Ngalesi sikhathi, ukutheleleka ngegciwane lesandulela ngculaza kuye kwabulala abantu abangaba yizigidi ezingama-40 - abantu abayizinkulungwane ezingu-7-8 abafa nsuku zonke, abangaphezu kwezigidi ezimbili ngosuku. Kwezinye izindawo zomhlaba, isibonelo eNingizimu Afrika, i-HIV isongela isimo sabantu bonke amazwe. Izingane ezingaba yizigidi ezingu-15 emhlabeni wonke ziyizintandane ngenxa yokutheleleka nge-HIV.
I-Russia ingokwamanye amazwe anesilinganiso esiningi sokutheleleka nge-HIV. Noma kunjalo, abantu abangaphezu kuka-100 000 abane-HIV babhalisiwe ngokomthetho kuleli zwe, futhi ukulingana kwangempela kokutheleleka, ngokusho kobuchwepheshe, kulinganiselwa izikhathi ezingu-3-5 ngaphezulu. Kusukela ngoSeptemba 1, 2010, kwakunezinkinga ezingu-561 zokutheleleka nge-HIV ezinganeni ezineminyaka engaphansi kwengu-14 ubudala, abangu-348 zazo zatholwa ngamama. Ngesikhathi sokubhaliswa kwe-HIV eRussia, izingane ezingu-36 zafa.
Isifundo esiyinhloko esifunde phakathi neminyaka yesifo se-HIV, ochwepheshe be-UN bakholelwa ukuthi singakwazi ukuvimbela ukutheleleka okusha futhi sithuthukise izinga lokunakekela nokwelashwa kubantu abaphila negciwane lesandulela ngculazi. Zombili lezi zindawo zesenzo - ukuvimbela nokwelashwa - kusebenza ngokugcwele ezinganeni.
Yini eguqukile?
Kuyamangalisa indlela umphakathi wezokwelapha emhlabeni wonke ohlangene ukuxazulula inkinga yokutheleleka nge-HIV. Unyaka emva kokuchazwa kokuqala kwesifo, i-agent yayo causative - igciwane lesifo sokuzivikela komzimba - litholakale. Ngemuva kweminyaka engama-4, ukuhlolwa kwelabhoratrasi yokuthola ukutheleleka kokuqala kwegciwane lesandulela ngculaza nokuhlolwa kwegazi lomnikelo kubonakala. Ngesikhathi esifanayo, inqwaba yezinhlelo zokuvimbela zaqala emhlabeni. Futhi eminyakeni engu-15 kuphela kamuva, ngo-1996, ukwelashwa kwansuku zonke lwe-HIV kubonakala, okwakwandisa kakhulu ubude kanye nekhwalithi yokuphila kwabantu abane-HIV futhi kwashintsha kakhulu isimo sengqondo somphakathi sibhekene nale nkinga.
Incazelo "yesifo sekhulu lama-20" iye yehla emlandweni. Njengamanje, i-HIV ibonakala odokotela njengesifo esingapheli esidinga ukwelashwa kwansuku zonke. Okusho ukuthi, kusukela ekuboneni kwezokwelapha, ukutheleleka ngegciwane lesandulela ngculazi sekube esinye sezifo ezingapheli ezifana nesifo sikashukela esivela noma isifo somfutho wegazi ophezulu. Ochwepheshe baseYurophu bamemezela ukuthi ngekhwalithi yokwelashwa kwe-HIV, ukulinda kokuphila kwabantu abanegciwane lesandulela ngculazi kufanele maduze lilingane nelomphakathi jikelele.
Abamele isonto, ababesebheka ukutheleleka ngegciwane lesandulela ngculaza ngokuthi "isijeziso sezono," bebekubiza ngokuthi "ukuvivinywa okudingeka umuntu adlule ngokufanele" iminyaka eminingi, futhi abambe iqhaza kakhulu ezinhlelweni zokusiza abantu abane-HIV. Manje ukutheleleka nge-HIV akubizwa ngokuthi "isifo sezidakamizwa, izifebe nezinsizwa", ngokuqaphela ukuthi ngisho nokuya ocansini okungavumelekile kungabangela ukuthi umuntu abe ne-HIV.
Indlela yokuvimbela ukutheleleka kwengane?
Indlela eyinhloko yokudluliselwa kwegciwane lesandulela ngculaza kubantwana ivela kumama kuya komntwana ngesikhathi ukhulelwe noma ukubeletha noma ubisi lwebele. Ngaphambili, ingozi yokutheleleka okunjalo yayinkulu, 20-40%. Izingane ezine-HIV zazalwa cishe kuwo wonke umama one-HIV. Kodwa ukutheleleka nge-HIV kokubeletha kuhlukile kulowo odokotela abaye bafunda ukuyivimbela ezimweni eziningi! Ngokuqondene nanoma yiziphi ezinye izifo ezithathelwanayo, ukuvimbela okuphumelelayo kuye kwenzelwa lokhu, okunganciphisa kakhulu ingozi yokutheleleka.
