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HIV da ciki

Daga Wikipedia, Insakulofidiya ta kyauta.
HIV da ciki
Bayanai
Ƙaramin ɓangare na complication of pregnancy, childbirth and the puerperium (en) Fassara da vertically transmitted infection (en) Fassara
Fuskar Kanjamau
Yana haddasa congenital human immunodeficiency virus (en) Fassara

HIV a cikin, shine kasancewar kamuwa da cutar HIV/AIDS a cikin mace yayin da take da ciki. Akwai haɗarin kamuwa da cutar kanjamau daga uwa zuwa ɗa a yanayi uku na farko: ciki, haihuwa, da lokacin shayarwa. Wannan batu yana da mahimmanci saboda ana iya rage haɗarin kamuwa da kwayar cutar ta hanyar da ta dace ta hanyar likita, kuma idan ba tare da magani ba HIV/AIDS na iya haifar da rashin lafiya da mutuwa a cikin uwa da yaro. An misalta wannan ta hanyar bayanai daga Cibiyar Kula da Cututtuka (CDC): A cikin Amurka da Puerto Rico tsakanin shekarun 2014-2017, inda ake samun kulawar haihuwa gabaɗaya, akwai jarirai 10,257 a Amurka da Puerto Rico waɗanda suka kamu da kamuwa da cutar kanjamau ta mahaifa a cikin utero waɗanda ba su kamu da cutar ba kuma 244 sun kamu da jarirai..[1]

Nauyin cutar kanjamau / AIDS, gami da yaduwar cutar kanjamao daga uwa zuwa yaro, yana shafar kasashe masu karamin karfi da matsakaici, musamman kasashen Kudancin Afirka. Hukumar Lafiya ta Duniya (WHO) ta kiyasta cewa mata da 'yan mata miliyan 1.3 da ke zaune tare da cutar kanjamau suna yin ciki a kowace shekara.[2]

Hadarin kamuwa da kwayar cutar kanjamau da cutar kanjamao ta hanyar yin bincike mai kyau, maganin kamuwa da cutar kansar HIV tare da maganin antiretroviral (ART), da bin shawarwari bayan haihuwa. Musamman, ba tare da magungunan antiretroviral ba, tsoma baki na haihuwa, da shawarwarin shayarwa, akwai kusan kashi 30% na hadarin yaduwar cutar kanjamau daga uwa zuwa yaro.[3] Wannan haɗarin ya ragu zuwa ƙasa da 1% lokacin da aka yi amfani da abubuwan da aka ambata a baya.[4] Kwalejin Amurka ta Obstetrics da Gynecology (ACOG) don haka tana ba da shawarar gwajin HIV a matsayin wani bangare na yau da kullun na duka kafin ciki da kulawa ta farko don tabbatar da saurin shiga tsakani da ya dace.[5]

Cutar kwayar cutar kanjamau ba wata matsala ce ga daukar ciki ba. Mata masu cutar kanjamau na iya zaɓar yin ciki idan suna so, duk da haka, ana ƙarfafa su su yi magana da likitocin su a gaba. Musamman, 20-34% na mata a Amurka da ke fama da cutar kanjamau ba su san ganewar cutar ba har sai sun yi juna biyu kuma sun yi gwajin haihuwa.[6]

Hanyar watsawa

[gyara sashe | gyara masomin]

Ana iya yada cutar kanjamau daga uwa mai dauke da cutar zuwa ga jariri a cikin yanayi uku: a fadin mahaifa a lokacin daukar ciki (a cikin mahaifa), a lokacin haihuwa saboda saduwa da tayin tare da kamuwa da kwayar cutar mahaifa da jini, ko kuma bayan haihuwa ta hanyar nono. Wannan nau'in watsa kwayar cuta kuma ana san shi da watsawar tsaye. Ana kyautata zaton cewa kamuwa da cutar kanjamau daga uwa zuwa yaro ya fi faruwa a lokacin haihuwa lokacin da jariri ya hadu kai tsaye da jinin mahaifiyar da ta kamu da shi ko kuma ruwan al’aura a cikin magudanar haihuwa[1]. Maganin mahaifa tare da maganin ART kafin haihuwa yana rage nauyin kwayar cutar hoto, ko adadin kwayar cutar da ke cikin jinin uwa da sauran ruwan jiki, wanda ke rage yiwuwar yada kwayar cutar kwayar cutar zuwa tayin yayin haihuwa.[7]

Alamomi ko alamomi

[gyara sashe | gyara masomin]

Matar uwa

[gyara sashe | gyara masomin]

Cutar HIV a cikin manya yawanci suna bin mataki na 3, kamar yadda aka bayyana a ƙasa:

Maculopapular Rash, lura: wannan hoton yana nuna wani rash wanda ba lallai ba ne ya danganta da kamuwa da kwayar cutar HIV.lura: wannan hoton yana nuna wani rash wanda ba lallai bane ya danganta da kamuwa da kwayar cutar kanjamau
Alamomin farko na Diagram na HIV.
Farko, mataki mai tsanani
Mataki na farko na kamuwa da kwayar cutar kanjamau ya haɗa da saurin yaduwar kwayar cuta da kamuwa da cuta.[8] Wannan matakin yawanci yana ɗaukar makonni 2-4 bayan kamuwa da cuta kuma daga baya ya warware ba zato ba tsammani. Tsakanin 50 da 90% na manya suna fuskantar alamun a lokacin wannan matakin kamuwa da cuta.[9] A wannan lokacin, mata na iya fuskantar zazzabi, ciwon makogwaro, barci, kumbura na lymph, zawo, da rash. An bayyana rash a matsayin maculopapular, wanda ke nufin ya ƙunshi raunin fata mai laushi da ya tashi, kuma ya bayyana a kan akwati, hannaye da kafafu amma bai bayyana a kan dabino ko ƙafafun ƙafa ba.[7]
Matsayi na tsakiya, na yau da kullun / na baya
Matsayi na tsakiya na kamuwa da kwayar cutar kanjamau na iya ɗaukar shekaru 7-10 a cikin mai haƙuri wanda ba a kula da shi da maganin ART ba.[7] A wannan lokacin, kwayar cutar kanta ba ta ɓoye ko kuma ba ta aiki, amma an tsare ta a cikin ƙwayoyin lymph, inda take maimaitawa a ƙananan matakan.[8] Mata gabaɗaya ba su da alamun bayyanar cututtuka a wannan lokacin amma wasu na iya fuskantar zazzabi mai ɗorewa, gajiya, asarar nauyi, da ƙwayoyin lymph masu kumbura, wanda aka sani da rikitarwa da cutar kanjamau (ARC). [7]
Mataki na baya, ci gaba / rashin lafiya
Cutar AIDS ta samo asali ne daga ci gaba da lalata CD4 T-helper cells na tsarin rigakafi ta hanyar kwayar cutar HIV. An bayyana cutar kanjamau ta hanyar ko dai ƙididdigar ƙwayoyin CD4 na ƙasa da ƙwayoyin 200 a kowace microliter (wanda ke nuna ƙarancin rigakafi mai tsanani), ko ci gaban takamaiman yanayin cutar kanjamawa.[8] Saboda suna da rigakafi, mata a wannan matakin suna cikin haɗari ga cututtukan cututtuka masu tsanani, waɗanda yawan jama'a ba sa kwangila ko kwangila sosai. Wadannan nau'ikan kamuwa da cuta suna haifar da cututtuka masu tsanani da mutuwa a cikin marasa lafiya tare da HIV / AIDS.[1] Mutanen da ke da irin wannan cututtukan HIV masu tasowa suna cikin haɗari don kamuwa da alamun jijiyoyin Jiki (misali dementia da Neuropathy), da wasu cututtukansun daji (misali Non-Hodgkin's B-Cell Lymphoma, Kaposi's Sarcoma, da cututtukun da ke da alaƙa da HPV ciki har da anal, cervical, oral, pharyngeal, penile da vulvar cancer). [7]
Oral Candidiasis (oral thrush) a cikin yaro.

Bayyanar cutar kanjamau na asibiti a cikin jariran da ba a kula da su ba shi da ƙarancin tsinkaya kuma takamaiman fiye da na babban kamuwa da cuta. Musamman ma, idan an gano cutar HIV kuma an yi maganinta yadda ya kamata, alamu da rikitarwa a cikin jarirai ba su da yawa. Ba tare da maganin ART ba, jariran da aka haifa tare da kwayar cutar HIV suna da rashin fahimta. Idan alamun bayyanar cututtuka sun bayyana, mafi yawan sun haɗa da zazzaɓi na yau da kullum, kumburin kumburin ƙwayar lymph, ƙara girma da kuma/ko hanta, gazawar girma, da gudawa. Waɗannan yara kuma na iya haɓaka cututtukan da ba za a iya amfani da su ba, musamman waɗanda suka haɗa da ciwon kai na baka mai maimaitawa (Candidiasis) da/ko Candida diaper rash, ciwon huhu, ko ƙwayoyin cuta, ƙwayoyin cuta, ƙwayoyin cuta, ko cututtukan fungal. Alamun cututtukan jijiyoyi, musamman kwayar cutar kanjamau, suna da yawa a cikin jarirai masu cutar HIV ba tare da magani ba..

