IPrEP yoKuthintela i-HIV: Oko Kufuneka Ukwazi Phambi Kokuba Uqalise

Isikhokelo SePrEP NoKuthintela i-HIV NgesiXhosa

Molo, ndingu Dr George Forgan-Smith, ndingugqirha wosapho (GP) osebenza eOstreliya. Esi sikhokelo silapha ukukunceda wenze isigqibo esisekelwe kulwazi malunga nokuba iPrEP ilungele wena kusini na. Zinike ixesha ngaso, kwaye uze nayo nayiphi na imibuzo kugqirha wakho.

Yintoni iPrEP?

IPrEP (i-pre-exposure prophylaxis, oko kukuthi ukhuselo lwangaphambi kokuchatshazelwa) lichiza olisebenzisayo ukuthintela i-HIV. Iqulethe izithako ezibini ezisebenzayo (i-tenofovir disoproxil ne-emtricitabine) kwipilisi enye. Xa uyisela ngendlela emiselweyo, iyayithintela i-HIV ekubeni iphindaphinde emzimbeni wakho. Uphando lubonisa ukuba, xa isetyenziswa ngendlela echanekileyo, iPrEP iyasebenza kakhulu ekuthinteleni i-HIV.

Phambi kokuba uqalise: amanqaku aphambili

Kufuneka ube ngu-HIV negative (akukho HIV) ukuze uqalise. Ugqirha wakho uya kuqinisekisa oku ngovavanyo phambi kokuba uqalise, kwaye uya kuphinda uvavanywe rhoqo ngalo lonke ixesha uyisebenzisa.
IPrEP iyasebenza kakhulu xa iselwa ngendlela emiselweyo. Uphando lubonisa ukuba iPrEP yemihla ngemihla inciphisa umngcipheko wokufumana i-HIV kwisini ngaphezu kwe-99%. Inani elincinci labantu kwihlabathi liphela lifumene i-HIV ngelixa lisebenzisa iPrEP; ezi meko zinqabileyo zihlala zibandakanya nokuba luhlobo lwe-HIV oluxhathisayo kuchiza okanye ichiza elinganelanga emzimbeni. Ukuyisela ngendlela emiselweyo kuko okuyenza isebenze.
IPrEP ikhusela kuphela kwi-HIV. Ayikhuseli kwizinye izifo ezosulelwa ngokwabelana ngesondo (i-STIs) ezinjenge-sifo lengqalumba (uphambano/syphilis), idrop (gonorrhoea) okanye i-chlamydia. Iikhondom zinciphisa umngcipheko wezo zifo, kwaye ukuvavanywa rhoqo kwi-STIs kuyinxalenye yokusebenzisa iPrEP.
IPrEP inokuchaphazela izintso zakho. Ngamanqabakade kunokwehla ukucoceka kwegazi zizintso. Esi siphumo sihlala sincinci kwaye siyabuyela emva xa iPrEP imisiwe. Xaphela ugqirha wakho ukuba wakhe waba neengxaki zezintso okanye usebenzisa amanye amachiza achaphazela izintso. Ugqirha wakho uvavanya ukusebenza kwezintso zakho phambi kokuba uqalise nakuvavanyo lwakho oluqhelekileyo.
Kukho isiphumo esincinci kuxinano lwamathambo. Xaphela ugqirha wakho ukuba une-osteoporosis, amathambo abuthathaka, okanye imbali yosapho yenye yezi meko.
Ugqirha wakho uya kujonga imeko yakho yesifo sesibindi i-hepatitis B phambi kokuba uqalise, kuba amachiza akwiPrEP nawo asebenza kwi-hepatitis B.
Abanye abantu bafumana ukungaphatheki kakuhle kwesisu okuncinci xa beqala (isicaphucaphu, ukudumba kwesisu, ukunya okuthe gxephu). Oku kuhlala kuphela kwiiveki ezimbalwa zokuqala.
Ukuhlolwa rhoqo kubalulekile. Ceba ukuhlolwa okupheleleyo kwempilo yesini nokudibana nogqirha wakho kwiinyanga ezi-3 ezinye.

Ukuba ufumana naziphi na iimpawu ezikukhathazayo nangaliphi na ixesha, thetha nogqirha wakho.