Owesifazane ngamunye ngesikhathi sokukhulelwa uhlolwe kabili nge-HIV. Uma kutholakala, izinyathelo zokuvimbela zithathwa. Zihlanganisa izinto ezintathu. Okokuqala ukuthatha imithi ethize. Inombolo yabo (eyodwa, emibili noma emithathu) nobude bokukhulelwa, okuvela lapho ukwemukela kufanele kuqale khona, kunqunywa udokotela. Owesibili yiyona ndlela yokukhetha indlela yokudiliva. Njengomthetho, owesifazane onesandulela ngculaza uboniswa isigaba se-cearean. Okwesithathu ukulahlwa kokuncelisa. Umama onesandulela ngculazi kufanele angondle umntwana hhayi ngesifuba, kodwa ngezimpawu zobisi ezilungisiwe. Yonke le misebenzi, kufaka nokuhlinzekwa kwezidakamizwa kanye namafomu okubisi, ayikhokhwa.
Ingozi yokudluliselwa kwegciwane lesandulela ngculazi kumama kuya kwengane ihlukana nesifunda, okungenzeka sihlobene nokukhubazeka ekuhlinzekeni kwezinyathelo zokuvimbela. Inkinga enkulu ukuthi abesifazane abakhulelwe abane-HIV ngokuvamile abakholelwa ekusebenzeni kokuvimbela, noma abazizwa benomthwalo wempilo yengane engakazalwa. Uma owesifazane onesandulela ngculaza enquma ukuzala, khona-ke kuba umgebengu ukwenqaba ukufeza izinyathelo zokuvimbela. Ngo-2008, uMnyango wezeMpilo uvume imfundo "Ukuhlinzekwa kokunakekelwa kwezempilo kwabesifazane nabantwana abakhulelwe abane-HIV ababelethwe ngamama-HIV anesandulela ngculazi", okuchaza ngokucacile udokotela ukuthi, ngokuhambisana namazinga omhlaba wesimanje, ukuvimbela ukudluliselwa kwegciwane lesandulela ngculazi kumama kuya emtholampilo ehlukene izimo.
Ingane ingenwa igciwane lesandulela ngculaza noma ngegazi lokungcoliswa kwegazi noma ngemishini yezokwelapha engcolisiwe. Kwakukhona ukungenelela kwezokwelapha okwaholela ekutheleleni kwe-nosocomial yezingane ngasekupheleni kwawo-1980 eRussia (Elista, Rostov-on-Don) naseMpumalanga Yurophu (eRomania). Lezi ziqhumane, lapho iningi lezingane, ikakhulukazi ezisanda kuzalwa, lalinesifo, lavuselela umhlaba wonke umphakathi futhi wenza ukuba bathathe inkinga ngokujulile. Ngenhlanhla, okwamanje, izindawo zokunakekelwa kwezempilo zihlala zigcina izinga eliphezulu lemibuso ye-hygiene kanye ne-epidemiological lapho isebenza negazi, okuye kwasiza ukugwema amacala we-nosocomial infections yezingane. Futhi, akekho abantwana abenegciwane lokumpontshelwa kwezingxenye zegazi, okubonisa izinga lomsebenzi we-donor service yethu. Izinsana zingenwa igciwane lesandulela ngculaza ngokuxhumana kocansi kanye nokusetshenziswa kwezidakamizwa zokujova.
Mayelana nokwelashwa kwe-HIV
Ukwelashwa okuqondile kokutheleleka nge-HIV ezinganeni - ukwelashwa kwama-antiretroviral (APT) - kwenziwe eRussia kusukela eminyakeni engu-90. Ukutholakala okubanzi kwe-APT kubonakale kusukela ngo-2005 futhi kuhlotshaniswa nokwethulwa kweprojekthi "Ukuvimbela Nokunakekelwa Kwegciwane lesandulela ngculazi nengculazi eRussian Federation", eyenziwa yiNhlangano Yezizwe Ezithuthukiswayo kanye noMnyango wezeMpilo wezwe lethu.
Ukwelashwa kunganciphisa ukukhiqizwa kwegciwane emzimbeni, lapho amasosha omzimba avuselelwa khona, futhi isigaba se-AIDS asikho. Ukwelashwa ukudla nsuku zonke kwezidakamizwa. Lokhu akusiyo "okuncane" kwamaphilisi okumele athathwe ngokuqinile ngehora, njengama-90, kodwa amaphilisi ambalwa noma ama-capsules athathwa ekuseni nakusihlwa. Okubaluleke kakhulu ukudla okuvamile kwansuku zonke izidakamizwa, ngoba ngisho nekhefu elifushane ekulawuleni igciwane liholela ekuthuthukiseni ukumelana nokwelapha. Izingane ezine-HIV zivame ukubekezelela ukwelashwa kahle futhi ziholele impilo egcwele ngokugcwele ngokumelene nayo.
Njengamanje, izingane ezinegciwane lesandulela ngculazi zivunyelwe ukuhlala eqenjini labantwana. Lesi sifo akuyona inkinga yokuvakashela inkulisa noma isikole. Phela, kubantwana abanesandulela ngculazi, inkinga emphakathini ayiyona into esemqoka. Kubalulekile ukuba babe phakathi kwontanga yabo, ukuhola impilo evamile nokusebenza ngendlela evamile.