Bincike / tantancewa

[gyara sashe | gyara masomin]

Shirye-shiryen ciki

[gyara sashe | gyara masomin]

Babban abubuwan da za a yi la'akari da su a cikin shirin daukar ciki ga mutanen da ke dauke da kwayar cutar kanjamau shine haɗarin yaduwar cuta tsakanin abokan jima'i da kansu da haɗarin yaddar da cuta ga tayin. Dukkanin haɗarin za a iya rage su tare da shirin perinatal da ya dace da kulawa ta rigakafi.[10]

ACOG da Cibiyoyin Lafiya na Kasa (NIH) suna ba da shawarar duk ma'aurata inda ɗaya ko duka biyu suke da cutar HIV suna neman shawara kafin ciki da kuma tuntuɓar masana a cikin Obstetrics da Gynecology, Cututtukan Cututtuka, da kuma yiwuwar endocrinology na haihuwa da rashin haihuwa don tabbatar da ma'auratare sun dace, jagora ta mutum bisa ga takamaiman yanayin cututtukan su da kuma auna haɗarin tayin da ke tattare da shan magunguna na ART.[11][12]

Ma'auratan da abokin tarayya ɗaya ne kawai ke da kwayar cutar HIV suna cikin haɗarin watsa kwayar cutar HIV ga abokin tarayya wanda bai kamu da cutar ba. Waɗannan ma'auratan ana kiransu da ma'auratan serodiscordant. CDC ta ba da rahoton cewa mutanen da ke dauke da kwayar cutar HIV waɗanda ke iya ɗaukar nauyin kwayar cutar da ba za a iya gano su ba yayin da suke shan maganin ART suna da mummunar haɗari na watsa kwayar cutar HIV ga abokin tarayya ta hanyar jima'i bisa la'akari da bayanan lura daga manyan binciken da yawa, musamman ma gwajin HPTN052 na asibiti, binciken PARTNER, binciken PARTNER2, da kuma Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararru. Saboda haka NIH ta ba da shawarar cewa masu dauke da kwayar cutar HIV waɗanda ke kula da nauyin kwayar cutar da ba a iya gano su ta hanyar yin amfani da maganin ART na dogon lokaci na iya ƙoƙarin yin tunani ta hanyar jima'i marar jima'i tare da ƙananan haɗarin kamuwa da cututtuka zuwa abokin tarayya mara kyau na HIV. NIH ta kara ba da shawarar cewa daidaita jima'i marasa kwaroron roba tare da kololuwar haihuwa, wanda ke faruwa a lokacin ovulation, ta hanyar gwaje-gwajen ovulation da tuntuɓar masana na asibiti na iya haɓaka damar ɗaukar ciki.[12]

In-Vitro Fertilization.

Lokacin da mai cutar kanjamau a cikin haɗin gwiwar haɗin gwiwa bai sami nasarar kawar da kwayar cutar ba ko kuma ba a san matsayinsa ko kwayar cutar ba, akwai wasu zaɓuɓɓuka don hana watsawa tsakanin abokan tarayya. Zaɓin na farko ya haɗa da ba da Pre-Exposure Prophylaxis ART Therapy (PrEP) ga abokin tarayya mara kyau na HIV, wanda ya haɗa da yin amfani da maganin haɗin gwiwa sau ɗaya kowace rana don hana watsa kwayar cutar HIV bayan jima'i marar jima'i. NIH ta ba da shawarar gudanar da PrEP ga ma'aurata masu jima'i waɗanda za su yi ƙoƙarin yin ciki ta hanyar jima'i maras amfani, duk da haka, sun jaddada cewa riko ya zama dole don kare abokin tarayya mara kyau na HIV. Wani zaɓi don samun ciki yayin hana kamuwa da cutar HIV a lokaci guda shine taimakon haihuwa. Lokacin da macen da ke yunƙurin daukar ciki tana ɗauke da cutar kanjamau, za a iya ba ta taimako ta hanyar ba da maniyyi daga abokiyar zamanta don rage haɗarin kamuwa da cuta[1]. Lokacin da mutumin da ke cikin haɗin gwiwa yana da kwayar cutar HIV, ma'aurata za su iya zaɓar yin amfani da maniyyi mai bayarwa ko amfani da dabarun shirye-shiryen maniyyi (misali, wanke maniyyi da gwajin hoto na samfurin samfurin) da kuma intrauterine ko in vitro hadi don samun ciki don rage haɗarin watsawa ga abokin tarayya.[12]

A cikin ma'aurata inda namiji da mace suke da cutar kanjamau, daukar ciki na iya faruwa ba tare da damuwa game da yaduwar cutar tsakanin juna ba. Koyaya, yana da mahimmanci ga kowace uwa mai cutar kanjamau ta fara da kuma kula da maganin ART mai dacewa a ƙarƙashin jagorancin ƙwararren ƙwararren HIV kafin da kuma duk lokacin ciki don rage haɗarin yaduwar perinatal ga tayin.[12]

Kodayake ana samun hanyoyin haihuwa masu taimakawa ga ma'aurata masu rikice-rikice, har yanzu akwai iyakoki don samun nasarar daukar ciki. An nuna mata masu cutar kanjamau sun rage yawan haihuwa, wanda zai iya shafar zaɓuɓɓukan haihuwa.[13] Mata masu cutar kanjamau suna iya kamuwa da wasu cututtukan da ake samu ta hanyar jima'i, wanda ke sanya su cikin haɗari mafi girma don rashin haihuwa. Maza da ke fama da kwayar cutar kanjamau sun bayyana sun ragu da yawan maniyyi da kuma motsi na maniyyi, wanda ke rage yawan haihuwa.[14] ART na iya shafar haihuwa na namiji da na mace kuma wasu magunguna na iya zama masu guba ga tayin.[15]

Gwaje-gwaje a cikin ciki

[gyara sashe | gyara masomin]
Ana gudanar da gwajin gaggawa na HIV ga mai haƙuri.

Gano farkon kamuwa da cutar kanjamau masu juna biyu da fara ART a cikin juna biyu yana da mahimmanci wajen hana kamuwa da cutar zuwa tayin da kuma kare lafiyar uwa, domin matan da suka kamu da cutar kanjamau wadanda ba su yi gwajin cutar ba suna iya yada cutar ga ‘ya’yansu. CDC, NIH, ACOG, da Kwalejin Ilimin Ilimin Yara na Amurka kowanne yana ba da shawarar gwajin HIV na farkon watanni uku ga duk mata masu juna biyu a matsayin wani ɓangare na kulawa da haihuwa na yau da kullun. NIH ta kara yin karin haske kan wannan shawarar, inda ta nuna cewa ya kamata a gudanar da gwajin cutar kanjamau da wuri a duk inda mace ta nemi kulawa da farko ta tantance tana da juna biyu (misali, a Sashen Gaggawa). Ana gudanar da gwajin cutar kanjamau na farko a lokaci guda tare da sauran abubuwan yau da kullun, aikin dakin gwaje-gwaje na farkon ciki a Amurka, gami da: cikakken kirga jini, bugun jini da abubuwan Rhesus, fitsari, al'adar fitsari, titer rubella, hepatitis B da C titers, gwajin kamuwa da cutar ta hanyar jima'i, da gwajin tarin fuka.[5] ACOG ta ba da shawarar cewa masu kula da masu juna biyu suna maimaita gwajin cutar kanjamau na uku kafin yin ciki na makonni 36 ga mata masu zuwa: waɗanda ke cikin haɗarin kamuwa da cutar kanjamau, waɗanda ke zaune a wuraren da ke da yawan kamuwa da cutar kanjamau a cikin ciki, waɗanda ke kurkuku, ko waɗanda ke da alamun bayyanar cutar HIV mai tsanani.[1] Ga matan da ba su sami kulawar haihuwa ba ko kuma waɗanda ba a yi musu gwajin cutar kanjamau a baya ba a lokacin da suke da juna biyu, ACOG da NIH sun ba da shawarar yin gwajin HIV cikin gaggawa a sashin nakuda da haihuwa kafin haihuwa ko kuma nan da nan bayan haihuwa.. [5] [6]

Ana ba da gwajin cutar kanjamau a Amurka a halin yanzu a kan wani zaɓi, fita ga shawarar CDC.[16] Gwajin Opt-out ya haɗa da ilimantar da mai haƙuri game da tasirin kamuwa da kwayar cutar kanjamau akan ciki, sanar da mai haƙƙin cewa ana ba da shawarar tantance cutar kanjamaun HIV ga dukan mata masu juna biyu, da kuma sanar da ita cewa za ta karɓi gwajin ta atomatik tare da sauran ayyukan dakin gwaje-gwaje na yau da kullun sai dai idan ta ƙi gwajin kuma ta sanya hannu kan fom ɗin yarda don cire shi daga kwamitin dakin gwajewar ta.[5] Sauran samfurin, wanda aka sani da samfurin opt-in, ya haɗa da ba da shawara ga mata kan gwajin HIV, bayan haka suka zaɓi karɓar gwajin ta hanyar sanya hannu kan fom ɗin yarda. CDC ba ta ba da shawarar samfurin opt-in ba, saboda yana da alaƙa da ƙananan ƙimar gwaji.[6]

