Caabuqa laba qof oo ku jira kiniinka ka hortagga ah ee welwelka laga qabo
Waxaa la soo sheegay 25kii Febraayo 2016, in nin qaata daroogada ka hortagga HIV-ga, Truvada , uu ku dhacay fayruska inkastoo uu si buuxda ugu habboon yahay nidaamka hal mar ah ee daroogada. Warka ayaa walaac weyn ka muujiyay qaar ka mid ah sida ay wax ku ool u tahay istaraatijiyadda loo yaqaan 'HIV Prevention Prognosis' ( PrEP ) -wax ahaan waxay hubinaysaa in dadka aan HIV-ga aan weli la daaweyn.
Warbixintooda, baarayaashii la yiraahdo Maple Leaf Medical Clinic (MLMC) ee Canada ayaa xaqiijiyay in 43-sano jirka gayiga ah uu baaritaan ku sameeyay HIV intii uu ku sugnaa PrEP, iyo in dib loo eego diiwaanka farmashiyaha iyo baaritaannada daaweynta bukaanka ( loo isticmaalo si loo cabbiro xoojinta daroogada ee dhiigga) caddaynta bixisay heerka shakhsi ahaaneed ee u hoggaansamida.
Natiijada baaritaanka dheecaanka dambe ayaa ugu dambeyntii muujisay in ninku uu helay cilad nadiif ah oo ah HIV-ga , taas oo u adkayd labadaas wakiil ee daroogada ah oo ka kooban Truvada.
Haddaba su'aashu way sii jiraysaa: miyuu yahay kiiskan "naadir" maadaama qaar ka mid ah warbaahinta ay soo wariyeen? Mise dhacdada, dhab ahaantii, waxay soo bandhigtaa qallalan suurtagal ah ee hubka ah ee istaraatiijiyadan ka hortagga HIV-ga?
Waxtarka Real-World ee PrEP
Inta badan ururada HIV-ga ayaa kugula talin doona in PrEP, haddii si sax ah loo qaato qaabka kiniiniyada maalinlaha ah ee Truvada, waxay hoos u dhigi kartaa halista HIV ee boqolkiiba 90 ama ka badan.
Waxay sidoo kale isticmaali doonaan digniinta, gaar ahaan kuwa halista sare leh , in daroogada aan loo isticmaalin gooni-goyn laakiin waxa ay qayb ka tahay barnaamijka guud ee ka-hortagga HIV (oo ay ku jiraan galmada, yaraynta tirada lamaanayaasha galmada iwm)
Laakiin farriinta ayaa inta badan u xaddidaysa dadweynaha waa siyaabo kala duwan, iyadoo warbaahinta bulshada iyo wargeysyada si joogto ah iskugu xirxiraan ama lagu dhejiyo caddaynta dhabta ah.
Maanta maaha wax aan caadi ahayn in maqlo in "PREP" ay tahay "99 boqolkiiba wax ku ool ah" ee ka hortagga HIV, ama in la arko cilmi-baaris si loo caddeeyo in "PrEP" 100 boqolkiiba "waxtarka leh" ee ragga khatarta sare leh aysan isticmaalin cinjirka .
Inkastoo ay run tahay in daraasaadka qaarkood ee ragga khatarta badan leh ay ka war hayaan kuwa aan si buuxda u daweynin daaweynta, natiijooyinka noocan ahi uma baahna inay turjumaan xaaladaha dhabta ah ee adduunka, halkaas oo dad badan oo naxdin leh ay si weyn u yareeyaan waxtarka PREP heer shakhsi ah.
Waa qaar badan oo ka mid ah shakiyeyaashan kuwaas oo dhigaya dhacdada Kanadiyaan ee iftiin badan.
Waxyaabaha Saameeya Saamaynta Waxtarka PrEP
Daraasaddooda, baadhayaasha MLMC waxay soo jeediyeen in nin Canadian ah uu ku dhacay cudurka lamaanaha ee HIV-ga kaas oo daaweyntiisa antiretrovoviral uu ku fashilmay. Ka dib markii baaritaanka iska caabinta hiddaha , fayruska lamaanaha ayaa lagu muujiyay inuu u adkaysto labadaba tobanka yar ee loo yaqaan 'Tenofovir' iyo 'emtricitabine' (daawooyinka qayb ka ah Truvada), si wax ku ool ah u joojiyaan faa'iidada ilaalinta ee PrEP.
