Aqoonsiga Caqabadaha isticmaalka PrEP
Waxaa la muujiyey in isticmaalka maalin walba isticmaalka daroogada antiretroviral, Truvada , ay si weyn u yareeyn karto khatarta caabuqa dadka qaba cudurka HIV-ga ee xiriirka xaraashka ah (tusaale ahaan, hal lamaane yahay HIV-ga iyo kan kale waa HIV-diidmo). Istaraatijiyadda, oo loo yaqaano Primer Pain Precax (ama PrEP) , ayaa lagu muujiyey inay hoos u dhigayso khatarta gudbinta meel kasta oo ka socota 62 boqolkiiba illaa 75 boqolkiiba haddii la qaado si joogta ah, oo aan adagtahay.
Marka laga eego aragtida tirakoobka, tirooyinka ayaa si weyn u taageeraya isticmaalka PrEP iyadoo qayb ka ah istaraatiijiyada guud ee ka hortagga HIV. Si kastaba ha noqotee, marka laga eego muuqaalka dhabta ah ee nolosha, lambarradu ma noqon karaan wax kasta oo ku qanacsan, oo leh ereyada "joogto ah" iyo "aan kala go 'lahayn oo soo bandhigaya caqabadaha hor istaagi kara kuwa laga yaabo in ay wax u qoraan.
Dhab ahaantii, sida laga soo xigtay cilmibaarista warshadaha, kaliya 1,774 qof oo Mareykanka ah ayaa buuxiyay rijeetooyin loogu talagalay Truvada ee PrEP intii u dhaxaysay Jannaayo 2011 iyo Maarso 2013. Laga soo bilaabo Juunyo 2016, tiradaasi waxay kor u kacday 76,000. Taasi waa walaac aad u xun oo lagu qiyaaso 50,000 oo ah cudurada cusub ee HIV-ga lagu qiyaasay in ay dhacaan sanad kasta Maraykanka.
Tirooyinka ayaa keenaya arrin badan oo ka mid ah arimahaa ka dhigaya PrEP in ay ka fiican tahay goob cilmi-baaris ah, laakiin wax yar ka dib marka la dhigo macnaha guud ee dunida. Mana aha kaliya arin waxbarasho ama wacyi-gelin (inkastoo ay kuwani yihiin qodobbada ugu muhiimsan). Dhab ahaan waxaa jira wax kale oo socda.
Saameynta qiimaha iyo xajinta
Sahan 2012 ah oo ay sameysay Xarumaha Xakamaynta iyo Ka Hortagga Cudurrada Maraykanka (CDC) ayaa gabagabaysay in in ka badan saddex daloolow hal qof oo Maraykan ah oo qaba HIV-ga daaweynta antiretroviral therapy (ART) aysan awoodin inay ilaaliyaan isticmaalka daroogada maalinlaha ah -waxaana loogu talagalay dadka HIV-ga ah wuxuu si toos ah ula xiriiraa muddada iyo tayada nolosha.
Ma filan karnaa caqabadaha in ay yaraadaan dadka qaata ART ma ahan "badbaado", laakiin ka hortagga HIV-ga? Kadib, inta uu kondhomku og yahay in uu bixiyo difaac aad u weyn, tirakoobku wuxuu muujinayaa in loo isticmaalo kaliya laba ka mid ah saddexda falood ee galmada ugu fiican.
Marka qaar waydiin karaan, "Sidee ayey u adagtahay in la qaato hal kiniin yar maalintii?", Cilmi-baarisyada badankood waxay muujinayaan in xajinta maalinlaha ah ay noqon karto mid aad u adag oo laga adkaan karo. Ka fikir in dawada joogtada ah ee sonkorowga ama cudurka wadnaha uu u baahan yahay in ka yar 70 boqolkiiba adherence (ama u dhiganta sagaal qiyaasta la goostay bishiiba). Marka la barbardhigo, PrEP wuxuu dalbanayaa u hoggaansanaan buuxda si loo gaaro himilooyinka ilaalinta.