Idan mace ta zaɓi ƙin gwajin, ba za ta sami gwajin ba. Koyaya, za ta ci gaba da karɓar shawarar cutar kanjamau a duk lokacin da take ciki don a san ta yadda ya kamata game da cutar da tasirin da take da shi. Za a ba ta gwajin cutar kanjamau a kowane mataki na ciki idan ta canza tunaninta.[17]

Mafi sabunta ka'idojin gwajin HIV sun ba da shawarar yin amfani da kwayar cutar HIV-1 da HIV-2 antigen/ antibody hade immunoassay azaman gwajin farko na kamuwa da cutar HIV. Wannan gwajin jini yana tantance ko mahaifiyar ta ƙirƙiri ƙwayoyin rigakafi, waɗanda furotin ne na yaƙi da cututtuka na ƙwayoyin cuta, HIV-1 da HIV-2. Waɗannan ƙwayoyin rigakafi za su kasance kawai idan mai haƙuri ya kamu da cutar HIV, saboda haka, suna aiki azaman alamar kamuwa da cuta. Har ila yau, wannan gwajin ya gano wani furotin da ake kira p24 a cikin jinin mahaifiyarsa, wanda wani yanki ne na kwayar cutar HIV kanta kuma yana aiki a matsayin alamar farko na kamuwa da cutar HIV. Idan wannan gwajin ya tabbata, CDC ta ba da shawarar yin gwajin bin diddigi ta amfani da gwajin da ake kira HIV-1/HIV-2 antibody differentiation immunoassay cewa duka biyun sun tabbatar da ganewar asali kuma suna ƙayyade takamaiman nau'in kamuwa da cutar kanjamau mai haƙuri dole ne ya keɓance ƙarin kulawar mara lafiya.[18]

Wani lokaci, duk da haka, mutum na iya kamuwa da kwayar cutar kanjamau amma jiki bai samar da isasshen magungunan rigakafi ba don a gano su ta hanyar gwajin.[6] Idan mace tana da haɗarin kamuwa da kwayar cutar kanjamau ko alamun kamuwa da cuta mai tsanani amma gwaje-gwaje marasa kyau a gwajin gwaji na farko, ya kamata a sake gwada ta cikin watanni 3 don tabbatar da cewa ba ta da kwayar cuta, ko kuma ya kamata ta sami ƙarin gwaji tare da gwajin RNA na HIV, wanda zai iya zama tabbatacce kafin gwajin rigakafin rigakafi / antigen.[6][19] Ya kamata a fara magungunan antiretroviral a lokacin da aka gano cutar kanjamau ta uwa kuma ya kamata a ci gaba da su har abada.[20]

Magani / Gudanarwa

[gyara sashe | gyara masomin]

Kulawa kafin haihuwa

[gyara sashe | gyara masomin]

Rigakafin yaduwar uwa zuwa yaro

[gyara sashe | gyara masomin]

Haɗarin watsa kwayar cutar HIV daga uwa zuwa yaro yana da alaƙa kai tsaye da nauyin ƙwayar ƙwayar cuta ta plasma na uwa. Uwar da ba a kula da su ba tare da babban (HIV RNA mafi girma 100,000 kofe / ml) suna da haɗarin watsawa sama da 50%. Don haka, ana ba da shawarar ART a duk lokacin da ake ciki don matakan ƙwayar cuta ya kasance ƙasa kaɗan gwargwadon yiwuwar kuma haɗarin watsawa ya ragu.[3][4] Yin amfani da magungunan ART waɗanda ke ƙetare mahaifa yadda ya kamata kuma na iya aiki azaman rigakafin rigakafi ga jarirai, saboda suna iya cimma isassun matakan magungunan ART a cikin tayin don hana kamuwa da cututtukan hoto. A ƙarshe, ana ba da shawarar amfani da magungunan ART ga jariri bayan haihuwa don ci gaba da ba da kariya daga kwayar cutar da jaririn zai iya kamuwa da shi yayin haihuwa da haihuwa.[21][22]

Magungunan antiretroviral na zamani

Dukkanin mata masu juna biyu da suka kamu da cutar kanjamau ya kamata su fara kuma su ci gaba da maganin ART ba tare da la'akari da ƙididdigar CD4 ko nauyin kwayar cuta ba don rage haɗarin yaduwar kwayar cutaa.[21] An fara ART na baya, mai yiwuwa za a dakatar da nauyin kwayar cuta ta lokacin isar da shi.[21][23] Wasu mata suna damuwa game da amfani da ART a farkon ciki, saboda jarirai sun fi kamuwa da guba a cikin watanni uku na farko. Koyaya, jinkirta farawa na ART na iya zama ƙasa da tasiri wajen rage yaduwar kamuwa da cuta.[24]

Ana amfani da maganin antiretroviral mafi mahimmanci a lokuta masu zuwa a cikin ciki don rage haɗarin yaduwar cutar kanjamau daga uwa zuwa yaro:

  • A lokacin daukar ciki: mata masu juna biyu da suka kamu da cutar kanjamau suna karɓar tsarin baki na akalla magungunan rigakafin HIV daban-daban guda uku.[25]
  • A lokacin haihuwa da haihuwa: mata masu juna biyu da suka kamu da cutar kanjamau wadanda suka riga sun kasance a kan ART uku ya kamata su ci gaba da tsarin su na baki. Idan nauyin kwayar cutar su yana da yawa (HIV RNA sama da 1,000 / ml), ko kuma akwai tambaya game da ko an sha magunguna akai-akai, to ana ƙara zidovudine (AZT) a lokacin isar.[26] Mata masu juna biyu waɗanda ba su kasance a kan ART ba kafin haihuwa ko waɗanda suka kasance a kanART ƙasa da makonni huɗu ya kamata a ba su AZT na intravenous ko kashi ɗaya na nevirapin (sdNVP), tenofovir (TDF) da emtricitabine (FTC) da kuma kashi uku na AZT.

Dangane da shawarwari na yanzu daga WHO, CDC da Ma'aikatar Lafiya da Ayyukan Dan Adam ta Amurka (DHHS), duk mutanen da ke fama da cutar kanjamau ya kamata su fara ART da zaran an gano su da cutar kansar HIV. Shawarwarin ya fi karfi a cikin yanayi masu zuwa: [27]

  • CD4 ƙidaya ƙasa da 3 sel/mm3
  • Babban nauyin kwayar cuta (HIV RNA sama da 100,000 kofe / ml)
  • Ci gaban kwayar cutar kanjamau zuwa cutar kanjamauyyar cuta
  • Ci gaban cututtukan da suka shafi cutar kanjamau
  • Ciki

Aiki da isar da shi

[gyara sashe | gyara masomin]

Ya kamata mata su ci gaba da ɗaukar tsarin ART a kan jadawalin kuma kamar yadda aka tsara a duk lokacin haihuwa da haihuwa. Nauyin kwayar cuta yana taimakawa wajen tantance wane yanayin haihuwa ya fi aminci ga uwa da jariri.[28]

A cewar NIH, lokacin da mahaifiyar ke karɓar ART kuma nauyin kwayar cutar ta yi ƙasa (HIV RNA ƙasa da 1000 / ml) a lokacin haihuwa, haɗarin yaduwar kwayar cutar yayin haihuwa yana da ƙarancin gaske kuma ana iya yin haihuwa ta hanyar jima'i. Ya kamata a yi aikin cesarean ko shigar da aiki ne kawai a cikin wannan yawan marasa lafiya idan sun zama dole a hanyar kiwon lafiya saboda dalilan da ba su da alaƙa da HIV.[28]

Idan nauyin kwayar cutar uwa yana da yawa (HIV RNA sama da 1000 / ml) ko kuma idan ba a san nauyin kwayar cuta ta HIV ba a lokacin haihuwa (fiye da makonni 34 na ciki), ya dace a tsara haihuwar kwayar cutar a makonni 38 don rage haɗarin yaduwar kwayar cutar kanjamau yayin haihuwa. A cikin waɗannan yanayi, wannan shine jagorar gudanarwa mai dacewa ba tare da la'akari da ko mahaifiyar ta ɗauki ART kafin haihuwa ba.[28]

Wani lokaci, mata da ke da babban nauyin kwayar cuta waɗanda ya kamata su karɓi isarwar caesarean za su gabatar da asibiti lokacin da ruwan su ya ragu ko kuma suna cikin haihuwa, kuma gudanarwa ga waɗannan marasa lafiya takamaiman ne ga kowane mai haƙuri kuma za a ƙayyade shi a lokacin gabatarwar, kamar yadda isarwar ta caesare ba za ta iya rage haɗarin yaduwar kamuwa da cuta ba.[28] NIH ta ba da shawarar cewa masu ba da kiwon lafiya a Amurka su tuntubi Cibiyar Ba da Shawara ta HIV / AIDS ta Kasa a 1-888-448-8765 don ƙarin shawarwari a cikin waɗannan yanayi.[28]

