Mitigating Hadarin a cikin Harshen mata da Same-Jima'i Couples
Rashin kamuwa da cutar ta HIV ta hanyar jima'i mai tsabta ba tare da kariya ba an gani yana da tsayi sosai, kamar yadda ya fi sau 18 fiye da haɗuwar mata. Dalili na haɗarin haɗari sune sananne kuma sun haɗa da abubuwan kamar:
- Sakamakon gyaran gyare-gyaren gyare-gyare, yakamata cutar ta samu damar shiga cikin jini ta hanyar ƙananan hawaye ko abrasions.
- Marousness na gyaran gyare-gyare da kuma tsayayyar su zuwa kamuwa da cuta ko da a lokacin da aka cutar da su.
- Babban adadin kwayar cutar HIV a cikin maniyyi da ruwa na farko ("pre-cum"), wanda zai iya ninka haɗarin kamuwa da cuta tare da kowane-log (watau, ɗaya lambar) a cikin nauyin hoto na jikin mutum.
Bugu da ƙari kuma, raunin jini daga lalacewar gyare-gyare na lalacewa zai iya ƙara haɗari ga abokin hulɗa ("top"), samar da cutar wata hanya ta watsawa ta hanyar kututture da kyallen takalma wanda shine layin azzakari (musamman a ƙarƙashin goshin).
Binciken Gwanin kwayar cutar HIV "Per-Act" da kuma "Abokin Ciniki"
A cikin binciken da suka yi na kimanin karatu 16 nagari, masu bincike a Kwalejin Kasuwancin Kasuwanci da Makarantar Kiyaye Tsaro da Tropical Medicine sun kammala cewa cutar ta HIV ta hanyar kwakwalwan roba ba tare da shan jima'i ba ne kusan kashi 1.4 cikin dari na mai karɓa (" kasa ") abokin tarayya.
Duk da yake ba a fahimci yanayin halayen da ya bambanta ta hanyar jima'i, ko namiji ko maza da suka yi jima'i da maza (MSM) , ana ganin haɗarin ya kara yawan gaske idan abokin tarayya mai ba shi kaciya (rashin kaciya marasa lafiya da kashi 0.62 da kashi 0.11 cikin dari) .
Ta hanyar kwatanta, haɗarin abokin tarayya -wanda wanda yake dauke da kwayar cutar HIV yana cikin dangantaka ta musamman tare da abokin tarayya na HIV-negative wanda ya zana hoto a cikin hoto mai kyau don abokan hulɗa da masu sa ido.
An gudanar da nazarin binciken goma ne kawai a cikin MSM kuma ba su hada da tsawon dangantakar ba ko kuma karfin kwakwalwa ba tare da jima'i ba.
Bayanan nazarin bayanai sun iya cewa:
- Abokan da ke shiga cikin jima'i mai jima'i da jima'i ba tare da kwaroron roba ba sun samu hadarin kashi 39.9 bisa dari.
- wani abokin tarayya mai cutar kanjamau da ke shiga cikin jima'i mai jima'i ba tare da kundoron roba ba yana da haɗari na taƙaitaccen kashi 21.7 cikin dari, yayin da abokin tarayya mai karɓar cutar HIV ya samu hadarin kimanin kashi 40.4.
(Yayin da sakamakon ma'anar ƙaddarar ke da ƙarfin hali, yana da muhimmanci a lura da cewa bambancin samfurori na nazarin da aka yi nazari ya bar wani daki don fassarar.)
Manufofin da za a rage Rashin ƙwayar cutar HIV daga jima'i mai jima'i
Kamar dai yadda wani irin yanayin HIV yake , rigakafin buƙatar haɗin dabarun don ingantawa sosai:
- Rage ciwon ƙwayar cutar ta HIV.
- Rage yiwuwar abokin tarayya na HIV.
- Riga HIV don shiga cikin kullun da kwayoyin cutar.
Amfani da hadewar maganin rigakafi (ART) a cikin abokin tarayya mai cutar HIV an san shi don ƙaddamar da haɗarin watsawa yayin da aikace-aikacen bidiyo ya cika da kuma ci gaba da matsawa zuwa matakan da ba a iya gani ba. An tabbatar da tsarin, wanda aka fi sani da magani kamar rigakafi (TasP) , don rage yawan cutar ta HIV ta hanyar 96% a cikin gina haɗin gwiwar.
A halin yanzu, yin amfani da maganin ƙwaƙwalwar jini (PrEP) - inda aka ba da abokin tarayya marasa lafiya a kowace rana na kwayar cutar ta HIV- Truvada -an san shi don rage haɗari ta kowace hanya tsakanin kashi 44 da kashi 75.
Yin amfani da kwaroron roba ya zama mahimmanci don hana rigakafin HIV, tare da Cibiyoyin Kula da Cututtuka da Cututtuka na Amurka da cewa rahoton amfani da kwaroron roba na iya hana bakwai daga cikin kwastan goma. (Har ila yau, rahoton ya kammala cewa, kawai MSM ne kawai, ke bayar da rahoton cewa, kododar roba ta yi amfani da ita.)
Bayanan da suka fi dacewa suna tallafawa amfani da TasP, PrEP, da kuma robar kwaroron roba a matsayin mafi mahimmanci na nufin rage ƙananan cutar HIV, duk ma a tsakanin maza da mata da MSM sun hada da jima'i da jima'i.
Ya bambanta, har yanzu ba a ba da shawarar jima'i ba tare da jima'i ba , koda ana amfani da TasP da PrEP, saboda akwai yiwuwar haɗarin damuwa na tsawon lokaci a wasu ma'aurata.
Abinda ke ciki da kuma jima'i
Idan kun yi imanin cewa an riga an fallasa ku da kwayar cutar ta HIV, ko dai ta hanyar kwakwalwa ta roba da yaduwar jima'i mai kwakwalwa, akwai magunguna waɗanda zasu iya rage yawan kamuwa da cuta da ake kira prophylaxis post-exposure (PEP).
PEP tana kunshe da kwanaki 28 na maganin rigakafi, wanda dole ne a dauka gaba ɗaya kuma ba tare da katsewa ba. Domin ya rage haɗarin kamuwa da cuta, dole ne a fara farawa PTP da wuri-wuri - a cikin lokaci daya zuwa 36 na daukan hotuna .
Sources:
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Cohen, M .; Chen, Y .; McCauley, M .; et al. "Rigakafin kamuwa da cutar HIV-1 tare da maganin cutar antiretroviral." New England Journal of Medicine. Agusta 11, 2011; 365 (6): 493-505.
Grant, R .; Lama, J. Anderson, P .; et al. "Magungunan cututtuka na maganin cutar HIV a cikin maza da ke da jima'i da maza." New England Journal of Medicine. Disamba 30, 2010; 363 (27): 2587-2599.
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Kula, V .; Viard, J; Costagliola, D .; et al. "Halin aure na dan uwa na cutar HIV ta hanyar jima'i a ƙarƙashin maganin rigakafi da yaduwar cutar HIV: nazari na tsari da kuma samfurin Bayesian." Cututtuka na cututtuka na asibiti. Afrilu 19, 2014; Ka ci gaba: Ciu223 [Epub gaba].