Ukuvimbela i-HIV kuye kwashintsha ngokuphawulekayo phakathi neminyaka eyishumi edlule. Asisacabangi ngamakhondomu noma ukuyeka ukuzibandakanya izinhlobo eziyinhloko zokuvikela i-HIV. Namuhla kukhona ububanzi obulokhu bukhula bamaqhinga angasebenza ndawonye ukunciphisa ingozi ye-HIV emazinga aseduze-anganaki.
Oyinhloko phakathi kwalezi zinto bekuyi- pre-exposure prophylaxis (i-PrEP) , iphilisi elilodwa kanye nosuku elinganciphisa ingozi ye-HIV ngamaphesenti angu-92.
Uma isetshenziselwa umlingani we-HIV ekwelashweni kwama-antiretroviral , ingozi ingadonsa ngisho nangaphezulu-kungaphezulu kwamaphesenti angu-99 ngezilinganiso ezithile.
Noma kunjalo, naphezu kokusebenza kwayo okuqinisekisiwe, kusekhona izinselele ezinkulu ekusetshenzisweni kwe-PrEP. Ngaphandle komsebenzi wokuthatha izidakamizwa nsuku zonke, asikaze siqiniseke ukuthi ukunamathela okuningi kuyadingeka ukufeza inzuzo egcwele yokuvikeleka. Ucwaningo oluthile luye lwasikisela ukuthi amadoda angama-gay nabesilisa nabesifazane abesilisa angadinga kuphela amanani amabili kuya kwesithathu ngesonto, kanti abesifazane bangase badinge ukunamathela okuzungezile ukuze bathole imiphumela efanayo.
Ngakho-ke, ukuthuthukisa ithuluzi, okungahlinzeka ngokuvikeleka isikhathi esigcwele kubhekwa njengento ebaluleke kakhulu phakathi kososayensi kanye nezikhulu zezempilo ngokufanayo.
NgoJanuwari 2017, uMthethosivivinywa noBelinda Gates wabeka i-gauntlet yokucwaninga ngokunikela ngemali eyizigidi ezingama-50 kuya ku-Intarcia Therapeutics, eqinile e-Boston-based biopharmaceutical, ukuthuthukisa idivayisi engasetshenziswa ngaphansi kwesikhumba ukuvikela ukuvikela i-HIV ngehora.
Umnikelo uphumelela ngokufaka izimpembelelo zokungena ngaphansi kwendlela yokuthuthukiswa, kanye nezinye izindlela zokwelashwa ezinde isikhathi eside ezihlolwe kokubili ukuvimbela nokwelashwa kwe-HIV.
Yeka ukuthi ukufakelwa kwesiNgisi kuzosebenza kanjani
Idivaysi ye-Intarcia akuyona idivayisi yokuqala yokusebenzisa ubuchwepheshe be-subdermal ukuletha imithi eqinile yemithi yokuvimbela.
Izitshalo zokuvimbela ukukhulelwa, cishe ubukhulu be-matchstick, zisetshenziswe kusukela ngo-1983 ukuvimbela ukukhulelwa kwabesifazane, ngamadivayisi amasha akwazi ukuletha iminyaka emithathu yokuvikelwa okuqhubekayo.
Imikhiqizo efanayo ehlongozwayo iphhenyelwe ukusetshenziswa kuhlobo lwe-2 lwesifo sikashukela, ukwelashwa komdlavuza, ukwelashwa kwesifo sofuba, ngisho nezifo eziphathelene nesifo se-schizophrenic.
Emkhakheni we-HIV, esinye sezimpembelelo zokuqala ezakhiwe ngaphansi kwe-Pasadena-based Oak Crest Institute of Science. Ukucwaninga kwezilwane zakuqala kubonise ukuthi idivayisi yabo, lapho ifakwe ngaphansi kwesikhumba sesiphambano, yakwazi ukuletha umthamo we-tenofovir alafenamide (TAF) njalo izinsuku ezingaba ngu-40 ngaphandle kwemiphumela emibi.
Ucwaningo luyaqhubeka ukwandisa ngalezo zinsuku, ngenhloso yokudala idivayisi ekwazi ukuletha ukusabalalisa okuqhubekayo izinyanga ezingu-12.
Ngenkathi efana nendlela, idivayisi ye-Intarcia (ebizwa nge-ITCA 650) inikeza uhlelo oluyingqayizivele "lwe-mini-pump" olungcono ekuqiniseni ukulingana izinyanga eziyisithupha. Amanzi avela ku-extracellular fluid afika komunye umkhawulo wedivaysi ngokusebenzisa i-membrane encane engenakunyakaziswa, eyandisa futhi iqhube i-piston ye-osmotic. I-ITCA 650 ibonakala iyisandulela esikhulu kumadivayisi wangaphambilini futhi isivele ithola imiphumela emihle ekuhlolweni kwesifo sikashukela.
Uma imiphumela efana nayo ifinyelelwa nge-HIV, idivayisi ingavunyelwa ngaphakathi kwesikhashana seminyaka embalwa. Ngenkathi i-Intarcia engakaqedi ukuthi yisiphi isidakamizwa se-antiretroviral sokuqashwa, iningi likholelwa ukuthi iTruvada (esicatshangelwe ukuthi iyimfuneko ye-oral PrEP) iyoba ngumuntu obhekene nalokho okunikezwa ukuthi i-patent yayo kufanele iphelelwe yisikhathi ngo-2018.