Dukkanin matan da suka halarci asibiti a cikin haihuwa da kuma matsayin su na cutar kanjamau ba a sani ba ko kuma suna cikin haɗarin kamuwa da cutar kanjamaun HIV amma ba su sami maimaita gwajin uku ba ya kamata a gwada su don cutar kanjamawa ta amfani da gwajin rigakafin HIV / maganin rigakafin jiki.[28] Idan saurin tantancewa yana da kyau, ya kamata a fara zidovudine na intravenous (IV) a cikin uwa nan da nan kuma ya kamata a ci gaba da gwajin tabbatarwa.[28]

IV Zidovudine magani ne na antiretroviral wanda ya kamata a ba mata a ko kusa da lokacin haihuwa a cikin yanayi masu zuwa: [28]

  • Babban nauyin kwayar cuta (HIV RNA mafi girma fiye da 1000 kofe / ml)
  • Rashin kwayar cuta da ba a sani ba
  • Tsoron asibiti don rashin bin doka da tsarin ART na haihuwa
  • Gwajin rigakafin HIV mai saurin kamuwa da cuta a lokacin haihuwa ko kafin a shirya zubar da shi

Gudanar da IV Zidovudine za a iya la'akari da shi a kan shari'a-da- shari'a ga mata waɗanda ke da matsakaicin nauyin kwayar cuta (HIV RNA mafi girma ko daidai da 50 / da kuma ƙasa da 1000 / ml) kusa da lokacin isar. IV Zidovudine ba a gudanar da shi ba ne kawai idan mata dukansu sun dace da tsarin ART da aka tsara a duk lokacin daukar ciki kuma sun ci gaba da karamin nauyin kwayar cuta kusa da lokacin haihuwa (HIV RNA kasa da 50 kofe / ml tsakanin makonni 34 zuwa 36 na ciki).

Ƙarin la'akari don sarrafa mata masu dauke da kwayar cutar kanjamau yayin haihuwa sun haɗa da shawarwari masu zuwa don rage haɗarin yaduwar kwayar cutar: [28]

Rigakafin rigakafi

[gyara sashe | gyara masomin]

Dukkanin mata masu juna biyu ya kamata su karɓi Allurar rigakafi mura da allurar rigakawa ta TdaP, wanda ke rufe tetanus, diphtheria, da pertussis (wanda ke tari) a cikin watanni uku na farko, ba tare da la'akari da matsayin su na HIV ba. Idan mace mai ciki ta kamu da cutar kanjamau, ya kamata a ba ta allurar rigakafin pneumococcal, allurar rigakawa ta meningococcal.[29] Allurar rigakafi tana da mahimmanci don hana mummunar rikitarwa da ke tattare da cututtukan da aka ambata a sama, waɗanda marasa lafiya da ke fama da kwayar cutar kanjamau suke cikin haɗarin kamuwa.[29]

Mata masu juna biyu bai kamata su sami allurar rigakafi ba, gami da allurar rigar cutar Human papilloma (HPV), allurar rigafin kyanda da rubella (MMR), allurar allurar rig rigakafin mura mai rai, da allurar allura ta varicella (Chicken pox) ba tare da la'akari da matsayin cutar kanjamau ba, saboda waɗannan allurar rigakanin na iya cutar da tayin.[30]

Ana ba da shawarar gwaje-gwaje masu zuwa ga matan da aka gano suna da cutar kanjamau kafin ko a lokacin daukar ciki: [31]

Magungunan rigakafin ƙwayoyin cuta

[gyara sashe | gyara masomin]

Makasudin gudanar da maganin cutar kanjamau a lokacin daukar ciki shi ne rage hadarin kamuwa da kwayar cutar kanjamau daga uwa zuwa ’ya’ya, da rage saurin kamuwa da cutar mata masu juna biyu, da kuma rage hadarin kamuwa da kamuwa da mace-macen mata masu juna biyu. Yana da mahimmanci a zaɓi magungunan da ke da lafiya kamar yadda zai yiwu ga uwa da tayin, kuma suna da tasiri wajen rage yawan nauyin ƙwayar cuta. Wasu magungunan antiretroviral suna ɗauke da haɗarin guba ga tayin. Duk da haka, gabaɗayan fa'idodin tsarin tsarin ART mai inganci ya fi haɗarin haɗari kuma ana ƙarfafa dukan mata su yi amfani da ART na tsawon lokacin da suke ciki.] Yana da mahimmanci a lura cewa ƙungiyoyin da ke tsakanin lahani na haihuwa da magungunan antiretroviral suna ruɗar da abubuwa masu mahimmanci waɗanda zasu iya ba da gudummawa ga waɗannan rikice-rikice, misali: fallasa ga masu adawa da folate, yanayin abinci mai gina jiki da folate, da kuma amfani da miyagun ƙwayoyi yayin amfani da barasa.

Tsarin ART da aka ba da shawarar ga mata masu juna biyu masu dauke da kwayar cutar HIV yayi kama da na yawan jama'a. A cikin Amurka, tsarin ART da aka fi so shine tsarin magani uku wanda magunguna biyu na farko sune NRTIs kuma na uku ko dai mai hana protease ne, mai hana integrase, ko NNRTI.[32]

  • Nucleoside reverse transcriptase inhibitors (NRTIs) ana ɗaukar su "ƙashin baya" na ART kuma 2 daga cikin waɗannan magunguna ana amfani da su a hade. Saboda sanannun bayanan tsaro da kuma amfani mai yawa a cikin marasa lafiya masu juna biyu, zidovudine-lamivudine shine zaɓi da aka fi so a matsayin kashin baya na NRTI. Zidovudine na iya kara tabarbarewar anemia don haka ana ba da shawarar marasa lafiya su yi amfani da madadin wakili. Ga matan da suka kamu da cutar hepatitis B, tenofovir tare da ko dai emtricitabine ko lamivudine shine mafi kyawun kashin baya na NRTI.[1] Amfani da NRTI na iya haifar da rikice-rikice mai haɗari da ake kira lactic acidosis a wasu mata, don haka yana da mahimmanci a saka idanu kan marasa lafiya don wannan matsala. Mutuwa daga lactic acidosis da gazawar hanta an danganta su da takamaiman NRTIs guda biyu, stavudine da didanosine. Sabili da haka, ya kamata a guje wa haɗuwa da waɗannan magunguna a cikin ciki.[2]

Maganin rigakafi (PrEP)

[gyara sashe | gyara masomin]

Pre-Exposure Prophylaxis (PrEP) ya kamata a ba da shi a cikin nau'i na tenofovir disoproxil fumarate / emtricitabine (TDF / FTC) ga marasa lafiya da ke cikin hadarin samun kwayar cutar HIV kuma suna ƙoƙarin yin ciki, masu ciki, waɗanda suke bayan haihuwa / shayarwa. Mutanen da ake ganin suna cikin haɗarin kamuwa da cutar kanjamau su ne waɗanda ke shiga cikin rashin kwaroron roba tare da abokin tarayya mai ɗauke da cutar HIV, marasa lafiya waɗanda aka gano suna ɗauke da cutar ta jima'i (STI) kwanan nan, da marasa lafiya waɗanda ke yin amfani da maganin allura. PrEP musamman zaɓi ne idan abokin tarayya mai cutar HIV ya dogara da ART kuma yana da nauyin hoto mai hoto wanda ba a iya gano shi ba. PrEP na iya rage haɗarin samun uwa da tayin HIV. Ya kamata a shawarci majinyatan da ke shan PrEP akan mahimmancin bin tsauraran magunguna da kuma gwada cutar kanjamau kowane wata uku kuma su san alamun kamuwa da cutar HIV mai tsanani idan an sami kamuwa da cutar ta hanyar hoto..[10]

Kulawa bayan haihuwa

[gyara sashe | gyara masomin]

Kula da jarirai da Biyewa

[gyara sashe | gyara masomin]

Dukkanin jarirai da aka fallasa su da cutar kanjamau a cikin mahaifa ya kamata su karɓi magungunan antiretroviral bayan haihuwa a cikin sa'o'i 6 na haihuwa, kuma ya kamata allurar su ta dogara da shekarun jaririn. Ya kamata jarirai da aka haifa da wuri su karɓi zidovudine, lamivudine, da / ko nevirapine bisa ga gwajin guba.[33]

