Dhibaataynta halista ah ee lamaanaha labka iyo dheddig-lab ah
Khatarta HIV-ga iyada oo loo marayo galmada aan la ilaalinayn waxaa loo arkaa inay aad u sarayso, 18 jeer ka weyn tahay galmada siilka. Sababaha khatarta kor u kaca ayaa si fiican loo yaqaan waxayna ku jiraan waxyaalahan:
- Maqnaanshaha unugyada malawadka, oo u oggolaanaya fayruska inuu si toos ah ugu galo dhiigga iyadoo la marayo ilmo yaryar ama abrasiis.
- Dareeraha unugyada malawadka iyo cufnaanta sare ee infekshanka xitaa marka aan waxyeelleyn.
- Fikradda sare ee HIV ee ku jirta shahwada iyo dheecaanka ka hor-dhiska ("pre-cum"), taas oo labalaabi karto halista infekshanka leh mid kasta oo isku-xiga (ie, hal rug) oo kordha culayska fayraska .
Intaas waxaa sii dheer, dheecaanka dhiigga ee unugyada maqaarka ee waxyeelloobay ayaa kordhin kara halista lamaanaha ("top"), oo fidiya fayruska habka lagu gudbiyo iyada oo loo mariyo kaadida iyo unugyada kuwaas oo xariiqaya guska (gaar ahaan hoosta buuryada).
Qiimaynta Khatarta HIV-ga "Per-Act" iyo "Per-Partner"
Marka ay dib u eegayaan 16 daraasadood oo tayo sare leh, cilmi-baarayaasha Imperial College iyo London School of Nutrition and Tropical Medicine waxay ku soo gabagabeeyeen in halista halista HIV ee galmada galmada aan dabiiciga ahayn ay qiyaastii ahayd boqolkiiba 1.4 qiyaasta soo dhawaynta (" hoose ").
In kasta oo heerka khatarta aan loo arkin in ay ku kala duwan yihiin jihada galmada, ha ahaato heterosexual ama ragga galmoodka la leh rag (MSM) , khatarta ayaa loo arkay in si weyn loo kordhiyo haddii lammaanaha mudnaanta leh aan la gudin (0.62 boqolkiiba aan la gudin iyo 0.11 boqolkiiba la guday) .
Marka la barbardhigo, khatarta halista ah ee -waxay qofka HIV-ga ahi ku xiran yahay xiriir gaar ah oo lala yeesho lamaane-HIV-negative-wuxuu sawir yar oo sawir leh u muujiyay labada lamaaneenta ah ee la isku soo dhaweynayo iyo kuwa kaleba.
Tobankii baadhitaan ee dib loo eegay ayaa lagu sameeyey kaliya MSM oo ay ku jiraan dhererka xiriirka iyo inta jeer ee jinsiga galmadu ka yar yahay.
Falanqaynta xogta waxay awoodeen inay soo jeediyaan in:
- Wada-hawlgalayaasha oo ku hawlanaa labada galmo ee isku-qabsashada iyo galmada aan lahayn cinjirrada galmada ayaa halis u ahaa 39.9 boqolkiiba.
- lamaane-yar oo HIV-ga ah oo ku hawlanaa keliya galmada galmada oo aan lahayn cinjir la'aan ayaa halis ugu jirta 21.7 boqolkiiba, lammaanaha hiv-qabka ah ee qabta HIV-ga wuxuu halis u yahay qiyaastii 40.4 boqolkiiba.
(Inkasta oo natiijooyinka falanqaynta meta ay tahay mid adag, waxaa muhiim ah in la ogaado in noocyada kala duwan ee daraasadaha dib loo eegay ay ka tagayaan qolka fasiraadda.)
Istaraatiijiyadaha lagu yareeyo Khatarta HIV-ga ee Galmada Anal
Sida nooc kasta oo kale ee gudbinta HIV , ka hortagga wuxuu u baahan yahay istiraatiijiyado isku dhafan si wax ku ool ah:
- Iska yaree infakshanka lammaanaha HIV-ga.
- Iska yaree caqli-galnimada lamaanaha HIV-ga ah.
- Ka hortag HIV-ga si uu ula xiriiro unugyada nugul iyo unugyada nugul.
