Duk da yake low, binciken bayar da shawarar yiwuwar ba za a iya share shi cikakke ba
Bincike na asibitoci ya nuna cewa maganin rigakafi (ART) zai iya rage haɗarin cutar HIV a cikin ma'aurata (majiyoyin) - inda abokin tarayya ke dauke da kwayar cutar kwayar cutar HIV kuma ɗayan yana da cutar HIV.
Manufofin sun hada da rage yawan ciwo da cutar ta HIV / AIDS ta hanyar yin amfani da shi a matsayin rigakafi, ko TasP ), da kuma yin amfani da kwayar cutar ta yau da kullum don rage yawancin cutar HIV a cikin abokin aikin da ba a cutar ba. (wanda aka sani da prephylaxis, ko PrEP ).
Har ila yau, an yi la'akari da mahimmanci ba kayan aikin rigakafi na ART ba, kamar kwaroron roba da kuma mazaunin maza (da aka sani don rage yawan cutar HIV a cikin wadanda basu kamu da cutar ba). Yayinda bincike na farko ya nuna cewa amfanin ART zai iya zama mai girma a cikin ma'aurata-tare da TasP ta rage yaduwar kwayar cutar HIV har zuwa kashi 96 cikin 100 da kuma PrEP ƙaddamar da hadarin ta hanyar kashi 75 cikin dari - wasu sunyi tambaya ko waɗannan lambobi zasu ci gaba ainihin duniya.
Jima'i maraba da jima'i da kwayar cutar HIV
A cikin taron 2014 game da Retroviruses da Hanyoyin Hanyoyin Ciki (CROI) a Boston, masu bincike tare da bincike mai suna SASKIYAR TSARKI sun nuna cewa, tsakanin 767 ma'aurata da suka yi amfani da TasP kadai, ba wata kamuwa da cuta ta faru ba tare da matakan jima'i ba. Binciken ya hada da ma'aurata maza da mata da suka hada da mata 37 da 43 na jima'i a kowace shekara.
Duk da haka, har ma da masu bincike suka mallaka, lamarin ya kasance mai banƙyama. Dangane da wasu abubuwa masu mahimmanci-ciki har da nau'in jima'i da kuma yayinda haɗuwa ya faru ko a'a-ƙayyadadden tabbacin (wanda aka yi amfani da shi don auna ma'auni na kimanta) ya tsaya a kashi 96.
Wannan yana nufin kimanin kashi 4 cikin dari na kamuwa da cuta-kuma ba kashi 0 cikin 100 wanda wasu zasu iya ɗauka ba. Ga wadanda ke yin jima'i da jima'i, yawancin da aka kiyasta ya kai kashi 10 cikin dari. Binciken da aka yi a baya ya jefa ƙari sosai game da yadda waɗannan kayan aikin rigakafi zasu iya rage yawan kamuwa da cuta a tsawon lokaci.
Bambanci A Hadarin Tsakanin Ma'aurata da Gay Couples
A cikin binciken da Cibiyar Kula da Cututtuka da Rigakafin {asar Amirka ke gudanarwa (CDC) , masana kimiyya sun binciko bayanan yanzu game da tasirin TasP, PrEP, da kuma robar roba a cikin ma'aurata maza da mata. Manufar binciken shine ba a hango ainihin hadarin watsawa a cikin tsarin "ainihin duniya" ba, amma don nuna yadda haɗarin haɗuwar lokaci-wato, bayan shekaru daya da 10.
Bisa ga yawan abubuwan da ke rikicewa, yiwuwar kamuwa da cuta a tsakanin ma'aurata da ke amfani da ART kadai an kiyasta su zama kashi biyu cikin dari na maza da mata da kuma kashi 25 cikin dari a cikin ma'aurata. Sakamakon ya samo asali ne akan wasu ra'ayoyin da suka dace, ciki har da:
- Rawanin kashi 80 cikin haɗari daga amfani da kwaroron roba
- Raguwar kashi 96 cikin hadarin lokacin da abokan hulɗa da kwayar cutar HIV ke kan ART / TasP
- Raguwar kashi 73 cikin hadari ga abokan hulɗa tsakanin maza da mata a kan PrEP
- Rage kashi 44 cikin hadarin ga abokan hulɗa marasa lafiya a kan PrEP
- Rage kashi 54 cikin haɗari ga wanda ba a taɓa cutar da shi ba
- Raguwar kashi 73 cikin haɗari ga marasa lafiya, wanda aka yi wa kaciya da abokin tarayya wanda ke da alaƙa na musamman ("saman") a lokacin jima'i da jima'i
- Dangane da nau'in jima'i shida na jima'i a cikin wata
Yana da mahimmanci a lura cewa bambancin jigilar tsakanin ma'aurata da maza da ma'aurata ba a tsare su kawai ga mafi girma da kamuwa da kamuwa da cuta ta hanyar jima'i jima'i , amma ga bincike na yanzu da ke nuna ƙananan rashawa tsakanin matasan gay. Masu bincike sun yarda cewa mafi girma na shirin PREP da / ko ingantattun bayanan dacewa na iya inganta waɗannan ƙididdiga.
