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treatment

Magazine of the Treatment Action Campaign August 2010

Ukuzimisela

ngoKuvimbela Isandulela ngculazi (HIV)

I-HIV nokukhulelwa: Okudingeka omama bak wazi Konke nge-HIV kanye nokusok wa k wabesilisa ngokok welashwa Incwadi yethu ethokozisayo ngokusebenzisa amakhondomu

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Umhleli: Marcus Low Umsizi Womhleli: Mara Kardas-Nelson Umhleli Wekhophi: Cathy Goudie Abafake isandla: Noloyiso Ntamehlo, Catherine Karlsson, Lefa Tlhame, Malusi Mbatha, Catherine Tomlinson, MaryJane Matsolo, Rebecca Hodes, Tandeka Vinjwa, Andrea Zeelie Ikhava yangaphambili: Aliza Waxman Ukuthathwa kwezithombe: Aliza Waxman, Damien Schumann, Sam Reinders, Jenny Matthews/Panos Pictures, Lefa Tlhame, Malusi Mbatha, Francesco Zizola/ Noor, Giacomo Pirozzi /Panos Pictures, Julien Harneis, Mary-Jane Matsolo, Thandeka Vinjwa, Jodi Bieber, Krista Vetting, Mikkel Ostergaard/Panos Pictures. Imifanekiso esekhasini 6 namakhathuni emakhasini 10­12 nguBrice Reignier. Sibonga ngokukhethekile ku-Dkt Stefanie Röhrs weGender, Health and Justice Research Unit e-University of Cape Town, no-Polly Clayden no-Simon Collins we-HIV i-Base. Ukuhanjiswa: Kagiso Seleka Ukuhlelwa kwamakhasi: Designs4development, www. d4d.co.za Ukuphrinta: CTP Book Printers Ukuhumusha: Bohle Conference and Language Services I-TAC izinikele ekuhlinzekeni abantu abane-HIV, imindeni yabo kanye nebanakekeli ulwazi oluyiqiniso ngemithi esindisa impilo kanye nokwelashwa. I-TAC kanye nabaholi bayo bazimele abekho embonini yokwenziwa kwemithi kanjalo nezimboni zemithi yemvelo neminye imithi futhi akukho luthando abanalo kuzo. Leli hlelo le-Equal Treatment lixhaswe ngezimali yi-Global Fund to Fight AIDS, Tuburculosis and Malaria kanye neOxfam Australia Leli phephabhuku liyatholakala ngesiTsonga, isiXhosa nesiNgisi. Ungathola leli hlelo le-Equal Treatment nawangaphambilini ku-inthanethi kuleli kheli www.tac.org.za/community/equaltreatment/

Equal Treatment is published by the Treatment Action Campaign.

Okuqukethwe

Ihlelo 34 ­ Agasti 2010 isiZulu

Ukuvinjelwa okuhlanganisiwe Akukho ukungenelela okukodwa okungamisa ukusabalala kwe-HIV.

pages 2 ­15

Sethula abanye abadlali abakha ithimba lethu lamasu okuvimbela futhi ubhekisise okuthathu kokusebenza ngempumelelo kakhulu: ukusoka kwabesilisa ngokokwelashwa, ukusetshenziswa kwamakhondomu ngendlela efanele kanye nokwelapha njengokuvimbela.

Abesifazane, ukukhulelwa kanye ne-HIV Ukusuka ekunceliseni ibele kuye

pages 16­21

ekuhlukaniseni amaseli esidoda noketshezi lwezitho zangasese zabesilisa (sperm washing), sikulethela isiqondiso esijulile sokukhulelwa ne-HIV. Sikhuluma futhi nabesifazane abasebasha abavela eKhayelitsha ngobunzima abahlangabezana nabo ngokuxoxa ngokubonisana ngocansi oluphephile.