Indlela yokuyisela iPrEP

Indlela oyisela ngayo iPrEP ixhomekeke kuhlobo lwesini olusenza ngokukodwa, kuba ichiza lithatha amaxesha awahlukeneyo ukufikelela kumanqanaba akhuselayo kwizicubu ezahlukeneyo.

Kumadoda angootata bobudoda nobudoda nesini ngesini (gay) nabathandana namabini (bisexual) abenza isini ngomva

Apha kukho iinketho ezimbini, kwaye zombini ziyasebenza kakuhle.

IPrEP yemihla ngemihla

Ukuqalisa: Qalisa ukusela ipilisi enye yonke imihla. Emva kwemihla emalunga ne-3 yokusela ngemihla, ukhuselekile kwisini ngomva. Ukuba udinga ukukhuseleka ngokukhawuleza, ungasela iipilisi ezimbini kunye njengesidlo sakho sokuqala, oko kufikelela kumanqanaba akhuselayo malunga neeyure ezi-2. Emva koko, qhubeka usele ipilisi enye yonke imihla.
Ukuqhubeka: Sela ipilisi enye yonke imihla. Akunyanzelekanga ukuba ibe ngexesha elinye yonke imihla, nangona ixesha elimisiweyo lisenza kube lula ukukhumbula.
Ukuyeka: Qhubeka usela iPrEP emva kwesini sakho somva sokugqibela ngomva: ipilisi enye emva kweeyure ezi-24, nepilisi enye emva kweeyure ezi-48. Ezo ntsuku ezimbini ezongezelelweyo zigcina amanqanaba akhuselayo endaweni ukugubungela nakuphi na ukuchatshazelwa kwakutsha nje. Emva koko ugqibile.

IPrEP yangokwexesha lesini (2-1-1)

Ukusela ngokwexesha lesini kuphandwe kakuhle kumadoda angoogay nabathandana namabini abenza isini ngomva. Kuvavanyo lwe-IPERGAY lwanciphisa umngcipheko we-HIV malunga ne-86%, lwenyuka lwaya malunga ne-97% kuvavanyo lokulandelela xa iselwa ngendlela echanekileyo.

Iipilisi ezi-2, kunye, iiyure ezi-2 ukuya kwezi-24 phambi kwesini.
Ipilisi e-1 iiyure ezi-24 emva kweso sidlo sokuqala esisibini.
Ipilisi e-1 iiyure ezi-24 emva koko (iiyure ezi-48 emva kwesidlo sokulayisha).

Ukuba isini siyaqhubeka kwiintsuku ezimbalwa, qhubeka usela ipilisi enye rhoqo kwiiyure ezi-24, kwaye sela eyakho yokugqibela iiyure ezi-48 emva kwexesha lokugqibela owabe nesini ngalo.

Amanqaku aphambili:

Ukusela ngokwexesha lesini kusebenza kuphela ngohlobo lwe-tenofovir disoproxil/emtricitabine (TDF/FTC) lwePrEP (Truvada nezilingane zayo).
Misa iialamu zeepilisi zeeyure ezi-24 nezi-48. Eyona ndlela iqhelekileyo yokutsho ukuba ukusela ngokwexesha lesini kungaphumeleli kukulibala iipilisi zokulandelela emva kokuba isini siphelile. Ezo pilisi zokulandelela zezo zikhuselo.
Ukuba uphila nesifo sesibindi i-hepatitis B, ukusela ngokwexesha lesini akukulungelanga. Eyemihla ngemihla iya kuba ngcono.

Kubantu abenza isini ngokwesibeleko okanye ngesibeleko esakhelweyo (abafazi, amadoda athandana nesini esahlukileyo, nabantu abanamava obungqingili/trans)

Kwisini sokwamkela ngokwesibeleko nangesibeleko esakhelweyo, iPrEP yemihla ngemihla yiyo indlela ecetyiswayo yokuyisela. I-tenofovir ithatha ixesha elide ukufikelela kumanqanaba akhuselayo kwezi zicubu kunesini ngomva, ngoko ke ukusela ngemihla kunika ukhuselo oluthembeke kakhulu.