Bugu da ƙari, ƙididdigar da aka yi a baya-bayanan sun ba da shawara sosai cewa amfani da matakan dan lokaci a cikin MSM na iya samun irin wannan amintacce kamar yadda ake amfani da shi na yau da kullum. Idan ana iya tabbatar da irin wannan sakamakon, kamar yadda mutane da yawa suna tsammanin, za a inganta tasiri a kan matakan PrEP a cikin ma'aurata na MSM.
Ƙananan Hanyoyin Dama Dama
Masu binciken sun kara nuna cewa ma'aurata da suke amfani da hanyar rigakafin guda daya sun fi fuskantar hadarin kamuwa da cuta, a cikin gajeren lokaci da dogon lokaci. Daga cikin bincikensu:
- Ma'aurata da suka dogara kan kwaroron roba sun samu kashi 13 cikin dari na kwayar cutar HIV a cikin shekara daya kuma suna da mummunan ciwon haɗari na kashi 76 cikin shekaru 10, bisa la'akari da bayanan da ake amfani dasu. A bambanta, an nuna mazaje maza da mata kashi 1 cikin dari da kashi 11 cikin hadarin, daidai da haka.
- Ma'aurata maza da suka dogara kan TasP sun samu raunin kashi 3 a cikin shekara daya kuma suna da kimanin kashi 25 cikin 100 a cikin shekaru 10. Ta hanyar kwatanta, ma'aurata maza da mata suna da kashi 0.2 da kashi 2 cikin dari, kamar yadda ya kamata.
- Daga ma'aurata da suka haɗu da TasP, PrEP, da kaciya, sun yi amfani da kwaroron roba, kuma basu shiga cikin jima'i na jima'i ba don abokin tarayya ba tare da cutar ba, hadarin HIV ya ragu zuwa kashi 0.1 bisa dari daya da 1 bisa dari fiye da shekaru 10.
- Bugu da ƙari, saukad da aka gani a cikin ma'aurata maza da suka haɗu da TasP, PrEP, kaciya, da kuma amfani da kwaroron roba . Ga maza, haɗari kan shekara guda shine kashi 0.1 cikin dari kuma kashi 1 bisa shekaru 10. Hadarin tsakanin mata ya kasance ma ƙasa da kashi 0.05 da kashi 0.5 cikin dari.
Wadannan sakamakon sun taimaka, a wani ɓangare, ta hanyar bincike na 2014 game da Jami'ar Sorbonne a Paris, wadda ta bincikar bayanai daga binciken daban-daban na shida game da amfani da TasP a tsakanin ma'aurata masu aure. Ma'aurata da aka haɗa a cikin binciken suna da jima'i tsakanin sau uku da 12 a kowane wata, tare da kashi 80 cikin dari na amfani da kwaroron roba.
Masu binciken sun tabbatar da cewa bayanan da aka samo baya tallafawa shawara cewa ART za ta iya rage yawan cutar HIV ba kome. Maimakon haka, ƙididdigarsu ya yanke shawarar cewa, yayin da hadarin kamuwa da cuta yana da ƙananan ƙila a cikin shekaru biyu na farko, wannan hadarin zai iya ƙara zuwa kashi 1 bayan watanni 18. Binciken bai gwada tasiri na tsawon lokaci na ART ba a tsakanin ma'aurata masu jima'i.
> Sources:
> Baeten, J .; Donnell, D .; Ndase, P .; et al. "Ciwon maganin cutar kanjamau don maganin rigakafin kwayar cutar HIV a maza da mata." New England Journal of Medicine. Agusta 2, 2012; 367 (5): 399-410.
> Rodger, A .: Bruun, T .; Cambiano, V .; et al. "Rigar kwayar cutar ta HIV ta hadari ta hanyar jima'i maras amfani da ita idan HIV + abokin tarayya a kan magance ART: SHEKIN SHEKARA." Taron 21 na Kasuwanci da Hanyoyin Ciki (CROI); Boston, Massachusetts; Maris 3-6, 2014; m 153LB.
> Lasry, A; Sansom, S .; Wolitski, R .; et al. "Harkokin jima'i na HIV ya haddasa matsala tsakanin ma'aurata da ke tattare da cutar ta HIV: tantance abubuwan da zasu haifar da haɗin dabarun rigakafi." AIDS . Yuni 14, 2014; 28 (10): 1521-1529.
> Kula, V. Viard, J; Costagliola, D .; et al. "Halin auren dan uwa na yaduwar kwayar cutar HIV ta hanyar jima'i a karkashin tsarin maganin cutar antiretroviral: nazari na yau da kullum da kuma tsarin Bayesian." Cututtuka na cututtuka na asibiti. Afrilu 19, 2014; 223 [Epub gaban bugawa].
> Molina, J; Fonsart, C .; Spire, B; et al. "Ana buƙatar RABI tare da TDF-FTC na Magana a cikin MSM: Sakamakon Sakamakon Jarrabawa na ANRS." Taron taron na 2015 a kan Rashin Magunguna da Hanyoyin Ciki (CROI); Yuli 24, 2015; Seattle, Washington; m 23LB