Ikheli Leposi: PO Box 2069, Cape Town 8001 Ikheli Lendawo: Westminster House, 122 Longmarket Street, 3rd Floor, Cape Town 8000 Ucingo: 0861 END HIV Ifeksi: +27 21 422 1720 Iwebhusayithi: www.tac.org.za TAC district offices Khayelitsha District: 021 364 5489 Ekurhuleni District: 011 873 4130 Lusikisiki District: 039 253 1951 Pietermaritzburg District: 033 394 0845 Gert Sibande District: 017 811 5085 Mopani District: 015 307 3381

Izinto Eziphathelene Nomphakathi kanye ne-IHV Ubumpofu, imfundo kanye nobulili

pages 22 ­27

konke kuxhumene nengozi yokuba ne-HIV. Sigqamisa izinto eziphathelene nomphakathi eziholela obhubhaneni lwe-AIDS. Futhi, ungalweqi ulwazi olusha lwe-PEP eNingizimu Afrika.

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Isithombe nguThandeka Vinjwa

Umbono womhleli

eziqondene ngqo nezingane ezisinde ekudlwengulweni, njengokwelashwa ngokudlala. Lapho lezi zinsizakalo zikhona khona, izingane kaningi zihamba amabanga amade ukuze zizithole. Njengoba manje sesenze ngcono iziqondiso zokwelashelwa i-HIV ezithembisa ukuvinjelwa okungcono kokudluliswa okusuka kumama kuye enganeni, kufanele futhi sisebenze kanzima ukweseka nokuqapha ukuthi lezi zinto ziqala kanjani ukusetshenziswa. Kunokukhathazeka ngesimo sokulungela emitholampilo kanye nokushoda kokuqeqeshwa kwabasebenzi bezempilo eziqondisweni ezintsha. Ukwengeza, ukushoda kwefomula yobisi kusalokhu kuyinkinga enkulu. Abanye omama bayaxuba lapho bencelisa izingane zabo uma ifomula ingekho, okunengozi enkulu yokudlulisela i-HIV ezinganeni zabo ezisandakuzalwa. Wonke umuntu angasiza ukunciphisa ukudluliswa kwe-HIV ngocansi. Ukusetshenziswa okufanele kwamakhondomu kusalokhu kungenye yezindlela ezisebenza ngempumelelo kakhulu ukufeza lokhu. Kudingeka siwabandakanye kakhudlwana amadoda ezingxoxweni zethu ngokusetshenziswa kwamakhondomu. Ngezikhathi eziningi kakhulu, isinqumo sokuthi asetshenziswe yini noma angasetshenziswa amakhondomu senziwa ngamadoda odwa. Ukusokwa kwamadodwa ngokokwelashwa kokuzithandela ngenye indlela esingayisebenzisa ukuvimbela ukudluliswa kwe-HIV. Le nqubo inganciphisa ingozi yokutheleleka ngama-60%. Uhulumeni ukhipha le nsizakalo futhi kufanele sikhuthaze amadoda ukuthi ayisebenzise, ngisho ngabe besebevele besokile ngokwendabuko ngendlela yendabuko. Sonke singasebenza ndawonye ukwehlisa ukutheleleka nge-HIV kanye namazinga okufa ngokuthi seseke lezi zinhlelo. I-TAC ikhuthaza wonke umuntu ukuthi ahlolelwe i-HIV. Uma une-HIV, funda konke ongakuunda ngegciwane futhi ube nomsebenzi wokunakekela impilo yakho. Uma ungenayo i-HIV, iqaphele impilo yakho futhi wenze konke ongakwenza ukugwema ukutheleleka. Noma ngabe isimo sakho se-HIV sinjani, lithokozele ihlelo le-Equal Treatment futhi ulisebenzise ukuze uhlale unolwazi. Sekuyisikhathi ukuthi ukuvimbela sikwenze. Noloyiso Ntamehlo, isishoshovu se-TAC, Lusikisiki

