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Bhizinesi Risina Kupedzwa reKuwaniswa Kuzvidzivirira pamuviri uye Kudzivirira HIV

Humbowo hunokosha hweNzira dzekuronga mhuri uye Migumisiro yeHIV (ECHO) Chidzidzo chekutanga chiyedzo chekiriniki chakakura-chikuru chekuongorora hukama huripo pakati pekushandiswa kwenzira dzemahomoni dzekuronga mhuri nenjodzi yekuwanikwa kweHIV.–mutoro wakapetwa kaviri vakadzi vazhinji vachiri kutarisana nawo. Kunyange zvazvo zvidzidzo zvekudzidza zvakapa ruzivo rwakakosha, vatinoshanda navo kuFHI 360 tsanangura kuti kuchine basa rakawanda rokuita.

Matanho makuru akaitwa mukuwaniswa kwekuwaniswa kwekuchengetwa kwekuronga mhuri nekudzivirira HIV; zvisinei, madzimai ari kuramba achitambura mitoro miviri yenhumbu yavasingafungidzirwe uye kutapurirwa HIV. Kunetsekana kwekuti kudzivirira pamuviri pachayo kunogona kuwedzera njodzi yekutorwa kweHIV kwakakonzera kugadzirwa nekuitwa kweyedzo yakakosha yeECHO.. ECHO yaive ongororo yekiriniki isina kurongeka ichienzanisa chiitiko cheHIV, zviitiko zvakashata, uye pamuviri mitengo pakati 7,829 Vakadzi vemuAfrica vakapihwa marezinesi matatu ekuronga mhuri: intramuscular depot medroxyprogesterone acetate (DMPA), mudziyo wemhangura we intrauterine, uye levonorgestrel implant. Zvakabuda pachena pamusangano wakaitwa muDurban, South Africa muna Chikumi 2019 uye rakabudiswa mukati The Lancet. Huwandu hweHIV hwakafanana mumapoka matatu uye nzira dzese dzaive dzakachengeteka uye dzakanyanya kushanda. Tichifunga nezvemigumisiro yeECHO, iyo World Health Organisation (WHO) akakoka boka renyanzvi kuti riongorore ruzivo rwekukodzera kubata pamuviri kune vakadzi vari panjodzi huru yekuwana HIV uye vakapihwa. yakagadziridzwa nhungamiro muna Nyamavhuvhu 2019, izvo zvairatidza kuti nzira dzese dzekuedza dzinogona kushandiswa zvisina njodzi nevakadzi vari panjodzi huru yeHIV.

Ongororo yeECHO yakaratidza huwandu hwehuwandu hweHIV hwepamusoro 3.8 pa 100 makore evakadzi pakati pevadiki vakapinda muchidzidzo (zera repakati 23 makore) kutsvaga kudzivirira kubata pamuviri munyika ina dzekudzidza: Eswatini, Kenya, Chamhembe Afrika, uye Zambia. Izvi zvinokatyamadza zvakaonekwa pakati pemadzimai aipihwa mabasa ekudzivirira HIV, kusanganisira kuongororwa STI, makondomu, uye pre-exposure prophylaxis (PrEP) gare gare mukutongwa, adzikamisa nhau dzinokurudzira dzekusava nemusiyano munjodzi yeHIV nenzira yekudzivirira kubata pamuviri. Hurukuro yezviwanikwa izvi yakatungamira kushevedzero dzechimbichimbi uye nehukasha hwekuwedzera mabasa ekudzivirira HIV akanyanya kuvakadzi., kusanganisira PrEP, kumadzimai muzvirongwa zvekuronga mhuri. Zvakawanikwa zvakatsigirawo kuwaniswa kwekuwaniswa kwekuwaniswa kwakazara kwezvigadzirwa zvekudzivirira pamuviri kune vakadzi vari panjodzi huru yeHIV. WHO yakatanga kushanda pamwe chete kutsigira zvirongwa zvenyika, kunyanya muAfrica, kuita zvehasha pane zvakawanikwa ECHO kuwedzera kubatana kweFP-HIV.

DMPA-IM, 2-rod levonorgestrel implant, and the copper IUD. Photo credit: Leanne Gray
DMPA-IM, 2-tsvimbo levonorgestrel kudyara, uye IUD yemhangura. Mufananidzo wechikwereti: Leanne Gray

Zvino, mu 2021, takatarisana nerimwe dambudziko reCOVID-19 denda pamusoro pekuwaniswa kwezvose zviri zviviri zvekuchengeta mhuri nekudzivirira HIV.. Nezvekuronga mhuri, matanho akakosha ekuchengetedza kuwana rubatsiro rwakakosha rwekuronga mhuri kuvakadzi nevasikana zvinosanganisira kushandisa telehealth pakupangwa mazano, kuongorora, nzira yekugadzirisa, uye side effects management; kushandiswa kwenguva refu kwemaIUD nemaimplants; uye kuzvitonga kweSayana Press (DMPA-SC). Sezvineiwo, mapurogiramu akawanda akaona madonhwe ekupinda uye zviratidzo zvekutanga zvekuwedzera kwekuita pamuviri pakati pevasikana.

