Ukukhomba izithiyo zokusetshenziswa kwe-PrEP
Kuye kwaboniswa ukuthi ukusetshenziswa kwansuku zonke kwedakamizwa ye-antiretroviral, i- Truvada , kunganciphisa kakhulu ingozi yokutheleleka kubantu abangenayo i-HIV ebuhlotsheni be-serodiscordant (okungukuthi, lapho umlingani owodwa enesandulela ngculaza kanti omunye engenayo i-HIV). Isu, esaziwa ngokuthi i- pre-exposure prophylaxis (noma i-PrEP) , siboniswe ukunciphisa ingozi yokudlulisela noma yikuphi ukusuka kumaphesenti angama-62 kuya kuma-75 amaphesenti uma kuthathwa ngokunamathela ngokungaguquguquki, okungaphazanyiswa.
Kusukela kumbono wezibalo, izibalo zixhasa kakhulu ukusetshenziswa kwe-PrEP njengengxenye yesu lokuvimbela i-HIV jikelele. Kodwa-ke, ngokubheka kwangempela impilo, izinombolo kungenzeka ukuthi azikho konke okukholisayo, ngamazwi "ahambisanayo" futhi "angaphazanyiswa" okwethula izithiyo ezingase zibe khona kulabo abangase bafune.
Eqinisweni, ngokucwaninga kwemboni, abantu abangu-1 774 kuphela e-US babenemigomo egcwele yeTruvada ye-PrEP phakathi kukaJanuwari 2011 no-Mashi 2013. Ngo-July 2016, leso sibalo sakhulile saba ngu-76,000. Lokho kusengumuntu onesizotha okwenziwe ukuthi ukutheleleka kwe-HIV entsha kuka-50 000 kulinganiselwa ukuthi kwenzeke e-US njalo ngonyaka.
Izibalo ziletha ekukhanyeni eziningi zezinkinga ezenza i-PrEP ibe yindawo enhle ekucwaningweni kocwaningo, kodwa kancane uma ibekiwe kumongo wezwe langempela. Futhi akuyona nje inkinga yemfundo noma ukuqwashisa (nakuba lezi yizici eziyinhloko). Ngokusobala kukhona okunye okuqhubekayo.
Umthelela Wezintengo Nokuvumelana
Ucwaningo olwenziwa ngo-2012 olwenziwa yi-US Centers for Disease Control and Prevention (CDC) luphetha ngokuthi abangaphezu kwengxenye yabantu abathathu abane-HIV abasebenzisa i-HIV mayelana nokwelashwa ngezidambisigciwane (ART) abakwazi ukugcina ukunamathela kwezidakamizwa nsuku zonke- futhi lokhu kubantu abane-HIV lapho ukunamathela khona libhekisela ngqo kumkhawulo kanye nekhwalithi yokuphila.
Ngabe singalindela ukuthi izithiyo zingabi ngaphansi kubantu abathatha i-ART hhayi "ukusinda" nge-se, kepha ngokuvimbela i-HIV? Ngempela, kuyilapho amakhondomu eyaziwa ukuhlinzeka ngokuvikelwa okukhulu kakhulu, izibalo zibonisa ukuthi zisetshenziselwa izenzo ezimbili zobulili ezingaphezu kokubili kuphela.
Ngesikhathi abanye bengase babuze, "Kungaba nzima kanjani ukuthatha iphilisi elilodwa ngosuku?", Ucwaningi oluningi lubonisa ukuthi ukunamathela nsuku zonke kungase kube yinkimbinkimbi enkulu yokunqoba. Cabanga ukuthi imithi engapheli yesifo sikashukela noma isifo senhliziyo idinga ukulingana okungamaphesenti angama-70 (noma okulingana namanani ayisishiyagalolunye aphuthelwe ngenyanga). Ngokuphambene, i-PrEP idinga eduze kokunamathela okuphelele ukuze kufezekiswe imigomo yokuvikela.