Kwaze kwaba unyaka ka-2003 ngangizizwa ngikhathazekile futhi ngithukuthele. Ngase ngilubheke yonke indawo ulwazi maqondana ne-HIV/AIDS kanye nezimo eziphathelene nayo, ngenxa yokuthi amalungu omndeni wami amaningi kakhulu ayebulawe yizo lezi zifo. Ngonyaka ka-2003 i- Médecins Sans Frontières (MSF) kanye nezinhlangano ezingabalingani ezimbalwa, kubandakanya ne-Treatment Action Campaign (TAC), zaqala uhlelo oluphelele lokuqeda ubhubhane lwe-HIV emiphakathini esezindaweni zasemakhaya. Kulapho-ke la engajoyina khona i-TAC njengevolontiya kwase kuthi ekugcineni ngakuthola lokhu ebengilokhu ngikufuna. Uhlelo lwanda lwafinyelela emitholampilo eyi-12 endaweni yaseLusikisiki, lapho engihlala khona. Namhlanje le mitholampilo isiza abantu abayi- 156,853. Kulaba bantu abayi-4,247 bahlolwe kwatholakala ukuthi bane-HIV ekwateni yokuqala yonyaka ka-2010. Sekube nokukhula futhi okubonakalayo kokusetshenziswa kokwelashwa ngezidambisi gciwane endaweni. Kodwa kusenebanga elide okusafanele silihambe ekulweni kwethu ne-HIV. Abantu abaningi kakhulu abatheleleka bengazi ngayo, kanti ngonyaka ka-2010 ukuhlolwa kusalokhu kubalulekile kakhulu. Umkhankaso omusha kaHulumeni woKwelulekelwa i-HIV Nokuhlola (HIV Counselling and Testing (HCT)) kuzosisiza ukuphokophela nakakhudlwana ukukhuthaza ukuhlolwa. Ngeshwa, imitholampilo yethu eminingi ayinaso isimo esinobungane emadodeni. Ngenxa yalokhu ambalwa amadodoa avakashela emitholampilo eyofuna izinsizakalo eziphathelene ne-HIV, njengokuhlolwa. Sidinga sibandakanye amadoda amaningi ngokushesha emkhankasweni we-HTC. Enye inhloso ebalulekile kithi ukuhlangansiwa kwezinsizakalo ukuze kwenziwe ngcono izinhlelo zangemuva kokubekeka engozini yokutheleleka (postexposure prophylaxis (PEP)) ezindaweni zasemakhaya, ikakhulukazi kulabo abasinde ekudlwengulweni (bheka ikhasi 22 ukuze uthole olunye ulwazi nge-PEP). Kuyinto ekhathaza kakhulu ukuthi kunodokotela abambalwa bokusiza abantu abahlushwe ngokudlwengulwa ezindaweni zokusiza ngezempilo. Lapha eLusikisiki, iziteshi zamaphoyisa zikude kakhulu nodokotela. Sidinga abeluleki abaningi ababhekene nezimo zokuphatheka kabi kakhulu, kuzo zombili lezi zindawo eziteshini zamaphoyisa nasezibhedlela. ILusikisiki ayinazo izinsizakalo

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Abadlali ethinjeni lethu lokuvimbela i-HIV

PEP Ukunikeza abesifazane amandla

Njengoba sifunde kabanzi nge-HIV eminyakeni esandakudlula, sifunde kakhulu futhi ngokuthi kuvinjelwa kanjani ukutheleleka. Sitholile ukuthi ukugxila nje endleleni eyodwa yokuvimbela akusebenzi kahle kakhulu. Kunalokho, sidinga ukusebenzisa izindlela ezimbalwa ezahlukene. Ukusebenzisa amakhondomu ngendlela efanele kanye nokungaguquki, ukusokwa ngokokwelashwa kwamadoda, ukuphuza izidambisi gciwane (uma une-HIV futhi ufanelekile ukuthi welashwe) nokuba nomkhawulo esibaalweni sabalingani bocansi konke kunciphisa amathuba okutheleleka noma okuphinde

Isayensi

MMC Imfundo

utheleleke, kodwa inhlanganisela yakho konke yikhona okungcono kakhulu. Akukho kulezi zindlela zokuvimbela okukunika ukuvikeleka okuwu-100%, yingakho nje sikuhlanganisa. Ndawonye, leli thimba lezindlela lingavimbela ukutheleleka kangcono kakhulu kunendlela eyodwa nje kuphela. UKatlego Mphela angakhahlela ibhola, kodwa ngeke akwazi ukufaka igoli ngaphandle kwethimba lonke leBafana Bafana.

ART

Amakhondomu Abalingani abambalwa

Ukubambelela

PMTCT

Usizo lomphakathi

Ukuvinjelwa kuwumsebenzi wawo wonke umuntu, kungaba awunayo i-HIV noma unayo.

