Taswirar tana nufin mayar da farashin a cikin yankuna masu haɗari
Kwayar cutar HIV a matsayin Rigakafin (TasP) wata hanyar shaida ne wanda mutane da ke dauke da kwayar cutar ta kwayar cutar ba su da wataƙila su iya kawo cutar zuwa wani abokin tarayya marar lafiya.
Yayinda aka fara ganin TasP a matsayin hanyar rage yawan haɗarin mutum lokacin da aka fara gabatar da manufar a shekara ta 2006, a shekara ta 2010 ne shaida ta daga binciken HTPN 052 ya nuna cewa za'a iya aiwatar da shi azaman kayan aikin rigakafin jama'a.
Binciken Binciken Nazarin Yammaci Mai Sauya Game
An gwada gwajin HTPN 052-wanda yayi nazarin tasiri na maganin maganin antiretroviral (ART) a kan yadda ake watsawa a tsakanin ma'auratan maza da mata - an dakatar da kusan shekaru hudu a farkon lokacin da aka nuna cewa mutane a kan jiyya sun kai kashi 96% ba tare da haɗuwa da abokan su ba fiye da wadanda suka halarta 't.
Sakamakon gwajin ya jagoranci mutane da yawa don tantance ko TasP zai iya jinkirin, idan ba a ƙare ba, yaduwar cutar ta HIV ta hanyar rage abin da ake kira "kayar hoto mai kama da al'umma." A ka'idar, ta hanyar rage girman nauyin hoto na hoto na kwayar cutar a cikin al'umman da ke fama, cutar ta HIV zata zama mawuyacin hali don dakatar da annobar a cikin waƙoƙin.
Shaida a goyan bayan TasP
Kafin gabatarwa da sababbin kwayoyi, ba a gane TasP ba saboda ƙananan magungunan miyagun ƙwayoyi da cututtuka na kyamarar hoto wanda kawai ke rufe kusan 80 bisa dari, har ma ga waɗanda suke tare da cikakken biyayyar.
Hoton ya canza sau da yawa a cikin 'yan shekarun nan, tare da gabatar da magunguna mafi mahimmanci. Koda a cikin kasashe masu tasowa kamar Afirka ta Kudu, yawancin tsararrakin da aka kashe (kimanin $ 10 a kowace wata) ya sa batun ya fi kusa.
Yayinda dukkanin wadannan batutuwan sun nuna TasP a matsayin wani muhimmin ɓangare na tsarin rigakafi na mutum, shin yana nufin cewa zai kasance a kan yawan jama'a?
Kalubale a aiwatarwa
Tun daga farkon, ya bayyana a fili cewa akwai matsala masu yawa don shawo kan idan TasP ya kasance mai yiwuwa:
- Yana buƙatar babban ɗaukar hoto da gwajin HIV, musamman ma a cikin yankunan da ba a san su ba. A Amurka, yawancin mutane biyar a cikin mutane biyar da ke dauke da kwayar cutar HIV ba su san komai ba. A mayar da martani, Kungiyar Harkokin Kiwon Lafiyar Amurka ta yanzu tana bada shawara ga gwajin gwagwarmaya na dukan jama'ar Amurkar shekaru 15 zuwa 65 a matsayin wani ɓangare na ziyarar likita.
- Yana buƙatar ƙara ƙarfafa bin bin marasa lafiya. Bisa ga Cibiyoyin Kula da Cututtuka da Cututtuka (CDC), kashi 44 cikin 100 na jama'ar Amirka da aka gano da kwayar cutar HIV suna da nasaba da kulawa. Binciken ya nuna cewa jin tsoron faɗarwa da kuma rashin kulawa da kwayar cutar kanjamau suna daga cikin dalilai da yawa na yin jinkirin jinkiri har sai bayyanuwar cututtukan cututtuka.
- Yana buƙatar hanyar da za ta tabbatar da amincewa da yawan jama'a, wanda nasararsa ta kasance mai sauƙin gaske kuma mai wuyar ganewa. A cewar CDC, mutanen da ke dauke da kwayar cutar kanjamau a halin yanzu, kusan daya daga cikin hudu ba su iya kula da adadin da ya dace don cimma burin maganin hoto ba.
- A ƙarshe, ana ganin kudaden aiwatarwa ya zama babbar matsala musamman a yayin da aka ci gaba da rage yawan kudaden duniya na HIV.