Jarirai da suka kamu da cutar kanjamau a cikin mahaifa da kuma waɗanda uwayensu ke kan ART kafin da lokacin daukar ciki kuma an sami nasarar hana kamuwa da cuta ta hanyar haihuwa yakamata a yi amfani da zidovudine na tsawon makonni 4 don ci gaba da hana kamuwa da cutar HIV bayan haihuwa. Idan mace mai ciki ta gabatar da nakuda tare da matsayin kwayar cutar HIV da ba a sani ba da ingantaccen sakamakon gwajin HIV ko kuma jariri yana da babban haɗari na watsa kwayar cutar HIV a cikin mahaifa (alal misali, mahaifiyar ba ta shan magungunan antiretroviral a lokacin daukar ciki ko a lokacin daukar ciki, mahaifiyar ba ta sami maganin kwayar cutar ba, ko mahaifiyar ta sami mummunar kamuwa da kwayar cutar HIV a lokacin daukar ciki ko yayin shayarwa), jariri ya kamata a fara maganin rigakafi har sai lokacin da aka yi ciki ko lokacin shayarwa. akwai sakamakon gwajin jarirai. Idan jaririn yana da shaidar kamuwa da cutar HIV bayan haihuwa, ya kamata a fara su akan ART 3-maganin magani a allurai na jiyya waɗanda za a ci gaba har abada..[33]

Sauran gwaje-gwaje masu mahimmanci ga jarirai sun haɗa da cikakken adadin jini a lokacin haihuwa don ƙayyade tushen lambobi na jinin jariri. Sa'an nan kuma a bi jariri tare da kulawar dakin gwaje-gwaje da ya dace dangane da shekarun haihuwa da yanayin asibiti, da kuma tsarin magungunan tayi da na mahaifa. Muhimman abubuwan da ake lura da su na hematologic sun haɗa da anemia da neutropenia. Idan ɗayan waɗannan matsalolin sun faru, jaririn na iya buƙatar dakatar da tsarin ART a ƙarƙashin kulawar likita. Yaran da suka kamu da cutar kanjamau a cikin mahaifa ya kamata kuma a ba su magungunan rigakafin cutar pneumocystis jirovecii ciwon huhu tsakanin makonni 4-6 da haihuwa bayan kammala aikinsu na makonni 4 na maganin rigakafin cutar HIV, saboda wannan cuta ce mai haɗari ga rayuwa.. [34]

Kodayake haɗarin yana da ƙarancin gaske, ana iya yaduwar kwayar cutar kanjamau ga jariri ta hanyar abincin da mahaifiyar ko mai kula da cutar kanjamaun kwayar cutar ta ta cinye a baya. Don zama lafiya, bai kamata a ciyar da jarirai da aka riga aka cinye ba.[34]

Yin shayarwa

[gyara sashe | gyara masomin]

Duk da yake bin iyaye mata da ART yana rage damar yaduwar kwayar cutar kanjamau ga jariri, har yanzu akwai haɗarin yaduwar cutar ta hanyar madara. Bugu da ƙari, akwai damuwa cewa magungunan antiretroviral na uwa na iya shiga cikin madara kuma ya haifar da matsalolin guba a cikin jariri ko juriya ta gaba. Saboda wadannan dalilai, NIH, CDC, da AAP kowannensu yana hanawa shayarwa tsakanin mata masu dauke da kwayar cutar kanjamau a Amurka da sauran kasashe masu tasowa saboda akwai hanyoyin ciyarwa masu aminci, masu araha da ruwan sha mai tsabta.[35][36][37] A zahiri, ACOG ta lissafa kamuwa da kwayar cutar kanjamau ta uwa a matsayin daya daga cikin 'yan kalilan da ke hana shayarwa.[38]

Duk da wadannan shawarwari, wasu mata a kasashen da suka ci gaba sun zabi shayar da jarirai.  A wannan yanayin, yana da mahimmanci iyaye mata su bi tsarin tsarin ART kuma an shawarce su cewa ana ba wa jarirai magungunan rigakafi don rigakafin yiwuwar kamuwa da kwayar cutar hoto na akalla makonni 6.  Musamman ma, lokacin da iyaye mata ba su bi ka'idodin ART ba, akwai haɗarin 15-20% na jarirai na HIV daga shayarwa fiye da shekaru 2.  Yakamata a rika gwada jarirai da uwaye a kai a kai a duk tsawon lokacin shayarwa don tabbatar da kashe kwayar cutar da ta dace da rashin kamuwa da cutar kanjamau.  Ya kamata a yi sa ido kan uwaye tare da tantance nauyin kwayar cutar kanjamau, kuma a yi gwajin jarirai tare da gwajin kwayar cutar HIV..[39]

WHO ta ce a cikin kasashe masu tasowa, yanke shawara game da ko uwaye sun shayar da jariransu dole ne su yi la'akari da haɗarin hana kamuwa da kwayar cutar kanjamau a cikin jariri game da karuwar haɗarin mutuwa daga rashin abinci mai gina jiki, zawo, da kuma mummunar kamuwa da cutar da ba ta da HIV idan ba a shayar da Jariri ba.[40] A cikin kasashe masu tasowa, ruwa mai tsabta da tsari ba su da sauƙin samuwa, saboda haka, sau da yawa ana ƙarfafa shayarwa don samar da yara da isasshen abinci mai gina jiki saboda amfanin abinci mai gina ciki ya wuce haɗarin yaduwar kwayar cutar kanjamau. Shawarwarin Kwayar cutar kanjamau da jarirai na WHO na 2010 sun yi niyyar kara yawan rayuwar HIV da rage haɗarin da ba na HIV ba a cikin jarirai da uwaye, kuma sun haɗa da waɗannan: [41]

  • Hukumomin kiwon lafiya na kasa a kowace ƙasa ya kamata su ba da shawarar ɗaya, takamaiman, aikin ciyar da jarirai na duniya ga uwaye da ke fama da cutar kanjamau, saboda uwaye za su buƙaci shawarwari yayin ciyar da jariransu kuma wannan ya fi ingantawa lokacin da hukumomin ƙasa suka haɗa kai a cikin jagorancin da suke gudanarwa. Zaɓuɓɓukan don ciyarwa sun haɗa da shayarwa yayin karɓar magungunan antiretroviral ko guje wa duk shayarwa.
  • Lokacin da hukumomin kiwon lafiya na kasa suka zaɓi aikin ciyarwa da suke da niyyar ingantawa da kuma tantance yadda za a aiwatar da shi, ya kamata suyi la'akari da yaduwar cutar kanjamau, yawan mutuwar jarirai da yara saboda abubuwan da ba na HIV ba, ciyar da jarirai da kananan yara na yanzu, matsayin abinci mai gina jiki na yara, ingancin ruwa, albarkatun tsabta, da ingancin ayyukan kiwon lafiya.
  • matan da suka shayar da nono yayin karbar ART ya kamata su shayar da jariransu na tsawon watanni 6 sannan su ci gaba da shayar da su har sai jariri ya kai watanni 12. An ba su shawara su daina shayarwa a watanni 6, duk da haka, an canza wannan shawarar don inganta sakamakon abinci mai gina jiki na dogon lokaci.
  • Ya kamata a guje wa ciyar da jariri da madara don rage haɗarin yaduwar kwayar cutar kanjamau da guje wa zawo da rashin abinci mai gina jiki.
  • "An tabbatar da ruwa mai aminci da tsabta a matakin gida da kuma cikin al'umma; da kuma
  • uwa ko wani mai kula na iya samar da isasshen madara na jariri don tallafawa ci gaban jariri na yau da kullun; da
  • uwa ko mai kula na iya shirya shi da tsabta kuma akai-akai don ya kasance lafiya kuma yana da ƙananan haɗarin zawo da rashin abinci mai gina jiki; da
  • uwa ko mai kula na iya ba jariri madara a cikin watanni shida na farko; kuma
  • Iyalin suna goyon bayan wannan aikin; kuma
  • uwa ko mai kula na iya samun damar kula da lafiya wanda ke ba da cikakkun sabis na kiwon lafiya na yara. "

Tasirin Jama'a

[gyara sashe | gyara masomin]

Nuna bambanci

[gyara sashe | gyara masomin]

An yi amfani da kwayar halitta a cikin ƙoƙari na iyakance yaduwar uwa zuwa yaro a Afirka, Asiya, da Latin Amurka. [42] [43][44] Ana tilasta mata su yi wa haihuwa ba tare da sanin su ba ko yardarsu, kuma ana amfani da bayanan da ba daidai ba don tilasta musu su yarda da hanyar. An tilasta wa mata masu dauke da kwayar cutar kanjamau a duniya a matsayin keta haƙƙin ɗan adam.[45]

Tallafin shari'a game da wannan aikin ya faru a wasu ƙasashe. A Namibia, mata uku masu dauke da kwayar cutar kanjamau ne suka kawo karar a kan gwamnati wadanda suka yi iƙirarin cewa an tilasta musu yayin aiki don sanya hannu kan takardun izini wanda ya ba asibitin izinin yin kwayar cuta.[46] Shari'ar LM & Others v Gwamnatin Namibia ita ce ta farko a irin ta a yankin Saharar Afirka don magance tilasta wa mata masu dauke da kwayar cutar kanjamau. Kotun ta yanke hukuncin cewa an yi wa wadannan mata kaciya ba tare da yardarsu ba amma sun kasa gano cewa wannan ya faru ne saboda matsayinsu na cutar kanjamau.[47] Wani shari'ar 2010 a Chile sun kuma nemi alhakin gwamnati don keta haƙƙin jima'i da haihuwa na mata da ke fama da cutar kanjamau.[48]