Ucwaningo oluthile lwamanje luqinisekisa izinselelo. Ngo-2013, iSifundo se-VOICE-esibheka ukusetshenziswa kwe-PrEP phakathi kwabangu-5 029, besifazane abasengozini yase-Afrika-kwathiwa yize lapho kuboniswa ukuthi amaphesenti angu-30 kuphela akwazi ukugcina ukunamathela kwansuku zonke. Imiphumela efanayo yaboniswa ku-FEM-PrEP Study, eyasuswa futhi ngenxa yezinga eliphansi lokunamathela kulabo abathatha iTruvada nsuku zonke.
Ngenxa yalezi zifundo kanye nezinombolo ezingezansi-ezilindeleke zokubhalisa kwabakwa-PrEP, ukugcizelela okukhulu kungadingeka ukuthi kubekwe emfundweni ehlosiwe, lapho abantu ababuhlobo be-serodiscordant ( kubandakanya labo abafuna ukukhulelwa ) bayalwa mayelana ne-PrEP njengenhlangano yomndeni jikelele ukujwayela, kunokuba nje kusetshenziswe i-HIV ekhethekile.
Abenzi bezinqubomgomo bangase futhi badinga ukuthi bahlole ukuthi izindleko ze-PrEP, ezilinganiselwa ukuthi zizungeze u-$ 12,000 ngonyaka, zingase zibe yisici esinqunyelwe kulabo abanezinhlelo zomshuwalense ezingasebenzi ngokugcwele.
Ngocwaningo luka-2013 lwezazi zase-US naseCanada ezithathelwanayo, amaphesenti angu-74 asekela ukusetshenziswa kwe-PrEP ngokubanzi kwabantu. Kodwa-ke, kuleli qembu, kuphela u-9% kuphela owawunikelwe iziguli.
Kuthemba ukuthi izincomo ezenziwe yi-CDC ngo-May 2014, zibiza ukuthi ukusetshenziswa kwe-PrEP kubantu ababhekwa njengengozi enkulu yokutheleleka, kuzokwandisa ukubhaliswa kwamaqembu e-US okuhloswe yi-CDC kubandakanya:
- amadoda alala namadoda (MSM) abangasebenzisi amakhondomu ;
- Abantu abangenayo igciwane lesandulela ngculazi abalala njalo ocansini nomuntu one-HIV;
- ukujova abasebenzisi bezidakamizwa (ama-IDU), futhi;
- abalingani bobulili obuhlukile abenza ubulili nabalingani abengozi kakhulu.
Imithombo:
Rawlings K, Mera R, uPekonkina A, et al. "Isimo se-Truvada ye-HIV ngaphambi-exposure prophylaxis (PrEP) e-United States: ukuhlaziywa kokusetshenziswa kwezidakamizwa zakuqala." Ingqungquthela yesi-53 ye-ICAAC Interscience yama-Agent Antimicrobial Agents kanye ne-Chemotherapy; Denver, Colorado; Ngo-Septhemba 10-13, 2013; abstract H-663a.
Amasevisi aseMelika okuLawula nokuvimbela izifo (CDC). "I-CDC Fact Sheets | I- HIV e-United States : Izinyathelo Zokunakekela." I-Atlanta, Georgia; eshicilelwe ngoJulayi 2012.
U-Anderson, J. "Ukusetshenziswa kweComm kanye neHIV phakathi kwabantu abadala base-US." I-American Journal of Health Public. Juni 2003; 93 (6): 912-914.
I-Microbicides Trial Network (MTN). Isitatimende se-MTN ngesinqumo sokunqeda ukusetshenziswa kwamathebulethi omlomo we-Tenofovir ku-VOICE, isifundo esikhulu sokuvimbela igciwane lesandulela ngculaza kwabesifazane. " Ukukhishwa kwezindaba kukhishwe ngoSepthemba 28, 2011.
I-National Institute of Allergy and Infectious Diseases (NIAID). "Uhlelo lwe-FEM-PrEP Isivivinyo Sokuvimbela I-HIV kanye Nethonya Lalo Lokucwaninga lwe-NIAID." I-Bethesda, e-Maryland; ukushicilelwa okukhishwe ngo-Ephreli 18, 2011.