Isticmaalka daaweynta antiretroviral therapy (ART) ee lammaanaha HIV-ga qabaa ayaa la ogyahay in si weyn loo yareeyo khatarta gudbinta marka firfircoonida fayrusku si buuxda oo joogto ah loo xakameeyo heerarka aan la ogaan karin. Istaraatiijiyadda, oo loo yaqaan ' Treatment as Prevention (TasP) , ayaa lagu muujiyay inay hoos u dhigayso khatarta HIV-ga iyada oo ugu badnaan boqolkiiba 96 ah lagu dhiso xiriirka isku-dhafan (serodiscordant).
Dhanka kale, isticmaalka horgaleeynta hore ee Primer-ka (PrEP) -waxaa la wadaagaa lammaanaha aan la daboolin ee loo qoro qiyaasta maalinlaha ah ee dawada HIV-ga Truvada - oo loo yaqaan inay hoos u dhacdo meel kasta oo udhaxeysa 44 boqolkiiba iyo 75 boqolkiiba.
Isticmaalka kondhomka joogtada ah ee saxda ah ayaa sidoo kale loo arkaa inay muhiim u tahay ka hortagga infekshanka HIV, iyada oo Xarunta Xakamaynta Cudurrada iyo Ka Hortegida ee Mareykanka ee isticmaalka isticmaalka joogtada ah ee kondhomku ka hortagi karo todoba ka mid ah 10 kaneecada anal ka. (Warbixin isku mid ah ayaa sidoo kale lagu soo gabagabeeyey in kaliya hal-lixdii qof ee MSM ay soo sheegeen isticmaalka kondhom joogta ah.)
Xogta waxay si weyn u taageertaa isticmaalka wadajirka ah ee TasP, PrEP, iyo kondomka sida habka ugu waxtarka leh ee loo yareeyo khatarta HIV, labadaba lammaane-yaqaanno iyo wada-hawlgalayaasha MSM waxay galmoodaan galmada.
Taas bedelkeeda, galmo-galmo yar-yar ayaan weli lagula talin, xitaa haddii labadaba TUSP iyo PrEP labadaba loo isticmaalo, maadaama ay dhici karto in ay dhici karto khatarta muddada-dheer ee lamaanayaasha xaalada isku dhafan.
Saameynta Shilalka iyo Galmada Analaha
Haddii aad aaminsantahay in aad HIV-ga soo gaadhsiisay, kumbuyuutarrada dabada lagu shubo, waxaa jira daawooyin si weyn u yareeya khatarta caabuqa ee loo yaqaan "PEP".
PEP waxay ka kooban tahay 28-maalmood oo daawooyinka antiretrovoviral ah, taas oo ah in si buuxda loo qaato oo aan kala go 'lahayn. Si loo yareeyo khatarta caabuqa, PEP waa in la bilaabo sida ugu dhakhsaha badan - ugu badnaan hal ilaa 36 saacadood oo soo-gaadhis ah .
Ilaha:
Baggaley, R .; White, R .; iyo Caano, C. "Khatarta gudbinta HIV iyada oo la adeegsanayo intercours anal: e dib u eegis nidaamsan, falanqeyn moodbeed iyo saameynta ka hortagga HIV." Wargeyska Caalamiga ah ee Epidemiology . Agoosto 2010; 39 (4): 1048-1063.
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.
Grant, R .; Lama, J .; Anderson, P .; et al. "Kaadi-saarista Chemoprophylaxis ee Ka-hortagga HIV ee Ragga la Galmoodo Ragga." Somali Journal of Medicine. Diisambar 30, 2010; 363 (27): 2587-2599.
Baeten, J .; Donnell, D .; Ndase, P .; et al. "Ka hortagga HIV-ga ee Ka hortaga HIV-ga ee Ragga iyo Haweenka Ragga ah." Somali Journal of Medicine. Agoosto 2, 2012; 367 (5): 399-410.
Supervie, V .; Viard, J; Costagliola, D .; et al. "Halista khatarta ah ee isu gudbinta HIV ee kufsiga jinsiga ah ee lagu sameeyo daaweynta dabiiciga ah ee isku dhafka ah: dib u eegis nidaamsan iyo qaabka Bayesian." Cudurada Cudurrada Cudurrada ah. Abriil 19, 2014; pii: ciu223 [Epub ka hor daabacaadda].