Stigma

[gyara sashe | gyara masomin]

Za'a iya bayyana alamar cutar kanjamau a matsayin rage darajar, rashin kulawa, da iyakance damar saboda matsayin cutar kanjamaun daji ko haɗin kai da cutar kanjamawa.[49] Mutane da yawa da ke fama da cutar kanjamau suna fuskantar kunya; duk da haka, wannan kunya na iya ƙaruwa idan wannan mutumin yana da ciki.[50] Sauran asalin da ke haɗuwa na iya ƙara matakin zargi da wasu asalin ke fuskanta, wannan ya haɗa da mata baƙi da waɗanda ke cikin LGBTQ + Community.[51] Stigma na iya ɗaukar siffofi da yawa, ko ta hanyar hulɗar zamantakewa, shingen tsarin, ko halayen ciki. Nau'o'i daban-daban na zargi na iya hulɗa da tasiri ga juna a rayuwar mutum. An danganta zargi na cutar kanjamau da yawan baƙin ciki, damuwa, da warewar jama'a.[50] Wani sakamako na zargi shine ƙananan ci gaba ko fara magani, wanda zai iya tasiri ba kawai ga lafiyar mai ciki ba har ma da lafiyar tayin.[52]

An kafa Stigma

[gyara sashe | gyara masomin]

Rashin amincewa da aka yi tsammani

[gyara sashe | gyara masomin]

Za'a iya bayyana zargi da ake tsammani a matsayin tsammanin cewa mutum zai fuskanci zargi daga wasu a nan gaba saboda yanayin cutar kanjamau.[53] Tsoron da aka saba da shi game da mutanen da ke da juna biyu da ke fama da cutar kanjamau shine asarar haɗin zamantakewa, ko warewa ne daga iyali, wasu masu mahimmanci suna barin su, ko asarar abokai.[54] Wadannan tsoro na iya haifar da kin bayyana matsayinsu na cutar kanjamau. Wannan nau'in zargi na iya tasiri ga waɗanda ba a san su ba. Misali, mutanen da ke cikin ciki waɗanda ke tsammanin zargi bisa ga yanayin cutar kanjamau na iya ƙin gwajin cutar kanjamaun daji saboda tasirin da sakamakon zai iya yi a rayuwarsu idan sun sami cutar kanjamawa.[54] Wannan nau'in zargi na iya yin tasiri sosai ga ciki saboda yana iya haifar da wasu kada su nemi kulawar likita, kamar guje wa wuraren kiwon lafiya yayin haihuwa saboda tsoron fuskantar zargi.[52]

Stigma na ciki

[gyara sashe | gyara masomin]

Internalised ko self-stigma ya samo asali ne daga cikialisation na mummunar imani da halaye game da tabbataccen matsayin HIV.[55] Kamar abin kunya da ake tsammani, abin kunya da aka yi a ciki sau da yawa ya fito ne daga abubuwan da suka gabata ko sanin abin kunya da mutum zai iya shiga ciki kuma ya yi imani da kansa gaskiya ne. Wannan shiga ciki na iya haifar da rashin son raba ko dai matsayin su na HIV ko wasu bayanai game da matsayinsu. Wannan jinkirin na iya zama saboda dalilai da yawa ciki har da ikon ƙin matsayinsu da kansu, amma kuma ba sa son jin kamar dai suna da nauyi ga wasu.[56] Wannan ya kara iyakance tsarin tallafin zamantakewar su. Mutanen da ke cikin ciki da ke fama da cutar kanjamau waɗanda ke fuskantar ƙyama a ciki suma suna da ƙarancin bin magani, wannan na iya zama saboda ƙin yarda game da matsayinsu ko kunya da suke ji game da matsayinsa yana hana su fara ko ci gaba da magani.[56]

Bayani game da kiwon lafiya

[gyara sashe | gyara masomin]

Mata masu juna biyu da ke fama da cutar kanjamau har yanzu suna karɓar Allurar rigakafin mura mai saurin aiki da allurar riguna ta tetanus, diphtheria, da pertussis (Tdap) yayin daukar ciki.[57]

Yawancin marasa lafiya waɗanda ke da cutar kanjamau suna da wasu cututtukan kiwon lafiya da aka sani da cututtukani. Hepatitis B, hepatitis C, tarin fuka da amfani da miyagun ƙwayoyi wasu daga cikin cututtukan da suka fi dacewa da cutar HIV. Mata da ke dauke da cutar kanjamau ya kamata a gwada su don waɗannan yanayi don a iya kula da su yadda ya kamata ko sarrafa su yayin daukar ciki. Cutar na iya haifar da mummunar mummunar tasiri ga uwa da yaro yayin daukar ciki, don haka yana da matukar muhimmanci a gano su da wuri yayin daukar ciki.[58]

Bambancin kiwon lafiya

[gyara sashe | gyara masomin]

Akwai bambance-bambance da aka rubuta game da wanda cutar HIV / AIDS ta shafa yayin daukar ciki.[59][60] Misali, binciken haihuwar Florida daga 1998 zuwa 2007 ya nuna iyayen da aka gano a matsayin Hispanic ko Black a cikin bayanan kiwon lafiya sun fi samun kwayar cutar kanjamau a lokacin daukar ciki.[60] Kodayake ana buƙatar ƙarin bincike, talauci babban rashin daidaito ne na tsarin da zai iya haifar da waɗannan bambance-bambance a cikin ƙimar cutar kanjamau.[61][62][63] Bugu da ƙari, akwai manyan bambance-bambance a cikin samun damar maganin antiretroviral, magunguna masu mahimmanci don hana yaduwar cutar kanjamau daga iyaye zuwa yaro.[64] Rashin karɓar maganin antiretroviral yana da alaƙa da ƙuntataccen cancantar Medicaid.[64] Wannan bayanan ya nuna cewa ingantaccen inshora don ganowa, tantancewa, da kuma kula da masu juna biyu tare da cutar kanjamau zai taimaka wajen kara samun damar samun magunguna masu mahimmanci da rage yaduwar cutar kanjamawa daga iyaye zuwa yaro.[64]

Ƙungiyoyin tallafi

[gyara sashe | gyara masomin]

Bateganya et al. sun yi nazarin tasirin kungiyoyin tallafi ga mutanen da ke fama da cutar kanjamau kuma sun gano cewa 18/20 (90%) na takardun da aka sake dubawa sun nuna kungiyoyin tallafin suna da sakamako mai kyau.[65] Bincike ya nuna cewa kungiyoyin tallafi suna rage cututtuka (suna da cuta ko alamun cuta), rage mutuwa (mai yiwuwa na mutuwa), kara ingancin rayuwa, da kara amfani da kiwon lafiya.[65] Har ila yau, akwai bincike da ke nuna cewa kungiyoyin tallafi, a cikin gajeren lokaci, suna da tasiri mai kyau ga mata masu juna biyu da ke fama da cutar kanjamau.[66] Mundell et al. sun nuna cewa mata masu juna biyu da suka yi rajista a cikin ƙungiyar tallafi suna da 1) inganta girman kai, 2) damar da za ta fi dacewa da maganin su, da kuma 3) suna iya bin ayyukan kiwon lafiya da raba binciken cutar kanjamau tare da wasu fiye da waɗanda ba su yi rajista cikin ƙungiyar tallafin ba.[66] Wannan binciken ya nuna cewa mata masu juna biyu da ke fama da cutar kanjamau na iya amfana daga kungiyoyin tallafin tsara.