Dhowr cilmi-baarisyo dhowaan ayaa xaqiijinaya caqabadaha Sannadka 2013, Daraasada VOICE-oo eegay isticmaalka PrEP ee 5,029, ee khatarta ku jirta haweenka Africa - ayaa lagu dhawaaqay mid aan habooneyn markii la muujiyay in boqolkiiba 30 keliya ay awoodeen inay ilaaliyaan joogtaynta maalin kasta ee daaweynta. Natiijooyin isku mid ah ayaa lagu arkay Daraasadda FEM-PrEP, oo sidoo kale la joojiyay sababtoo ah heerarka hooseeya ee dadka qaata Truvada maalin kasta.
Marka la eego daraasaddan iyo tirooyinka ka hooseeya ee ka mid ah diiwaannada barnaamijka PrEP, xoogaa weyn ayaa laga yaabaa in loo baahdo in lagu meeleeyo waxbarashada bartilmaameedka, oo ay dadka ku dhexyihiin xidhiidhada xaraashka ah (oo ay ku jiraan kuwa doonaya inay uuraystaan ) waxaa lagula talinayaa PrEP sida koorsada guud ee qoyska dhaqanka, halkii laga heli lahaa goob caafimaad oo gaar ah.
Siyaasiyiinta dejiyeyaashu waxay kaloo u baahan karaan inay qiimeeyaan in kharashka PrEP, lagu qiyaasay inuu yahay qiyaastii $ 12,000 sannadkii, wuxuu noqon karaa caqabad ku ah kuwa leh qorshooyinka caymiska ee aan si buuxda u daboolin isticmaalka.
Daraasad 2013 ah oo ku takhasusay cudurrada caabuqa Maraykanka iyo Canadianka, 74 boqolkiiba ayaa taageeray isticmaalka PrEP ee ku saleysan dadweynaha oo dhan. Si kastaba ha noqotee, kooxdani, 9% kaliya ayaa dhab ahaantii u qorey bukaanada.
Waxaa la rajeynayaa in talooyinka ay soo saareen CDC ee May 2014, iyaga oo ku baaqaya isticmaalka PrEP ee dadka loo tixgelinayo khatarta sare ee cudurka, waxay kordhin doontaa diiwaangelinta diiwaangelinta ee Kooxaha Maraykanka ee lagu bartilmaameedsaday CDC waxaa ka mid ah:
- ragga galmada la sameeya ragga (MSM) ee aan isticmaalin cinjirka galmada ;
- Dadka qaba HIV-ga oo si joogta ah u galmoodaya qof qaba HIV;
- Isticmaalayaasha mukhadaraadka (IDUs), iyo;
- heterosexuals kuwaas oo galmo la leh lamaanayaasha khatarta sare.
Ilaha:
Rawlings K, Mera R, Pechonkina A, et al. "Xaaladda Truvada ee HIV-ga horey u soo saartay kahortaga (PrEP) ee Maraykanka: falanqayn hore loo isticmaalo daroogada." Shirka 53aad ee ICAAC Cilmi-baarista ee ku saabsan wakiilo ka hortaga cudurada iyo daaweynta kiimikada; Denver, Colorado; Sebtembar 10-13, 2013; abstract H-663a.
Xarumaha Xakamaynta iyo Kahortagga Cudurrada Maraykanka (CDC). "Warqada Xaqiiqda CDC | HIV-ga ee Mareykanka : Heerarka Daryeelka." Atlanta, Georgia; la daabacay July 2012.
Anderson, J. "Isticmaalka Galmada iyo Halista HIV ee Dadka waaweyn ee Mareykanka." Somali Journal of Public Health. Juun 2003; 93 (6): 912-914.
Microbicides Network Trial (MTN). "Warbixinta MTN ee Go'aanka joojinta Isticmaalka Jadwalka Tenofovir ee Afka VOICE, Daraasad Daraasad oo Hordhac ah oo Ka Hortagga Dumarka." War saxaafadeedka la soo saarey September 28, 2011.
Machadka Qaran ee Xasaasiyadda iyo Cudurada faafa (NIAID). "Daraasad ka hortagga HIV ee FEM-PrEP iyo Waxyaabaha ay u leedahay baadhitaanka NIAID." Bethesda, Maryland; saxaafadeed ay soo saartay April 18, 2011.