Okwamanje i-PrEP Isiqondiso esivela kwi-US Public Health Service
Ukusetshenziswa kwansuku zonke kwesidakamizwa i- Truvada (tenofovir + emtricitabine) kuboniswe ukunciphisa ingozi yomuntu we-HIV nge-92%. Isu, esaziwa ngokuthi i- HIV pre-exposure prophylaxis (PrEP) , kuthathwa njengendlela ephumelelayo yokuvimbela ukusakazeka kwe-HIV kubantu abangenalutho futhi kungase kuguqulwe izinga lokutheleleka kubantu abengozi kakhulu.
Njengamanje, kuwo wonke amazwe angenayo ephezulu eNyakatho Melika naseYurophu, i-US inezinga eliphezulu kakhulu lesigciwane lesandulela ngculazi (izifo ezintsha ezingama-50 000 ngonyaka) kanti izinga lesibili eliphakeme kakhulu legciwane lesandulela ngculazi (0.6%, noma abantu abangaba ngu-1.2 million abane-HIV) wonke amazwe. I-Latvia kuphela, izwe elinabakhamuzi abangaphansi kwezigidi ezimbili kanye nezifo ezingama-10,000 ezihlolwe, zinezinga eliphezulu lokusakaza (0.7%).
Njengomphumela walezi zibalo, i-US Public Health Service (USPHS) ikhishwe imihlahlandlela yokusebenza yomtholampilo ebuyekeziwe ngoMeyi 14, 2014, icela ukusetshenziswa kwe-PrEP nsuku zonke kubantu abangenayo i-HIV engozini enkulu yokutheleleka, kanje:
Amadoda abesilisa ocansini abenza ubulili namadoda (MSM) abangekho ebuhlotsheni bomuntu oyedwa obesandulele i-HIV, futhi bahlangabezana neyodwa noma ngaphezulu kwalokhu okulandelayo:
- Yenza ucansi olungasenalo ikhanda (ukwamukela noma ukufaka) .
- Ube nesifo sofuba (STI) ezinyangeni eziyisithupha ezedlule.
- Kungaphakathi kohlobo lwe-serodiscordant (isimo esixutshwe) nomlingani ophethe i-HIV.
Amadoda abesilisa ocansini abenza ucansi nabesilisa nabesifazane (MSMW) abangekho ebuhlotsheni bomuntu oyedwa nomlingani omusha ongenayo i- HIV, futhi bahlangabezana neyodwa noma ngaphezulu kwalokhu okulandelayo:
- Yenza ucansi olungasenalo ikhanda (ukwamukela noma ukufaka).
- Ube nesifo sofuba (STI) ezinyangeni eziyisithupha ezedlule.
- Kungaphakathi kohlobo lwe-serodiscordant (isimo esixutshwe) nomlingani ophethe i-HIV.
Amadoda abesilisa nabesifazane abesilisa ocansini ocansini noma abesilisa abangekho kulowo ongabambisene naye nomlingani omusha ohlolwe i-HIV osanda kuhlolelwa, futhi bahlangabezane nesisodwa noma ngaphezulu kwalokhu okulandelayo:
- Sebenzisa njalo amakhondomu nomuntu oyedwa noma abalingani abaningi besimo se-HIV engaziwa ngenengozi enkulu ye-HIV (abasebenzisi abasebenzisa izidakamizwa, MSMW).
- Kungaphakathi kohlobo lwe-serodiscordant (isimo esixutshwe) nomlingani ophethe i-HIV.
Abasebenzisi abasebenzisa izidakamizwa (abakwa-IDU) abahlangana nabo baye bajova izidakamizwa ezinyangeni eziyisithupha ezedlule, futhi bahlangabezana neyodwa noma ngaphezulu kwalokhu okulandelayo:
- Yabelana ngezinaliti noma wabelane ngezinaliti ezinyangeni eziyisithupha ezedlule.
- Kuye ku-methadone, buprenorphine noma uhlelo lwe-suboxone yokwelashwa ezinyangeni eziyisithupha ezedlule.
- Yiba neyodwa yalezi zingozi ezibalwe ngenhla zokuthola ngokocansi.
Ngaphezu kwalokho, i-PrEP ingahle ibekwe kumibhangqwana exutshwe (serodiscordant) efuna ukukhulelwa noma obesalindele. Zombili izinkomba ze-FDA zokubhekwa kwezidambisigciwane kanye nesandulela ngculaza zihlinzekela lokhu.
Kuthiwani Uma Angikho ohlwini?
Ekugcineni, isinqumo sokumisa i-PrEP kufanele senziwe esimweni sokwethenjelwa ngamacala, ngenhloso yokuhlola ingozi yomuntu ngamunye yokutheleleka kanye nezindlela zokunciphisa leyo ngozi.
Uma ukholelwa ukuthi ufanelekela i-PrEP, kubalulekile ukusebenza nomeluleki oqeqeshwe noma ochwepheshe bezezempilo ukuqinisekisa ukuthi uyaqonda izinzuzo kanye nokulinganiselwa kokwelashwa .
I-PrEP akufanele nanini ibhekwe njengengxenye yamakhondomu noma isetshenziselwa indawo yokwelapha isikhathi esigcwele nomlingani one-HIV.
I-PrEP ingamiswa kuphela udokotela futhi idinga kokubili ukuhlolwa kwe-HIV ngaphambi kokuqala ukwelashwa kanye nezinyanga ezintathu emva kwalokho. I-Medicaid kanye nezinhlelo eziningi zomshuwalense wase-US zihlanganisa izindleko ze-PrEP, kanti ukukhokhela usizo lwezidakamizwa kuyatholakala kulabo abafanelekayo nge-Truvada yaseGileyadi ye-PrEP Medication Assistance Program.
Imithombo:
Amasevisi Okulawula Nokuvimbela Izifo (CDC). "Pre-Exposure Prophylaxis (PrEP)." E-Atlanta, eGeorgia; kufinyelelwe ngoNovemba 6, 2014.
I-World Health Organization (WHO). "Ukukhula kwegciwane lesandulela ngculazi phakathi kwabantu abadala kuya ku-49 - Idatha yezwe." I-Geneva, eSwitzerland; kufinyelelwe ngoNovemba 6, 2014.
Iqembu leBhange Lomhlaba. "Izwe Nokulondoloza Amaqembu." Washington, DC; kufinyelelwe ngoNovemba 6, 2014.
Isevisi yezempilo yomphakathi yase-US (PHS). "I- Preexposure Prophylaxis Yokuvimbela Ukwelashwa Kwegciwane lesandulela ngculazi e-United States - 2014: Umhlahlandlela Wokusebenza Ngokwemitholampilo." Washington, DC; eshicilelwe uMeyi 14, 2014; kufinyelelwe ngoNovemba 6, 2014.
Izikhungo Zempilo Zikazwelonke (NIH). "Izincomo zokusetshenziswa kwezidambisigciwane ezikhulelwe abesifazane abanegciwane lesandulela ngculaza-1 abanesifo somama kanye nokungenelela ekunciphiseni ukudluliselwa kwe-HIV e-United States." I-Bethesda, e-Maryland; kufinyelelwe ngoNovemba 6, 2014.