  1. ↑ 1.0 1.1 "HIV Surveillance Report". U.S. Centers for Disease Control and Prevention. May 2020.
  2. ↑ "Mother-to-child transmission of HIV". www.who.int (in Turanci). Retrieved 2022-08-21.
  3. ↑ Workowski KA, Bolan GA (June 2015). "Sexually transmitted diseases treatment guidelines, 2015" (PDF). MMWR. Recommendations and Reports. 64 (RR-03): 1–137. PMC 5885289. PMID 26042815.
  4. ↑ "Preventing Perinatal Transmission of HIV | NIH". hivinfo.nih.gov (in Turanci). Retrieved 2022-08-21.
  5. ↑ 5.0 5.1 5.2 "ACOG Committee Opinion No. 752: Prenatal and Perinatal Human Immunodeficiency Virus Testing". Obstetrics and Gynecology. 132 (3): e138–e142. September 2018. doi:10.1097/AOG.0000000000002825. PMID 30134428. S2CID 52070003.
  6. ↑ 6.0 6.1 6.2 6.3 6.4 Panel on Treatment of Pregnant Women with HIV Infection and Prevention of Perinatal Transmission. "Maternal HIV Testing and Identification of Perinatal HIV Exposure". Clinical Info HIV gov. Office of AIDS Research (OAR), National Institutes of Health (NIH), U.S. Department of Health and Human Services. Archived from the original on 2021-01-22. Retrieved 2021-01-20.
  7. ↑ 7.0 7.1 7.2 7.3 7.4 Empty citation (help)
  8. ↑ 8.0 8.1 8.2 "About HIV/AIDS". U.S. Centers for Disease Control and Prevention (in Turanci). 2020-11-03. Retrieved 2021-01-20.
  9. ↑ Niu MT, Stein DS, Schnittman SM (December 1993). "Primary human immunodeficiency virus type 1 infection: review of pathogenesis and early treatment intervention in humans and animal retrovirus infections". The Journal of Infectious Diseases. 168 (6): 1490–501. doi:10.1093/infdis/168.6.1490. PMID 8245534.
  10. ↑ 10.0 10.1 "Pre-exposure Prophylaxis (PrEP) to Reduce the Risk of Acquiring HIV During Periconception, Antepartum, and Postpartum Periods | Perinatal | ClinicalInfo". Clinical Info HIV gov. Office of AIDS Research (OAR), National Institutes of Health (NIH), U.S. Department of Health and Human Services. Archived from the original on 2021-01-26. Retrieved 2021-01-27.
  11. ↑ "Prepregnancy Counseling". www.acog.org (in Turanci). Retrieved 2021-01-21.
  12. ↑ 12.0 12.1 12.2 12.3 "Preconception Counseling and Care for Women of Childbearing Age with HIV". Clinical Info HIV gov. Office of AIDS Research (OAR), National Institutes of Health (NIH), U.S. Department of Health and Human Services. Archived from the original on 2021-01-28. Retrieved 2021-01-21.
  13. ↑ Glynn JR, Buvé A, Caraël M, Kahindo M, Macauley IB, Musonda RM, et al. (December 2000). "Decreased fertility among HIV-1-infected women attending antenatal clinics in three African cities". Journal of Acquired Immune Deficiency Syndromes. 25 (4): 345–52. doi:10.1097/00126334-200012010-00008. PMID 11114835. S2CID 22980353.
  14. ↑ van Leeuwen E, Prins JM, Jurriaans S, Boer K, Reiss P, Repping S, van der Veen F (2007-03-01). "Reproduction and fertility in human immunodeficiency virus type-1 infection". Human Reproduction Update. 13 (2): 197–206. doi:10.1093/humupd/dml052. PMID 17099206.
  15. ↑ Kushnir VA, Lewis W (September 2011). "Human immunodeficiency virus/acquired immunodeficiency syndrome and infertility: emerging problems in the era of highly active antiretrovirals". Fertility and Sterility. 96 (3): 546–53. doi:10.1016/j.fertnstert.2011.05.094. PMC 3165097. PMID 21722892.
  16. ↑ "An Opt-Out Approach to HIV Screening". U.S. Centers for Disease Control and Prevention. Retrieved 2015-11-13.
  17. ↑ "Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States" (PDF). U.S. Department of Health and Human Services (HHS). Archived from the original (PDF) on 5 January 2012. Retrieved 1 February 2012.
  18. ↑ (Report). Missing or empty |title= (help)
  19. ↑ Cornett JK, Kirn TJ (September 2013). "Laboratory diagnosis of HIV in adults: a review of current methods". Clinical Infectious Diseases. 57 (5): 712–8. doi:10.1093/cid/cit281. PMID 23667267.
  20. ↑ "British HIV Association guidelines for the management of HIV in pregnancy and postpartum 2018" (PDF). Retrieved 14 January 2021.
  21. ↑ 21.0 21.1 21.2 "Overview | General Principles Regarding Use of Antiretroviral Drugs during Pregnancy | Antepartum Care | Perinatal | ClinicalInfo". Clinical Info HIV gov. Office of AIDS Research (OAR), National Institutes of Health (NIH), U.S. Department of Health and Human Services. Archived from the original on 2021-01-22. Retrieved 2021-01-25.
  22. ↑ "Antiretroviral Management of Newborns with Perinatal HIV Exposure or HIV Infection | Management of Infants Born to Women with HIV Infection | Perinatal | ClinicalInfo". Clinical Info HIV gov (in Turanci). Office of AIDS Research (OAR), National Institutes of Health (NIH), U.S. Department of Health and Human Services. Archived from the original on 2021-01-22. Retrieved 2021-01-25.
  23. ↑ Townsend CL, Byrne L, Cortina-Borja M, Thorne C, de Ruiter A, Lyall H, et al. (April 2014). "Earlier initiation of ART and further decline in mother-to-child HIV transmission rates, 2000-2011". AIDS. 28 (7): 1049–57. doi:10.1097/QAD.0000000000000212. PMID 24566097. S2CID 19123848.
  24. ↑ Hoffman RM, Black V, Technau K, van der Merwe KJ, Currier J, Coovadia A, Chersich M (May 2010). "Effects of highly active antiretroviral therapy duration and regimen on risk for mother-to-child transmission of HIV in Johannesburg, South Africa". Journal of Acquired Immune Deficiency Syndromes. 54 (1): 35–41. doi:10.1097/QAI.0b013e3181cf9979. PMC 2880466. PMID 20216425.
  25. ↑ (HHS) Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission, a working group of the Office of AIDS Research Advisory Council (OARAC). "HIV and Pregnancy" (PDF). aidsinfo.nih.gov. U.S. Department of Health and Human Services. Archived from the original (PDF) on 21 April 2015. Retrieved 1 August 2015.
  26. ↑ Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission. "Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States" (PDF). Archived from the original (PDF) on May 15, 2012. Retrieved 20 November 2015.
  27. ↑ "When to Start Antiretroviral Therapy | HIV/AIDS Fact Sheets | Education Materials | AIDSinfo". AIDSinfo. Archived from the original on November 17, 2013. Retrieved 2015-11-21.
  28. ↑ 28.0 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8 "Intrapartum Care for Women with HIV | Perinatal | ClinicalInfo". Clinical Info HIV gov. Office of AIDS Research (OAR), National Institutes of Health (NIH), U.S. Department of Health and Human Services. Archived from the original on 2021-01-22. Retrieved 2021-01-25.
  29. ↑ 29.0 29.1 Cite error: Invalid <ref> tag; no text was provided for refs named :2
  30. ↑ "Vaccine Safety: Vaccines During Pregnancy FAQs". Centers for Disease Control and Prevention. 24 August 2020. Retrieved 25 January 2021.
  31. ↑ "Monitoring of the Woman and Fetus During Pregnancy | Antepartum Care | Perinatal | ClinicalInfo". Clinical Info HIV gov. Office of AIDS Research (OAR), National Institutes of Health (NIH), U.S. Department of Health and Human Services. Archived from the original on 2021-01-22. Retrieved 2021-01-25.
  32. ↑ "Panel on Treatment of Pregnant Women with HIV Infection and Prevention of Perinatal Transmission. Recommendations for Use of Antiretroviral Drugs in Transmission in the United States" (PDF). Archived from the original (PDF) on 25 January 2021. Retrieved 26 January 2021.
  33. ↑ 33.0 33.1 "Antiretroviral Management of Newborns with Perinatal HIV Exposure or HIV Infection | Pediatric ARV | ClinicalInfo". Clinical Info HIV gov (in Turanci). Office of AIDS Research (OAR), National Institutes of Health (NIH), U.S. Department of Health and Human Services. Archived from the original on 2021-01-27. Retrieved 2021-01-28.
  34. ↑ 34.0 34.1 "Initial Postnatal Management of the Neonate Exposed to HIV | Management of Infants Born to Women with HIV Infection | Perinatal | ClinicalInfo". Clinical Info HIV gov. Office of AIDS Research (OAR), National Institutes of Health (NIH), U.S. Department of Health and Human Services. Archived from the original on 2021-01-22. Retrieved 2021-01-28.
  35. ↑ "Postpartum Follow-Up of Women with HIV | Perinatal | ClinicalInfo". Clinical Info HIV gov. Office of AIDS Research (OAR), National Institutes of Health (NIH), U.S. Department of Health and Human Services. Archived from the original on 2021-01-22. Retrieved 2021-01-28.
  36. ↑ Committee on Pediatric AIDS (February 2013). "Infant feeding and transmission of human immunodeficiency virus in the United States". Pediatrics. 131 (2): 391–6. doi:10.1542/peds.2012-3543. PMID 23359577.
  37. ↑ "Breastfeeding: HIV". Centers for Disease Control and Prevention. February 4, 2020. Retrieved January 28, 2021.
  38. ↑ "Optimizing Support for Breastfeeding as Part of Obstetric Practice". www.acog.org (in Turanci). Retrieved 2021-01-28.
  39. ↑ "Counseling and Managing Women Living with HIV in the United States Who Desire to Breastfeed | Perinatal | ClinicalInfo". Clinical Info HIV gov. Office of AIDS Research (OAR), National Institutes of Health (NIH), U.S. Department of Health and Human Services. Archived from the original on 2021-02-02. Retrieved 2021-01-28.
  40. ↑ "World Health Organization. Breastfeeding and HIV" (PDF). Retrieved 14 January 2021.
  41. ↑ Organization, World Health (2012). "HIV and Infant Feeding 2010: An Updated Framework for Priority Action" (PDF). World Health Organization. Retrieved January 28, 2021.
  42. ↑ "Positive and pregnant — how dare you: a study on access to reproductive and maternal health care for women living with HIV in Asia: by Women of the Asia Pacific Network of People Living with HIV, March 2012". Reproductive Health Matters. 20 (sup39): 110–8. January 2012. doi:10.1016/S0968-8080(12)39646-8. ISSN 0968-8080.
  43. ↑ Roseman MJ, Ahmed A, Gatsi-Mallet J (2012). "'At the Hospital There are No Human Rights': Reproductive and Sexual Rights Violations of Women Living with HIV in Namibia". SSRN Working Paper Series. doi:10.2139/ssrn.2220800. ISSN 1556-5068. |hdl-access= requires |hdl= (help)
  44. ↑ Kendall T, Albert C (January 2015). "Experiences of coercion to sterilize and forced sterilization among women living with HIV in Latin America". Journal of the International AIDS Society. 18 (1): 19462. doi:10.7448/IAS.18.1.19462. PMC 4374084. PMID 25808633.
  45. ↑ "Forced sterilisation as a human rights violation: recent developments". ijrcenter.org. 21 March 2019. Retrieved 2019-12-02.
  46. ↑ "Government of the Republic of Namibia v LM and Others (SA 49/2012) [2014] NASC 19 (03 November 2014); | Namibia Legal Information Institute". namiblii.org. 3 November 2014. Retrieved 2019-12-02.
  47. ↑ "Namibia Women Coerced into Being Sterilised". International Business Times UK. 2012-07-30. Retrieved 2019-12-02.
  48. ↑ "Harvard Human Rights Law Journal — Litigating against the Forced Sterilization of HIV-Positive Women: Recent Developments in Chile and Namibia. 2010". Harvard Human Rights Journal. Namibia. 2010. doi:10.1163/2210-7975_HRD-9944-0037. Archived from the original on 2022-02-06. Retrieved 2019-12-02 – via BRILL.
  49. ↑ Stackpool-Moore, Lucy; Logie, Carmen H.; Cloete, Allanise; Reygan, Finn (July 2022). "What will it take to get to the heart of stigma in the context of HIV?". Journal of the International AIDS Society (in Turanci). 25 (S1): e25934. doi:10.1002/jia2.25934. ISSN 1758-2652. PMC 9274335 Check |pmc= value (help). PMID 35818934 Check |pmid= value (help).
  50. ↑ 50.0 50.1 Ion, Allyson; Wagner, Anne C.; Greene, Saara; Loutfy, Mona R.; for the HIV Mothering Study Team (February 2017). "HIV-related stigma in pregnancy and early postpartum of mothers living with HIV in Ontario, Canada". AIDS Care (in Turanci). 29 (2): 137–144. doi:10.1080/09540121.2016.1211608. ISSN 0954-0121. PMID 27449254.
  51. ↑ Fletcher, Faith; Ingram, Lucy Annang; Kerr, Jelani; Buchberg, Meredith; Bogdan-Lovis, Libby; Philpott-Jones, Sean (July 2016). ""She Told Them, Oh That Bitch Got AIDS": Experiences of Multilevel HIV/AIDS-Related Stigma Among African American Women Living with HIV/AIDS in the South". AIDS Patient Care and STDs (in Turanci). 30 (7): 349–356. doi:10.1089/apc.2016.0026. ISSN 1087-2914. PMC 4948216. PMID 27410498.
  52. ↑ 52.0 52.1 Turan, Janet M.; Nyblade, Laura (September 2013). "HIV-related Stigma as a Barrier to Achievement of Global PMTCT and Maternal Health Goals: A Review of the Evidence". AIDS and Behavior (in Turanci). 17 (7): 2528–2539. doi:10.1007/s10461-013-0446-8. ISSN 1090-7165. PMID 23474643.
  53. ↑ Zeng, Chengbo; Li, Xiaoming; Qiao, Shan; Yang, Xueying; Shen, Zhiyong; Zhou, Yuejiao (2020-08-02). "Anticipated stigma and medication adherence among people living with HIV: the mechanistic roles of medication support and ART self-efficacy". AIDS Care (in Turanci). 32 (8): 1014–1022. doi:10.1080/09540121.2020.1728213. ISSN 0954-0121. PMC 7368809. PMID 32336130.
  54. ↑ 54.0 54.1 Turan, Janet M.; Bukusi, Elizabeth A.; Onono, Maricianah; Holzemer, William L.; Miller, Suellen; Cohen, Craig R. (August 2011). "HIV/AIDS Stigma and Refusal of HIV Testing Among Pregnant Women in Rural Kenya: Results from the MAMAS Study". AIDS and Behavior (in Turanci). 15 (6): 1111–1120. doi:10.1007/s10461-010-9798-5. ISSN 1090-7165. PMC 3127002. PMID 20827573.
  55. ↑ Stevens, Marianne E.; Parsons, Janet A.; Read, Stanley E.; Nixon, Stephanie A. (2019-01-16). "The conceptualization of stigma within a rehabilitation framework using HIV as an example". Disability and Rehabilitation (in Turanci). 41 (2): 235–243. doi:10.1080/09638288.2017.1385099. ISSN 0963-8288. PMID 28978242.
  56. ↑ 56.0 56.1 Weglarz, Anya; Hanson, Olivia (2024-07-30). "Internalized HIV Stigma Among Women Giving Birth in Tanzania: A Mixed-Methods Study" (in Turanci). Cite journal requires |journal= (help)
  57. ↑ Madhi SA, Cutland CL, Kuwanda L, Weinberg A, Hugo A, Jones S, et al. (September 2014). "Influenza vaccination of pregnant women and protection of their infants". The New England Journal of Medicine. 371 (10): 918–31. doi:10.1056/NEJMoa1401480. PMID 25184864. |hdl-access= requires |hdl= (help)
  58. ↑ Solomon SS, Hawcroft CS, Narasimhan P, Subbaraman R, Srikrishnan AK, Cecelia AJ, et al. (May 2008). "Comorbidities among HIV-infected injection drug users in Chennai, India". The Indian Journal of Medical Research. 127 (5): 447–52. PMC 5638642. PMID 18653907.
  59. ↑ Centers for Disease Control and Prevention (CDC) (February 2006). "Racial/ethnic disparities in diagnoses of HIV/AIDS—33 states, 2001–2004". MMWR Morb Mortal Wkly Rep. 55 (5): 121–5. PMID 16467777.

