimba uzokhiqiza uhlobo lwe-dendritic cell (okuthiwa i- Langerhans cells ) ukusiza ukulawula amabhaktheriya.
Uma indoda inezocansi ezingavimbelwe owesifazane onesandulela ngculazi, lawo maseli angakwazi "ukubamba futhi ahudule" igciwane lawo emkhakheni wezicubu bese uwahambisa kuma-CD4 T-cells ukuze aphethwe. Izifo zesifo socansi kanye nezifo ezithathelwana ngocansi zikhuphula ingozi ye-HIV.
Kusukela embonweni wamasiko, incazelo yomphakathi yobuningi ingavame ukugcizelela i-adventure yezocansi emadodeni ngisho nokuyikhuthaza. Yakha izinga eliphindwe kabili elingenza umuntu abe engozini enkulu ye-HIV ngokuhlanganisa ubudlelwane nabalingani abaningi noma ezinye izindlela zokuziphatha eziphezulu.
Ukuhlukunyezwa Kwabesilisa Nabesifazane
Kunokukhubazeka okwandisa amathuba okutheleleka kokubili amadoda nabesifazane. Phakathi kwazo:
- Noma yimuphi ukwanda komthamo wegciwane lesandulela ngculazi (umthamo wegciwane egazini) kwandisa ingozi kumlingani ongathintekile. Ucwaningo luye lwabonisa ukuthi ukwanda komkhiqizo ngamunye we-viral load - kusuka ku-100 kuya ku-1,000 - kungaba kabili futhi kathathu ingozi yokutheleleka.
- Ukwengeza, umthamo omkhulu wegciwane lesandulela ngculaza ngesikhathi sokutheleleka okunzima (isiteji ngokushesha emva kokuchayeka) kuhlotshaniswa nokukhuphuka kwama-28 kwengozi. Lokhu kuhumusha kumuntu oneminyaka engama-50 ithuba lokuthola i-HIV uma ungowesifazane futhi uma kungenzeka uma kungenzeka ukuthi uneminyaka engu-500 uma ungumuntu.
- Ukuphuza utshwala noma ukuphuza izidakamizwa kunganciphisa amandla futhi kuthinte ikhono lomuntu lokwenza izinqumo eziphephile, njengokusebenzisa amakhondomu noma ukuhlala unamathele ekwelashweni kwe-HIV.
Ingozi Yokuzivocavoca Ngcansi Yobulili
Ngokombono we-"expos-exposure" engozini (ithuba lokuthola igciwane lesandulela ngculaza ngesenzo esisodwa socansi), ingozi ingashintsha ngokusekelwe ubulili, umthamo wegciwane lesandulela ngculazi, ngisho nengxenye yezwe ohlala kuyo .
Lezi zibalo azicabangi nanoma yiziphi ezinye izici ezingakwandisa ingozi, kubandakanya nokuba khona kwe-STI, ukujova ukusetshenziswa kwezidakamizwa, noma ukutheleleka okwenziwe ngokufanayo njenge-hepatitis C.
Ukuvezwa | Uhlobo lokungena | Ingozi Yokuzivocavoca |
I-vaginal | Ubulili besilisa, i-female-to-male (izwe elinenzuzo ephezulu) | 0.04% (eyodwa ngo-2500) |
Ubulili besilisa, abesilisa nabesifazane (izwe elinenzuzo ephezulu) | 0.08% (eyodwa ngo-1250) | |
Ubulili besilisa, i-female-to-male (izwe elingenayo imali engenayo) | 0.38% (eyodwa ngo-263) | |
Ubulili be-vaginal, abesilisa nabesifazane (izwe elingenayo imali engenayo) | 0.3% (eyodwa ku-333) | |
Ubulili be-vaginal, i-HIV engenasifo | 0.07% (eyodwa ngo-1428) | |
Ubulili be-vaginal, isandulela-ngculaza esesimweni esibucayi se-HIV | 0.55% (eyodwa ngo-180) |
Ukuvezeka Kwengozi kanye Nezocansi Zomzimba
Uma ukholelwa ukuthi kungenzeka ukuthi utholakale ne-HIV, noma ngekhondomu ye-condomless anal, kukhona imithi enganciphisa kakhulu ingozi yokutheleleka okuthiwa i-post-exposure prophylaxis (i-PEP).
I-PEP inezinsuku ezingama-28 zemithi elwa nezidambisigciwane, okufanele zithathwe ngokuphelele futhi zingaphazanyiswa. Ukuze unciphise ingozi yokutheleleka, i-PEP kumele iqaliswe ngokushesha ngangokunokwenzeka - kungakapheli amahora angu-36 okuvezwa .
Izwi elivela
Ukuhlola ingozi yakho siqu ye-HIV akumelwe neze kube ngumdlalo wezinombolo. Kungakhathaliseki ukuthi izinkinga ziyingxenye eyodwa kweyishumi noma eyodwa ku-100,000, kubalulekile ukukhumbula ukuthi ungathola i-HIV emva kokuvezwa okulodwa nje.
Hlola wonke amathuluzi atholakalayo wokuvimbela i-HIV. Ngaphezu kwe-PrEP, isu elinganciphisa ingozi ye-HIV ngamaphesenti angama-76, umthamo wegciwane elingenakulinganiswa kumlingani we-HIV ungadlulisela ingozi ngamaphesenti angu-96 noma ngaphezulu. Futhi ungakhohlwa ikhondomu evivinywe-yeqiniso, ukusetshenziswa okungahambisani nakho okuhlotshaniswa nokuncipha kwe-20 kuncipha engozini.
Ngokwenza indlela ephelele yokuvimbela, ungaqhubeka nokujabulela impilo enempilo ngokocansi ngenkathi uzivikela wena noma othandekayo engozini ye-HIV.
> Imithombo:
> Boily, M .; I-Baggaley, i-R .; Wang, L .; et al. "Ingozi yokuhlukunyezwa ngokobulili ngokobulili ngesandulela ngculaza-1 ngesenzo socansi ngalunye: Ukubuyekezwa kwesistimu kanye nokuhlaziywa kwemeta yezifundo zokuhlola." Izifo ezithathelwanayo zeLancet. Februwari 2009; 9 (2): 118-129.
> Amasevisi Okulawula Nokuvimbela Izifo (CDC). " Isifo Sengculaza Namuhla ." I-Atlanta, Georgia; Agasti 2016.
> Cohen, C .; Lingappa, J .; I-Baeten, i-J .; et al. "I-bacterial vaginosis ihambisana nengozi eyengeziwe yokudluliswa nge-HIV: owesifazane ozobe ehlaziywa phakathi kwamabhangqwana ase-Afrika." PLoS Medicine. Juni 2012; 9 (6): e1001251.
> Hollingworth, T .; U-Anderson, uR .; noFraser, C. "Ukudluliswa kwe-HIV-1, ngesigaba sokutheleleka." Journal of Infectious Diseases. Ngo-September 1, 2008; 198 (5): 687-693.
> Uhlelo lweZizwe Ezihlangene mayelana neHIV / AIDS (UNAIDS). " Ukuvuselelwa kwe-AIDS emhlabeni wonke 2016. " I-Geneva, eSwitzerland; 2016: 9.