Faɗakar da Gaskiya daga Fallacy
Yin amfani da cututtukan maza da jin dadin jiki (VMMC) don rage haɗarin kwayar cutar HIV a cikin mazajen maza da mata yana kasancewa mai matukar rikici. Duk da yake akwai tabbacin shaida cewa masu kaciya ba su da sauki ga cutar ta HIV ta hanyar jima'i tsakanin maza da marasa kaciya, yawancin lokuta yakan nuna mummunar zargi daga ko dai waɗanda suka ƙi amincewa da kaciya ko kuma sun tambayi ainihin binciken farko.
Hanyoyin gwajin gwagwarmaya da aka gudanar a Afirka daga shekara ta 2005 zuwa 2007 sun nuna cewa VMMC na iya rage haɗarin haɗari na ciki-by-penile ta ko'ina daga 51% zuwa 60%.
Dangane da ƙaddamar da waɗannan gwaje-gwajen, Hukumar Lafiya ta Duniya (WHO) da Shirin Majalisar Dinkin Duniya akan HIV / AIDs (UNAIDS) sun bayar da shawarwari a 2007 suna cewa:
"Ya kamata a gane kaciyar namiji a matsayin wata ƙari, muhimmiyar hanya don kare rigakafin cutar HIV a cikin mutane ... (amma) kada ya maye gurbin hanyoyin da aka sani na rigakafin HIV."
A shekara ta 2011, an yi VMMC fiye da miliyan 1.3, yawanci a gabas da kudancin Afrika inda yawancin adadin yawan mutanen da ke girma ya kai kashi 26%. Shugaba Obama ya ci gaba da ƙaddamar da tallafin kimanin miliyan 4.7 a ƙarshen 2013.
Kaciya kamar Rigakafin: Hanyar Daya?
A yayin da aka rufe wannan fitowar, yawancin binciken da aka gudanar ya nuna cewa kaciya namiji ba ta samar da irin wannan amintacce ga mace marar lafiya ba tare da cutar ba a cikin dangantakar da ke tsakanin mata da maza .
Akwai dalilai masu yawa da ke haifar da wannan mummunan yanayi-ciki har da yanayin rashin lafiyar halitta na mace, kuma, a wasu lokuta, rashin jima'i da jima'i ba kafin a yi masa rauni ba.
Babu wata hujja da ta bayar da shawarar cewa kaciya zai rage hadarin kamuwa da cuta a cikin maza da suka yi jima'i da maza (MSM) , inda hanyar farko ta kamuwa da cuta ita ce jima'i .
Ko kaciya zai iya samar da amintaccen tsaro a cikin maza da suke yin jima'i da jima'i tare da abokin auren mata yana kasancewa daidai.
Ƙarin karin muhawara shi ne gaskiyar cewa ƙetare bai nuna tasirin tasirin cutar HIV ba a kasashe masu tasowa kamar yadda suke yi a cikin yawancin jama'a, yawanci kamar yawancin ƙasashen Saharar Afrika.
Bisa ga yawancin hujjoji, WHO / UNAIDS ta tsara hanyar da ta dace ta hanyar cewa:
"Babban tasirin lafiyar jama'a zai kasance cikin saituna inda cutar HIV ke da kwayar cutar (yawan kwayar cutar HIV a cikin yawan jama'a ya wuce 15%), yaduwar yawanci ta hanyar bazawar mata, kuma inda ba a yi kaciya ba a matsayin mutum (misali fiye da 80%) . "
A shekarar 2011, UNAIDS ya bayar da rahoton cewa yawan adadin yawan tarin yara a yankin Saharar Afrika ya kasance tsakanin 10% (a Malawi) da 26% (a Swaziland). Ta hanyar kwatanta, adadin yawan tarin yara a Amurka ya kai kashi 0.6%.