Inkastoo qaar ka mid ah faleqooyinka ay sheegeen in nooca noocyada kala duwan ee daawada daroogadu ay aad u yar tahay - ayadoo ka badan boqolkiiba hal-daraasad kale oo yar oo sawir ka kooban sawir ka duwan. Waan ognahay, tusaale ahaan, in caabuqa Tenofovir uu hadda ka socdo halkii 20 boqolkiiba (ee Yurub) ilaa 57 boqolkiiba (Afrika) oo ka mid ah bukaannada kufilan daaweynta, sida laga soo xigtay warbixinta 2016 ee ka tirsan Kooxda Daraasada TenoRes.
Xaaladaha sidan oo kale ah, xitaa haddii qaybta 'emtricitabine' ay tahay mid sii jiri karta, awooddeeda inay ka hortagto caabuqku weli waa, ugu fiican, hoos udhaca ama aan sugnayn. Tani waxay kali waydiineysaa haddii xaaladaha caabuqa ee kiisaska Kanadiyadeed ay muhiim u tahay "naadir", iyada oo muujinaysa caqabadaha hortaagan bulshooyinka halkaa oo ah heerarka iska caabinta ee tenofovir.
Dhanka kale, kalsooni-darro kale ayaa dhici karta inay wiiqi karto waxtarka "PrEP". Madaxa iyaga ka mid ah:
- Ku guuldareysiga in la gaaro lana ilaaliyo heerarka ku filan ee Truvada ee dhiiga. Inkasta oo qiyaasta daaweyntu ay badanaa tahay sababta keentay guul darrooyinkan, waxaa sidoo kale loo yaqaanaa in bukaanada bilaabaya PrEP u baahan yihiin daaweyn qiyaastii 20-30 maalmood ka hor inta aan daroogada loo tixgelin karin. Marka heerarka daaweynta lagu daweeyo, marmarka qaarkood la seegay qiyaasta ayaa ka yaraada arrin-ugu yaraan dadka raga ah ee ragga ah.
- Kala duwanaan la'aanta waxqabadka PrEP ee raga khaniisiinta ah ee ka soo horjeeda haweenka heterosexual. Waxaa sidoo kale jira caddayn muujinaya in PrEP aysan noqon karin mid wax ku ool ah oo haweenka ah iyo in xitaa la raaco, oo aan si buuxda loo raacin, lacagta badbaadada ayaa laga yaabaa inay ka hooseyso boqolkiiba 90 qiimaha ragga ah ee ragga.
Dhammaantood, xaqiiqooyinkani waxay soo jeedinayaan laba arrimood: in waxtarka "PrEP" ee qaar ka mid ah dadku ay aad uga hooseeyaan kuwa kale, iyo in baahida loo qabo kondamyada iyo waxqabadyo kale oo ka hortag ah ay weli yihiin kuwo ku habboon weligood.
PrEP iyo Iskaashatooyinka Jinsiga ah
Iyadoo la sheegayo, waxtarka 'PrEP' uma muuqdaan in si caadi ah loo yareeyo waxyaabo badan oo ka mid ah khatarta caadiga ah ee la xiriirta cudurka. Inkastoo isticmaalka kondhom aan habooneyn iyo lamaanayaal badan oo galmo ah, tusaale ahaan, la og yahay in la kordhiyo kartida HIV, ma ahan inay khasab tahay in la yareeyo waxtarka "PrEP" ee shaqsiyaadka khatarta sare leh.
Xaqiiqdii, ragga raggu u arkeen inay ka mid yihiin halista ugu sareysa, isticmaalka PrEP weli wuxuu la xidhiidhaa qiyaastii boqolkiiba 86 qiyaasta ilaalinta ee kaashka ah ee aan isticmaalin PrEP. Faa'idada waxaa lagu arki karaa oo kaliya in ay kordhiso kuwa si joogto ah u isticmaala, oo isticmaala cinjirada si joogta ah, iyo kuwa xadidaya tirada lamaanahooda galmada (gaar ahaan kuwa aan la aqoon ama xaalad daaweyn).