Ukuqalisa: Sela ipilisi enye yonke imihla. Emva kwemihla emalunga ne-7 yokusela ngemihla, unamanqanaba akhuselayo wesini ngokwesibeleko nangesibeleko esakhelweyo. Ngokungafaniyo nesini ngomva, “ukuqalisa ngokukhawuleza” ngesidlo esiphindwe kabini akuyifinyezi le nto, ngoko ke yinike yonke imihla emi-7 epheleleyo.
Ukuqhubeka: Sela ipilisi enye yonke imihla.
Ukuyeka: Qhubeka usela ipilisi enye yonke imihla iintsuku ezingama-28 emva kwexesha lakho lokugqibela osemngciphekweni. Lo msila mude ugcina amanqanaba akhuselayo endaweni ukugubungela nakuphi na ukuchatshazelwa kwakutsha nje.

Ukukhulelwa nokuthintela ukukhulelwa: Ukuba ungakhulelwa kwaye wenza isini ngaphandle kweekhondom, khumbula ukuba ungakhulelwa; cinga ngokuthintela ukukhulelwa ukuba awuzami. Uhlobo lwe-TDF/FTC lwePrEP lucetyiswa njengolulungele ukuqhubeka ngelixa uzama ukukhulelwa, ngexesha lokukhulelwa, nangelixa wanyisa, kwaye izikhokelo zangoku azilithathi njengomqobo wokuqalisa usapho. Ukuba ukhulelwe, ucwangcisa ukukhulelwa, okanye uyanyisa, xelela ugqirha wakho.

Ukusela ngokwesehlo (inketho entsha oza kuthetha ngayo nogqirha wakho): IPrEP yemihla ngemihla yinketho esemgangathweni, ecetyiswayo kweli qela. Izikhokelo zamanye amazwe ezintsha (BASHH, UK, 2025) nazo zixhasa ukusela ngokwesehlo kwabanye abantu abenza isini sokwamkela ngokwesibeleko okanye ngesibeleko esakhelweyo. Oku akukabi semgangathweni kuyo yonke indawo, ngoko ke yiphakamise uyicwangcise nogqirha wakho endaweni yokuziqalisela wedwa. Ukuba ungoyamkelayo (receptive partner), ucwangciso oluxhasiweyo lulu 2 emva koko 7: iipilisi ezi-2 iiyure ezi-2 ukuya kwezi-24 phambi kwesini, emva koko ipilisi e-1 yonke imihla iintsuku ezi-7 emva kwexesha lokugqibela owabe nesini ngalo. Ukuba ungofakayo (insertive partner), ucwangciso oluxhasiweyo lulu 2-1-1. Ukusela ngokwesehlo kusebenza kuphela ngohlobo lwe-TDF/FTC.

Ukuhlolwa rhoqo

Njengenxalenye yendlela eqhelekileyo yePrEP, uya kubona ugqirha wakho kwiinyanga ezi-3 ngazinye. Oku kungelokwabela isiyalezo esitsha, uhlolo olupheleleyo lwempilo yesini, kunye nokujongwa kwezintso, kwaye lithuba elihle lokuthetha ngeziphumo ezingahambelaniyo.

Bona ugqirha wakho

IPrEP lichiza elinikwa ngesiyalezo (prescription). Ukuze ufumanise ukuba ilungele wena kusini na nokuba yeyiphi na inketho elungele imeko yakho, thetha nogqirha okanye ikliniki yempilo yesini apho ukhoyo. Bhukisha ukuba ufumana naziphi na iimpawu ezikukhathazayo, ukuba ucinga ukuba usenokuba uchatshazelwe yi-HIV ngaphandle kokhuselo olukhoyo, okanye ukuba lifikile ixesha lokuhlolwa kwakho kweenyanga ezi-3.

Olu lwazi luluhlu jikelele kwaye aluthathi ndawo yengcebiso yonyango eyenzelwe wena buqu. IPrEP lichiza elinikwa ngesiyalezo. Thetha nogqirha wakho malunga nokuba ilungele wena kusini na.

— Dr George Forgan-Smith, Ugqirha Wosapho (GP), usebenza eSydney naseMelbourne