Ana ƙaddamar da Shaida
Daga tsakanin 1989 da 2005, yawan binciken da ake yi a Afrika ya lura da dangantakar da ke tsakanin yawan mazajen kaciya da ke cikin yawan mutane masu yawan gaske da kuma yawan ƙwayar cutar HIV. Duk da yake wasu daga cikin sakamakon ya tilastawa - ciki har da wani babban gwagwarmaya a kasar Uganda wanda ya nuna rashin daidaito da kashi 42 cikin 100 a cikin mazajen kaciya - akwai kusan karatu da yawa ko dai ya yi tsayayya da sakamakon ko yin tambaya ga binciken marubucin.
A shekara ta 2005, nazari na yau da kullum na nazarin nazarin karatun nan 35 ya tabbatar da haɗin gwiwa tsakanin ƙananan yawan kaciya da rage yawan yawan mata da maza. Duk da haka, ana ganin shaidar da bai dace ba don tabbatar da amfani da kaciya a matsayin kayan aiki na gida.
Daga shekara ta 2005 zuwa 2007, jerin tsararren gwajin da aka gudanar a kasashe uku na Afirka sun bayar da hujjoji masu dacewa a cikin sha'anin aikin.
- A} asar Kenya , mutane 2,784 daga shekarun 18 zuwa 24 sun kar ~ e su ne don nazarin Jami'ar Illinois. An dakatar da shari'ar a lokacin da aka yanke kaciya don samun inganci na 53% a hana rigakafin HIV.
- A Afirka ta Kudu , kimanin mutane 3,273 tsakanin 16 zuwa 24 sun shiga cikin shari'ar da Agence Nationale de Recherches sur la SIDA (ANRS) ta bayar. An kammala shari'ar bayan watanni 17 bayan bayanan lokaci ya nuna kashi 60 cikin 100 a cikin kaciya.
- A Uganda , mutane 4,996 daga tsakanin 15 zuwa 49 sun halarci kotu ta John Hopkins Bloomberg School of Health. Har ila yau an dakatar da shari'ar ba tare da jimawa ba bayan ya nuna tasiri na 51%.
Yayinda maganganu masu mahimmanci sun taimaka mahimman binciken da ke tattare da annobar Afrika, wasu sun yi tambaya ko yunkurin aiwatar da kalubalen-ciki har da rage amfani da robaron roba ba tare da cin zarafi ba - duk da haka ba a cika cikakken bayani ba.
Tsarin Halitta na Halitta na Musamman don Rage Gyara
Yawan karatu a cikin 'yan shekarun nan sun nuna cewa kwayar cutar kwayan halitta a ƙarƙashin kututturewa na iya zama dalilin haifar da ƙara yawan watsawa a cikin maza marar kaciya. Binciken ya nuna cewa yawancin kwayoyin cutar kwayar cutar na iya juya rayukan da ake kira Langerhans akan fatar jiki a cikin "masu cin amana" don kare kansu.
Yawancin lokaci, kwayoyin Langerhans ke aiki ta hanyar kamawa da kuma kaiwa ga kwayoyin kwayoyin halitta zuwa kwayoyin halitta mai yaduwa (ciki har da sel CD4 ), inda aka fara da su don neutralization. Duk da haka, yayin da kwayar cutar ta ƙara ƙaruwa, kamar yadda ya faru a karkashin kasa, amsawar ƙwayar cutar ba ta faruwa kuma waɗannan kwayoyin Langerhans suna jigilar kwayoyin halitta tare da microbes masu laifi amma maimakon gabatar da su.
Ta hanyar yin kaciya da azzakari, kwayoyin anaerobic karkashin kasa ba za su iya bunƙasa ba, don haka ya sace amsawar ƙwayar cuta. Ƙarin bincike na iya haifar da ci gaba da magungunan microbicidal ko wasu hanyoyin da ba a da magungunan ba don magance sakamakon.
Amfanin Tsaro a Afirka
Misalin tsarin lissafi na WHO, UNAIDS da Cibiyar Afirka ta Kudu don Nunawa da Labaran Tsari (SACEMA) sun nuna cewa, a cikin wani wuri mai zurfi wanda aka ba da jima'i tsakanin maza da namiji, za a cire sabon ƙwayar cuta don kowane mutum biyar da aka yi wa kaciya . A ka'idar, idan kashi 90% na maza suna kaciya a cikin wadannan al'ummomin, za'a iya rage haɗin gwiwa a cikin cututtukan mata daga kimanin 35% zuwa 40% (saboda ƙananan ƙwayar cutar al'umma).