Iyadoo la sheegayo, "PrEP" weli looma tixgelin karo "xashiish jilicsan" oo si khaas ah u diidaya faa'iidooyinka noocyada kale ee badbaadinta, sida cinjirka. Bishii Febraayo 2017, nin saddexaad ayaa la baaray intii uu ku sugnaa PrEP. Xaaladdan, si kastaba ha ahaatee, cilmi-baarayaashu waxay aaminsan yihiin in gudbinta ay ka dhacday qeyb weyn sababtoo ah tirada "aadka u sareysa" ee lamaanayaasha galmada uu lahaa.
Nin 50 jir ah oo reer Dutch ah ayaa ka qaybqaatay daraasad Yurub ah oo PrEP ah waxaana lagu soo warramey in ka badan 90 qof oo wada-jir ah iyo in ka badan 100 fal oo galmo aan caadi aheyn intii lagu jiray tijaabadii 12-usbuuc. Inkastoo uu ku jiray PrEP, naasku laba jeer ayaa la ogaaday qanjirada malawadka iyo hal mar oo kalamiidiya.
Inkastoo dabeecadda aadka u ba'an ee kicisay ay rumaysan tahay in tani ay tahay dhacdo hal mar ah, qaar kalena ma hubin. Baaritaanka fayruska ninka, waxay ogaadeen in aysan jirin wax isku-buuqsan oo HIV-ga ah oo nooc kasta ah oo fayruuskana waxaa loo tixgeliyaa nooc "nooca duurjoogta ah".
Taas macnaheedu waa in, marka la eego diiwaanka xakamaynta, daawooyinka waa in ay wali siiyeen difaac haddii xaaladaha kale ay fududeeyeen caabuqa. Hadday sidaas tahay, arrimahan aan weli la aqoonsan ayaa dadka kale ku ridi kara halis. Ilaa inta cilmi-baarayaashu ay wax badan ogaanayaan, waa in lagu dhaqmaa hababka galmada ee nabadgelyo leh haddii ay kaliya bixiyaan lakab kale oo ilaalin ah.
Ilaha:
> Hoornenborg, E. iyo de Bree, J. "Caabuq Ba'an oo qaba Virus-Nooca HIV-1 ee isticmaala PrEP ee leh Heerarka TDF." Shirka Retroviruses iyo Infekshinka Fursadaha; Seattle, Washington; Febraayo 13-16, 2017; abstract 953.
> Molina, J .; Capitant, C .; Spire, B .; et al. "Digniinnada Digniinka ah ee Ka Hortagga Ragga ee Ragga Dhibaatada Sare ee Hurgunka HIV-1." Somali Journal of Medicine. Diisambar 1, 2015; ku daabacan internetka kahor daabacaadda; DOI: 10.1056 / NEJMoa1506373.
> POZ Magazine. "PrEP waxa ay ku guuldareysatey ninkeeda guurka ah ee ku habboon Daily Truvada, wuxuu qandaraas geliyaa daroogada HIV-ga." Febraayo 25, 2016.
> Kooxda Waxbarashada TenoRes. "Epidemiology caalami ah ee daawada daroogada ka dib markii uu ku fashilmay WHO ayaa kugula taliyey habka ugu horreeya ee HIV-1 loogu talagalay: Daraasad daraasad badan oo dib-u-celin ah." Lancet Cudurrada faafa. Janaayo 28, 2016; lagu daabacay internetka; DOI: 10.1016 / S1473-3099 (15) 00536-8.
> UK UK PROUD Guddiga Hagaajinta kormeerka. "Daraasad ku salaysan falanqaynta ku-meel-gaadhka ah ayaa lagu ogaaday in horey looga baaray cudurka Precaxis (PrEP) ay tahay mid aad u ilaalisa HIV-ga rag rag iyo ragga kale ee ragga ah ee ku nool UK." London, England; war-saxaafadeed la soo saarey October 16, 2014.