Istaraatijiyadda ayaa ujeedadeedu tahay in lagu celiyo heerarka jaaliyadaha halista badan leh
Daaweynta HIV sida Daaweynta (TasP) waa istaraatejiyad ku saleysan caddaynta oo ay dadka ku dhejiya fayraska aan la garan karin ee fayruuska ah ay u badan tahay in ay u gudbin karaan fayraska si lamaane aan loo daboolin.
Inkastoo TasP markii hore loo arkay in la yareeyo khatarta shakhsiyadeed marka fikradda ugu horreysa la soo bandhigo sannadkii 2006, waxay ahayd sannadkii 2010 oo ahayd caddayn ka timid daraasadda HTPN 052 soo jeedisay in la fulin karo qalab ka-hortag dadweyne.
Horumarinta Cilmi-baarista waxaa loo tixgeliyaa qalabka isboortiga
HTPN 052 oo tijaabo ah oo daraasad ku sameeyay saameynta daaweynta antiretroviral (ART) ee ku saabsan heerka isu gudbinta ee labada lammaane ee hijroolka ah - ayaa la joojiyay ku dhawaad afar sano ka hor markii la tusay in shakhsiyaadka daaweynta ay 96% ka yartahay in ay u gudbiyaan lamaanayaashooda intii kaqeybgalay 't.
Natiijada maxkamadeynta ayaa keentay in dad badani ay u arkaan in DKM laga yaabo inay sidoo kale gaabiso, haddii aysan si joogta ah u joojin, faafitaanka HIV-ga iyada oo la yareeyo sida loogu yeero "viral load community". Aragtida, iyada oo la yareeyo celceliska cirridka celceliska ee dadka qaba cudurka, gudbinta HIV ayaa ugu dambeyntii noqotaa mid aad u dhif ah si loo joojiyo cudurrada faafa.
Caddaynta Taageerada Tasp
Ka hor intii aan la hirgelin daawooyinka cusub ee loo yaqaan 'anti-injection therapy', TasP waxaa loo tixgeliyay inaysan macquul ahayn sababtoo ah heerarka sare ee sunta daroogada iyo xayiraadda fayruuska oo kaliya boqolkiiba 80%, xitaa kuwa kufilmaamsan.
Sawirka ayaa badiyaa isbeddelay sannadihii la soo dhaafay, iyadoo la hirgelinayo daawooyin waxtar leh, daaweyn ka jaban. Xitaa haddii ay si aad ah ugu dhufato wadamada sida South Africa, helitaanka jilicsanaanta qiimaha jaban (sida ugu yar $ 10 bishiiba) ayaa fikradda u dhaweyd meel u dhow.
Inkasta oo dhammaan xaqiiqooyinkani ay tilmaamayaan in ay tahay qayb muhiim ah oo ah istiraatiijiyad ka hortag shakhsi ku salaysan, miyay macnaheedu tahay in ay ku xirnaan lahayd qiyaasta dadweynaha ku saleysan?
Caqabadaha Hirgelinta
Laga bilaabo bilawga, waxay caddaynaysaa in ay jiri doonto caqabado istiraatiiji ah oo ka soo horjeeda haddii ay TPF noqotey mid suurogal ah:
- Waxay u baahnaan doontaa daboolka sare ee baaritaanka iyo daaweynta HIV, gaar ahaan bulshooyinka aan baahsaneyn, oo aad u sarreeya. Maraykanka gudaheeda, midba mid ka mid ah shantii qof ee qaba HIV ayaa si buuxda uga warqabaya xaaladooda. Jawaabta, Adeegga Ka Hortagga Adeegyada Ka Hortagga Mareykanka wuxuu hadda kugula talinayaa imtixaanka mar-ka-dembiga ah ee dhammaan dadka asaasiga ah ee da'doodu u dhaxayso 15 ilaa 65 sida qayb ka mid ah booqashada dhaqtarka caadiga ah.
- Waxay u baahan tahay in la xoojiyo sii socodka bukaanada hadda jira. Marka la eego Xarumaha Xakamaynta iyo Ka Hortagga Cudurrada (CDC), keliya boqolkiiba 44 dadka Maraykanka ah ee laga helay HIV ayaa la xiriirta daryeelka caafimaadka. Cilmi baaris ayaa soo jeedinaysa in cabsida sheegidda iyo la'aanta xanuunka HIV-ga gaarka ah ay ka mid tahay sababaha badan ee daaweynta dib loo dhigo illaa iyo inta muuqaalka cudurka muuqda.
- Waxay u baahan tahay habka loo xaqiijiyo xoojinta ku saleysan dadweynaha, guusha taas oo ah mid aad u qiimo badan oo adag in la saadaaliyo. Sida laga soo xigtay CDC, dadka qaba HIV-da ee hadda daaweyntu, ku dhawaad hal afartii mid ayaa awoodi waayeen inay sii wadaan xoojinta lagama maarmaanka u ah si loo gaaro xakamaynta fayraska dhammaystiran.
- Ugu dambeyntii, kharashka fulinta waxaa loo arkaa in uu yahay caqabad wayn, gaar ahaan miisaaniyadda caalamiga ah ee HIV-ga ay sii socoto in si aad ah loo yareeyo.