Denda reCOVID-19 yapikisawo kudzivirira HIV, care, uye kurapwa zvirongwa. Munzvimbo dzakawanda umo vakadzi vari panjodzi huru yeHIV, kuwedzera kwePrEP richiri padanho rekutanga. Kubatanidza mabasa ePrEP nekuronga mhuri kunopa mukana we "win-win".. Iyo ichangoburwa yeEuropean Medicines Agency kutsigirwa kwe dapivirine vaginal ring kudzivirira Mukondombera kuvakadzi vari munzvimbo dzakaremerwa neHIV kunofanira kutungamira kune nzira yekudzivirira inopindirana pamwe nekuita zvepabonde zvakachengeteka apo vakadzi vasingakwanisi kutora kana kusawana mukana weOral PrEP.. Uyezve, Sangano reHIV Prevention Trials Network nguva pfupi yadarika rakazivisa kuti kuyedza kuongorora kuchengetedzeka uye kushanda kweyakareba ichiita jekiseni cabotegravir. (CAB LA) yePrEP mumadzimai muAfrica yakamiswa kare neData and Safety Monitoring Board apo CAB LA yakaonekwa kuti iri nani pane oral PrEP mukudzivirira kuwanikwa kweHIV. Kuwedzerwa kwejekiseni rePrEP rinoita kwenguva refu kubhokisi rekudzivirira rinofanirwa kubatsira kudzikisira kuwana uye kutevedzera matambudziko.. Uyezve, hurongwa hwejekiseni hwemavhiki masere hunogona kuwiriraniswa kune jekiseni rekudzivirira kubata pamuviri. Tsvagiridzo iri kuenderera mberi ine tariro yekuti ichapa nzira dzakasiyana siyana dzinodzivirira kubata pamuviri neHIV.

Pakupedzwa kwechidzidzo cheECHO, kutya kukuru kwevaongorori vezvidzidzo kwaive kuti nyika yekuronga mhuri nekudzivirira Mukondombera yaizodzokera kubhizinesi semazuva ese, uye kusaenderera mberi nekuita pane zvakakosha zvakawanikwa zvehutano hwevakadzi. Zvino, nekutyisidzira katatu kweCOVID-19, HIV, uye nhumbu yausingatarisiri, isu tinofanira kufamba zvine hungwaru kuvimbisa kuti kutya kudzokera kubhizinesi semazuva ese, kana kunyange bhizimisi zvishoma pane zvenguva dzose, hazvina kuitika.

 

Kudzidza zvakawanda pamusoro pekugadzirisa kuronga mhuri uye kuwana nzira dzekudzivirira nadzo pamuviri mumamiriro ezvinhu edenda aripo, tarisa zvedu COVID-19 content.

Bhizinesi Risina Kupedzwa reKuwaniswa Kuzvidzivirira pamuviri uye Kudzivirira HIV
Timothy D. Tenzi, MD, DTM&H

Chief Science Officer, FHI 360

Timothy D. Tenzi, MD, DTM&H ndiye Chief Science Officer kuFHI 360, Durham, North Carolina. Iye zvakare Adjunct Purofesa weEpidemiology muGillings Chikoro cheGlobal Public Health, Yunivhesiti yeNorth Carolina kuChapel Hill. Anotarisira zvirongwa zveFHI 360 zvekutsvaga nesainzi-zvakavakirwa muUnited States uye kuburikidza nemahofisi eFHI 360 mu. 50 nyika dzepasi rose. Dr. Mastro akabatana neFHI 360 mu 2008 kutevera 20 makore muzvinzvimbo zvehutungamiriri hwesainzi kuUS Centers yeChirwere Kudzora nekudzivirira (CDC). Basa rake rakanangana netsvakiridzo nezvirongwa zvekurapa nekudzivirira HIV, TB, STI uye hutano hwekubereka, kusanganisira kushanda mukomiti yezvesainzi inotungamira yeECHO randomized clinical trial ichiongorora njodzi yekuwana HIV uye mabhenefiti enzira nhatu dzekudzivirira nadzo pamuviri pakati pevakadzi muAfrica..

Kavita Nanda, MD, MHS

Mutungamiriri weKutsvakurudza Kwezvokurapa, Kuvandudza Chigadzirwa uye Nhanganyaya, FHI 360

Kavita Nanda, MD, MHS, Mutungamiriri weKutsvakurudza Kwezvokurapa, FHI 360, chiremba wekubereka/gynecologist akazvipira basa rake mukuvandudza nekuvandudza mashandisirwo enzira dzekudzivirira kubata pamuviri kuvakadzi.. Aive muongorori-muongorori uye sachigaro wekomiti yekudzivirira-kudzivirira-chengetedzo yehumbowo hweSarudzo dzekudzivirira kubata pamuviri. (ECHO) kutongwa, multicenter randomized muyedzo wezvitatu zvakasiyana zvekuronga mhuri uye kuwana HIV mukati 7,800 Vakadzi vemuAfrica vari panjodzi huru yeHIV. Dr. Nanda akashanda semuongorori mukuru weFHI yakati wandei 360 zvidzidzo, kusanganisira kugadzirisa kuchengetedzwa kwemishonga yekudzivirira pamuviri pakati pevakadzi vane zvirwere zvakasiyana-siyana, uye semukuru wezvidzidzo zvezvokurapa kumayedzo makuru akati wandei ekudzivirira HIV. Parizvino, Dr. Nanda ndiye mutungamiriri wechirongwa chekugadzira imwe biodegradable implant yekudzivirira kubata pamuviri inopihwa mari neBill and Melinda Gates Foundation..

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