Shaida a Taimako ga TasP
Birnin San Francisco na iya zama mafi kusantar abin da ke cikin TasP. Tare da mazaunin maza da mata da suka hada da kusan kashi 90 na yawan yawan mutanen da ke fama da cutar, yawanci, abin da aka sa ido ya sa hakan ya haifar da ƙananan lamurran da ba a san su ba. Harkokin fasahar da aka yaduwa ta ART ya haifar da kashi 33 cikin 100 na sabon cututtuka daga 2006 zuwa 2008. A shekarar 2010, gabatarwar kulawar duniya akan ganewar asali ya haifar da haɓaka sau shida a yawan mutanen da suka iya kula da maganin ciwon hoto .
Amma mafi yawan sun yarda cewa San Francisco yana da mahimmanci na musamman ga sauran mutanen HIV. Akwai sauran shaidar da ba za ta iya tallafawa ko TasP zai kawo saurin kamuwa da ƙwayar cuta ba a cikin wannan hanya a wasu wurare.
A gaskiya ma, nazarin 2015 na Jami'ar North Carolina ya nuna cewa tasirin TasP na ainihi zai iya ɓacewa a cikin wasu mutane masu mahimmanci. Bisa labarin da aka yi a wannan binciken, wanda ya yi la'akari da ma'aurata 4,916 a lardin Henan tun daga shekara ta 2006 zuwa 2012, ya bincika tasiri na ART a kan yawan watsawa a yawancin mazaunin da ake amfani dasu na kwaroron roba a cikin kaso (63 bisa dari) da kuma jima'i na kamuwa da cutar jima'i. Harkokin jima'i da aka haifa ba su da yawa (0.04 da 0.07 bisa dari).
Bisa ga binciken, kashi 80 cikin 100 na abokan hulɗa da kwayar cutar HIV, wadanda dukansu da aka saba da su a farkon fitinar, an sanya su a kan ART ta 2012. A wannan lokacin, saurin sabon kamuwa da cuta ya haɗu da raguwa gaba daya. hadarin kimanin 48 bisa dari.
Bugu da ƙari, yayin da aka ci gaba da binciken kuma an sanya abokan hulɗa da kwayar cutar HIV a kan ART, yawancin farashin sun nuna cewa sun kasance sun kara. Daga shekara ta 2009 zuwa 2012, yin amfani da ART ta rage yawan cutar HIV ta hanyar kashi 67 cikin dari, kusan sau uku abin da aka gani daga shekara ta 2006 zuwa 2009 lokacin da kawai kashi 32 cikin dari ne.
Kalma Daga
Yayin da yake damuwa kamar yadda waɗannan sakamakon ya kasance, yana da muhimmanci a lura cewa, a kan kowane mutum, TasP ba a taɓa la'akari da salo daya kadai ba, har ma a tsakanin ma'aurata, ma'aurata. Ba a taba nufin maye gurbin kwaroron roba ba ko kuma samar da kyauta kyauta don watsar da ayyukan jima'i na aminci.
Da wannan aka ce, manufofin dabarun suna da karfi. Wannan hakika gaskiya ne ga ma'aurata da suke so su haifi 'ya'ya ko mutane a babban hadarin kamuwa da cuta . A irin waɗannan lokuta, za'a iya sanya prephylaxis na pre-exposure (PrEP) don a kara kare maƙwabcin HIV. Idan aka yi amfani da su, TasP da PrEP iya rage haɗarin kamuwa da cuta zuwa kusa da rashin kudi.
Koyaushe tattauna da waɗannan likita tare da likitanku kafin a fara yin irin wannan tsarin.
> Sources:
> 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.
> Gill, V. Lima, V .; Zhang, W .; et al. "Amfanin Harkokin Gyaran Halitta a Birnin Columbia wanda ya dace da ragewar cutar HIV irin na 1 Deteg Resistance Detection." Cututtuka na cututtuka na asibiti. Janairu 1, 2010; 50 (1): 98-110.
> Cibiyoyin Kula da Cututtuka da Cututtuka na Amurka (CDC). "Alamomin da ke faruwa a ciki: Rigakafin HIV ta hanyar kulawa da jiyya - Amurka." Rashin ƙuntatawa da Mutuwa na Bayani (Weekly Report) (MMWR). Disamba 2, 2011; 60 (47): 1618-1623.
> Charlebois, B; Das, M. Porco, T; da kuma Havlir, D. "Hanyoyin Ƙarfafa Harkokin Kwayoyin cutar Kanjamau ta HIV / AIDS tsakanin maza da ke da jima'i da maza a San Francisco." Cututtuka na cututtuka na asibiti. Afrilu 15, 2011; 52 (8): 1046-1049.
> Smith, K .; Westreich, D .; Liu, H .; et al. "Jiyya don hana yaduwar cutar HIV a cikin 'yan uwan juna biyu a Henan, Sin, daga 2006 zuwa 2012." Cututtuka na cututtuka na asibiti. Maris 13, 2015; fara: civ200. [Afubu gaba].