Isizathu sokuthi ukufakelwa kwesiNgisi kusemqoka kakhulu
Ngenkathi abantu abaningi bethatha i-PrEP ngomlomo bayakwazi ukugcina amazinga aphezulu wokunamathela, ukusetshenziswa kwawo phakathi kwamaqembu aphezulu okubeka ingozi kungashintsha kakhulu. Ngokusho kocwaningo olwethulwa eNgqungqutheleni yesi-21 ye-AIDS eThekwini, abantu abasengozini enkulu yegciwane lesandulela ngculaza abavame ukuba labo abathatha i-PrEP.
Lokhu kubandakanya abantu base-Afrika baseMelika, abamele amaphesenti angu-44 wezifo ezintsha zonyaka kodwa kuphela amaphesenti ayishumi emigomo ye-PrEP.
Ngenkathi intengo impela idlala indima kulokhu ukungalingani, ukucwasa nokudalula kuyasiza kakhulu, ikakhulukazi emantombazaneni abesilisa nabesifazane abesilisa nabesifazane abama-Afrika aseMelika abaphethe ingozi engama-50 engozini yokuthola i-HIV . Kweminye yala madoda, noma yiluphi uhlobo lwe-HIV yokwelapha (ngisho nokwelapha okuvimbela) luhambisana nesimemezelo esiqondile sokuzibophezela ngokobulili.
Njengoba kunikezwe lezi zinto zangempela, ingabe ithuluzi lokuvikela elingabonakali lingakunqoba lezi zikwesaba?
Umbuzo owenziwa yizikhulu zezempilo emhlabeni wonke, osekuyisikhathi eside ezama ukuvikela igciwane lesandulela ngculaza kubantu abanosizini, ikakhulukazi abesifazane nabamantombazane abangenamandla. Kodwa-ke, eziningi zamasu ahlongozwayo, ngenkathi zihle kakhulu ephepheni, ziye zahluleka noma zawa kancane okulindelwe. Phakathi kwazo:
- Izivivinyo ze-VOICE ne-FEM-PrEP, izifundo ezimbili zokuqala ze-PrEP ezahluleka ukuvimbela ukutheleleka eqenjini labesifazane base-Afrika, ngenxa yokubambelela kokunakekelwa kwemithi.
- Izivivinyo ze-ASPIRE kanye ne-RING, ezanikeza izindandatho eziphathekayo eziphathekayo ezingaphezu kuka-5 000 abesifazane base-Afrika. Kuzo zombili izimo, amadivaysi afinyelele ukuncipha okuncane kakhulu kwe-HIV (amaphesenti angu-27 namaphesenti angu-37, ngokulandelana). Ngaphezu kwalokho, labo abasengozini enkulu (abaneminyaka engu-18 no-24) babengenaso nzuzo yokuvikela.
Ngokumelene nalesi sihloko ukuthi izimpande zesikhashana zibonisa isithembiso esikhulu kakhulu. Akufanele nje ukuthi bakwazi ukukhiqizwa ngamanani aphansi kunezokwelapha zomlomo, bavumela abesifazane nabanye ukuba bazivikele ngokuthola okuncane. Futhi ngokungafani namasongo okugcoba kanye nezinye imikhiqizo ye-microbicidal , azikwazi ukusetshenziselwa kabi noma ukususwa kalula. (Enye yezinsizakalo kuphela ezingaba yiqiniso lokuthi inqubo yokufakelwa izodinga ukwenziwa ngaphansi kokuhlinzekwa kwezinzwa zendawo.)
Nakuba kungenzeka ukuthi eminyakeni eminingi ngaphambi kokuba noma iyiphi idivayisi ivunyelwe ukwelashwa noma ukuvimbela i-HIV, ucwaningo lokuqala luhlala luthembisa. Kuze kube sekugcineni, i-Gates Foundation ithembise imali engaphezulu kwezigidi ezingu-90 zamaRandi ngezibonelelo ezibalulekile ukuze kuqinisekiswe ukuthi isithembiso se-HIV esinqunyiwe senziwa ngokoqobo.
> Imithombo:
> Bancroft, a. "I-Intarcia ithola u-$ 140m we-Gate Foundation Grant ye-HIV Tech" engenawo inaliti. " Ku-Pharma Technologist. Ishicilelwe ngo-January 4, 2017.
> Montanya, J. "I-Handbook ye-Incretin-Based Based Therapies ngohlobo lwe-2 lwesifo sikashukela." Juni 8, 2016; Isixhumanisi se-Springer; k. 77-92.
> Du Toit, L .; Pillay, V .; noDanckwerts, M. "Isifo sofuba se-Chemotherapy: izindlela zokwethula izidakamizwa zamanje." Ukuphefumula. Res. September 2006; 7 (1): 118.
> Gunawardana, M .; Remedios-Chan, M .; Miller, C .; et al. "I-Pharmacokinetics ye-Tenofovir Alafenamide (GS-7340) Imishanguzo Engaphansi Kwe-HIV Prophylaxis." Amagciwane Antimicrobial and Chemotherapy. Ngo-Ephreli 15, 2015; 4 (2): 186-190.