    "Racial/Ethnic Disparities in Diagnoses of HIV/AIDS—33 States, 2001–2004". JAMA. 295 (13): 1508. 2006-04-05. doi:10.1001/jama.295.13.1508. ISSN 0098-7484.
  60. ↑ 60.0 60.1 Salihu HM, Stanley KM, Mbah AK, August EM, Alio AP, Marty PJ (November 2010). "Disparities in rates and trends of HIV/AIDS during pregnancy across the decade, 1998-2007". Journal of Acquired Immune Deficiency Syndromes. 55 (3): 391–6. doi:10.1097/qai.0b013e3181f0cccf. PMID 20729744. S2CID 34024641.
  61. ↑ Krawczyk CS, Funkhouser E, Kilby JM, Vermund SH (2009). "Delayed access to HIV diagnosis and care: Special concerns for the Southern United States". AIDS Care. 18 (Suppl 1): S35-44. doi:10.1080/09540120600839280. PMC 2763374. PMID 16938673.
  62. ↑ Enriquez M, Farnan R, Simpson K, Grantello S, Miles MS (2007). "Pregnancy, Poverty, and HIV". The Journal for Nurse Practitioners. 3 (10): 687–693. doi:10.1016/j.nurpra.2007.08.015. ISSN 1555-4155.
  63. ↑ Krueger LE, Wood RW, Diehr PH, Maxwell CL (August 1990). "Poverty and HIV seropositivity: the poor are more likely to be infected". AIDS. 4 (8): 811–4. doi:10.1097/00002030-199008000-00015. PMID 2261136.
  64. ↑ 64.0 64.1 64.2 Zhang S, Senteio C, Felizzola J, Rust G (December 2013). "Racial/ethnic disparities in antiretroviral treatment among HIV-infected pregnant Medicaid enrollees, 2005-2007". American Journal of Public Health. 103 (12): e46-53. doi:10.2105/ajph.2013.301328. PMC 3828964. PMID 24134365.
  65. ↑ 65.0 65.1 Bateganya MH, Amanyeiwe U, Roxo U, Dong M (April 2015). "Impact of support groups for people living with HIV on clinical outcomes: a systematic review of the literature". Journal of Acquired Immune Deficiency Syndromes. 68 (Supplement 3): S368-74. doi:10.1097/qai.0000000000000519. PMC 4709521. PMID 25768876.
  66. ↑ 66.0 66.1 Mundell JP, Visser MJ, Makin JD, Kershaw TS, Forsyth BW, Jeffery B, Sikkema KJ (August 2011). "The impact of structured support groups for pregnant South African women recently diagnosed HIV positive". Women & Health. 51 (6): 546–65. doi:10.1080/03630242.2011.606356. PMC 4017076. PMID 21973110.
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