Caddaynta Taageerada Tasp
Magaaladda San Francisco waxaa laga yaabaa inay ahaato midka ugu dhow ee caddaynta fikradda ah ee Dammaanadda. Iyadoo rag iyo haween labadaba ah oo ka kooban 90% dadka magaalooyinka qaba cudurka qabta, si joogta ah, faragelinta la beegsanayaa waxay keentay in tiro yar oo aan la ogaan karin. Baahsanaanta baahsan ee ART ayaa si toos ah u keentay hoos u dhac boqolkiiba 33 ah ee infekshannada cusub ee laga soo bilaabo 2006 ilaa 2008. Sanadkii 2010, hirgelinta daaweynta guud ee ku saabsan cudurka ayaa sii kordhisay lix laab laabashada tirada dadka awood u leh inay ilaaliyaan xakamaynta fayraska oo buuxa .
Laakiin intooda badan waxay isku raaceen in San Francisco ay leedahay jaanis gaar ah dadka kale ee HIV. Weli waxaa jira caddayn ku filan oo lagu taageerayo in DKP ay hoos u dhigto heerarka faafa ee isla meel kale.
Dhab ahaan, daraasaddan 2015 ee Jaamacadda Waqooyiga Carolina ayaa soo jeedisay in waxtarka runta ah ee DHAMP ay dhici karto in ay gaabiso dad muhiim ah. Daraasaddan, oo eegtay 4,916 lamaane xayawaan ah oo ku nool gobolka Henan ee dalka Shiinaha laga soo bilaabo 2006 illaa 2012, wax ka bartay saamaynta ART ee sicir-isdhaafsiga ee dadwaynaha isticmaalka kondhomka joogtada ah (63 boqolkiiba) iyo heerka cudurrada galmada lagu kala qaado iyo jinsiga qaxoontiga ah ayaa aad u hooseeya (0,04 iyo 0.07%, siday u kala horreeyaan).
Sida laga soo xigtay cilmi-baadhistan, boqolkiiba 80 ee la-hawlgalayaasha HIV-ga, kuwaas oo dhammaantood la daweeyey bilowga tijaabada, ayaa lagu soo rogay ART sannadka 2012. Inta lagu jiro xilligaas, hoos u dhaca infekshanka cusub ayaa hoos u dhigaya hoos u dhaca guud halista qiyaastii boqolkiiba 48.
Intaa waxaa dheer, markii daraasadda la sameeyay oo la-hawlgalayaal badan oo qaba HIV-ga la dhigey ART, qiimaha ayaa u muuqda inay sii deynayaan. Laga soo bilaabo 2009 ilaa 2012, isticmaalka joogtada ah ee ART ayaa hoos u dhigtay khatarta HIV iyadoo boqolkiiba 67%, ku dhowaad saddex jeer laga soo bilaabo 2006 ilaa 2009 markii ay ahayd 32 boqolkiiba.
Ereyga
Iyaga oo u hoggaansamaya natiijooyinkaas, waxaa muhiim ah in la ogaado in shakhsi ahaan, TasP aan marnaba loo tixgelin istiraatiijiyad istiraatiiji ah, xitaa ka mid ah labada qof ee xayawaanka ah. Weligeed looma jeedin in la bedelo cinjirrada ama bixinta ruqsadda bilaashka ah si looga tago dhaqan galmo nabadgelyo leh.
Iyadoo la sheegayo, hadafyada istiraatiijiyadu waa kuwo xoogan. Tani waxay si gaar ah u tahay lammaaneyaasha doonaya inay carruur ama shakhsiyaad khatar sare ugu jiraan cudurka . Xaaladaha noocaas ah, PREP ayaa horey loogu qori karaa si loo ilaaliyo loona wadaago lamaanaha HIV-ga ah. Marka la wada isticmaalo, TasP iyo PrEP waxay yareeyaan khatarta caabuqa ilaa heer aan ku dhicin.
Had iyo jeer kala hadal fursadahaas dhakhtarkaaga ka hor inta aadan bilaabin istaraatiijiyad noocaas ah.
> Ilo:
> Cohen, M .; Chen, Y .; McCauley, M .; et al. "Kahortagga infekshanka HIV-1 oo leh daaweyn antiretroviral ah oo hore." Somali Journal of Medicine. Agoosto 11, 2011; 365 (6): 493-505.
> Gill, V .; Lima, V .; Zhang, W .; et al. "Natiijooyinka Fayadhowrka ee Horumarinta ee British Columbia oo ka kooban hoos u dhac ku yimid dhacdooyinka HIV-ga 1 Cilad-qaadista Dawada." Cudurada Cudurrada Cudurrada ah. Janaayo 1, 2010; 50 (1): 98-110.
> Xarumaha Maraykanka ee Xakamaynta iyo Kahortagga Cudurrada (CDC). "Calaamadaha muhiimka ah: Ka Hortagga HIV-ga Daryeelka iyo Daaweynta - Maraykanka." Xuruufta iyo Mortality Reporting Weekly (MMWR). Diisambar 2, 2011; 60 (47): 1618-1623.
> Charlebois, B .; Das, M .; Porco, T .; iyo Havlir, D. "Saamaynta Istaraatiijiyooyinka Daaweynta Antiretroviral Antiretroviral ee ku saabsan Cudurka HIV-ga ee Ragga ah ee Galmoodka Ragga ee San Francisco." Cudurada Cudurrada Cudurrada ah. Abriil 15, 2011; 52 (8): 1046-1049.
> Smith, K .; Westreich, D .; Liu, H .; et al. "Daaweynta Ka Hortagga Looga Hortago HIV ee Xaasaska Sharciyaysan ee Henan, Shiinaha, 2006 ilaa 2012." Cudurada Cudurrada Cudurrada ah. Maarso 13, 2015; pii: qaran200. [Epub ka hor daabacan].