Ƙididdiga masu amfani da farashin sun nuna cewa, ta hanyar watsar da waɗannan cututtukan, za a iya rage nauyi ga tsarin kiwon lafiyar. Ɗaya daga cikin binciken da aka yi a lardin Gauteng a Afirka ta Kudu-inda yawancin kamuwa da cutar ya kai 15% - ya nuna cewa ƙimar mazajen 1,000 (kimanin $ 50,000) na iya samar da kuɗin kuɗin fiye da $ 3.5 a cikin magungunan rigakafi kawai, ba a kai tsaye ba likita da / ko asibiti.
Duk da haka, wasu sunyi jayayya cewa lissafin sunyi tsammanin, yayin da ɗayan binciken (yayinda aka yi muhawara) ya tabbatar da cewa aiwatar da shirye-shiryen kwaroron roba kyauta sau 95 ne mafi yawan kuɗi fiye da yanke hukunci akan kawar da kwayar cutar HIV.
A shekara ta 2013, WHO ta yarda da amfani da Prepex, na'urar farko ta yanke kaciya. Ƙaƙwalwar roba mai nauƙi ba ta buƙatar ƙwayar cuta ba kuma an haɗa ta kai tsaye zuwa ƙyamar ido, saboda haka yanke ikon jinin. A cikin kusan mako guda, za'a iya cire gawawwakin fata ba tare da wani rauni ba ko kuma sutura. Wannan sabuwar fasaha ana fatan samun karin yawan VMMC ta miliyan 27 da 2020.
Shin Kisanci a matsayin Rigakafin Mariya a Amurka?
Daga hanyar kula da lafiyar jama'a, yana da mahimmanci a lura cewa babu wata duniya da ta taba bada shawarar kaciya mazaunin duniya a matsayin zaɓi na rigakafi na HIV. A bayyane yake, akwai wasu bambance-bambance a cikin tasiri na annobar Afrika da na ci gaba da duniya, musamman tun da fiye da 60% na sababbin cututtuka a Amurka suna cikin MSM.
Bugu da ƙari, matsalar mummunar tasiri ga mata da suka riga ya kasance saboda yanayin rayuwa da kuma tattalin arziki - an ga cewa ba za ta iya yin amfani da aiwatar da manyan ayyuka ba, har ma a cikin ƙananan ƙananan wuraren da yawancin mazaunan mata da maza suke. Wasu ma sun yi imanin cewa saƙonnin da aka yi niyya game da kaciya za su sami tasiri mara kyau a kan al'ummomin da sigina ya riga ya yi girma da kuma yin amfani da robaron buƙata amfani da ƙasa a ƙasa da kashi 50%.
Duk da haka, ƙididdiga da dama sun nuna cewa ƙin kaciya na iya rage mace mai rai na Amurka da ke iya samun cutar ta HIV ta hanyar 20%. A shekara ta 2012, Cibiyar Harkokin Ilimin Yammacin Amirka ta bayar da wata sanarwa game da manufofi da ke nuna cewa "amfanin lafiyar ɗan gajeren ɗa namiji ya wuce hadarin da kuma yadda hanyoyin ta ke ba da damar shiga wannan hanya ga iyalan da suka zaɓa." Daga cikin abubuwan da aka ambata sune rigakafin cutar cututtukan urinary , ciwon kwari na penile , da kuma watsa wasu cututtuka da ake yi da jima'i , ciki har da HIV .
Yawancin likitoci da hukumomi na kiwon lafiya sun dauki matsayi marar takaici dangane da kaciya maza da mata na zaɓaɓɓe, suna ƙarfafa cewa yana ragewa maimakon kawar da haɗarin cutar HIV-cututtuka. A halin yanzu babu wani shawarwari a Amurka don yin amfani da kaciya maza da maza don su rage haɗarin watsawa a cikin maza.
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