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1 Ukusetshenziswa kwamakhondomu ngendlela efanele kanye nokungaguquki 2 Ukusokwa ngokokwelashwa kwamadoda (MMC) 3 Ukwelashwa Ngemuva kokubekeka engozini 4 Ukuvinjelwa kokudluliselwa okusuka kumama kuye enganeni 5 Abalingani bocansi abambalwa 6 Ukwelashwa ngezidambisi gciwane 7 Ukufunda ngesayensi ye-HIV 8 Ukubambelela ekwelashweni okuhle 9 Ukunikeza abesifazane amandla 10 Imfundo 11 Usizo lomphakathi

Sonke sibhekene nomsebenzi wezimpilo zethu zocansi kanye nempilo yabalingani bethu esiya nabo ocansini. Uma ungenayo i-HIV, sebenzisa inhlanganisela yezindlela zokuvimbela ukuze uhlale ungenayo. Uma une-HIV, yenza okufanayo ukuqinisekisa ukuthi umlingani wakho uhlala engenayo / abalingani bakho bahlala bengenayo nokuvikela impilo yakho. Noma ngabe une-HIV kubaluleke kakhulu ukuthi uvimbele ukubuye utheleleke, okungabanga izinkinga ekwelashweni kwakho noma kukwenze ukuthi kungasebenzi ngempumelelo. (Ukuphinde utheleleke kwenzeka lapho muntu etheleleke ngohlobo olwehlukile lwe-HIV ukusuka kulowo obathelele kuqala.)

UKUVINJELWA OKUHLANGANISIWE

NguMarcus Low

Uzivikela kanjani uma uyindoda

1 Njalo uma uya ocansini sebenzisa ikhondomu. Qiniseka ukuthi ikhondomu uyisebenzisa ngendlela efanele. 2 Yenza ukusoka ngokokwelashwa. Ukusokwa ngokwelashwa kunciphisa ingozi yakho yokutheleleka ngo-60%. Ukusokwa ngokwendabuko akukuniki izinga elifanayo lokuvikeleka. Uma usokwe ngokwendabuko usangasokwa futhi ngokokwelashwa. (Bheka ikhasi 4-7 ukuthola kabanzi ngokusoka). 3 Nciphisa isibalo sabalingani bakho oya nabo ocansini. Yize ucansi oluphephile luyimpilo futhi lujwayelekile, ukuba nabalingani abaningi oya nabo ocansini kwandisa ingozi yokutheleleka njengoba ubebekeke engozini yokuthola igciwane kakhulu. 4 Uma udlwenguliwe, kubalulekile ukuthi uthole ukwelashwa kwangemuva kokubekeka engozini (PEP) emahoreni angama-72. Imithi ye-PEP inciphisa ingozi yokuba ne-HIV. Uma une-HIV futhi uphuza imithi eyizidambisi gciwane, ukubambelela ekwelashweni okuhle kanye nenani legciwane egazini eliphansi kuzokwenza ukuthi kucishe kungenzeki ukuthi uthelele umlingani wakho oya naye ocansini/abalingani bakho oya nabo ocansini. Kodwa-ke, ngoba ingozi encishisiwe inomkhawulo, kusabalulekile ukuthi usebenzise ikhondomu.

Kufanele uzivikele kanjani uma ungumuntu wesifazane

1 Njalo sebenzisa ikhondomu uma uya ocansini. Qiniseka ukuthi umlingani wakho ikhondomu uyifaka kahle. Noma ungasebenzisa ikhondomu yabesifazane, uma ekhona emtholampilo wangakini. Khumbula, unelungelo lokuthi cha ocansini futhi unelungelo lokuthi hhayi ocansini ngaphandle kwekhondomu. Uma umlingani wakho kungowesilisa, mkhuthaze ukuthi aye ekusokweni kokwelashwa. Uma elala nabantu abaningi, ukusoka kokwelashwa kuzomenza ukuthi abe mancane amathub okuthi atheleleke futhi buye abe mancane amathuba okuthi athelele wena. Nciphisa isibalo sabalingani bakho oya nabo ocansini. Ukwenza ucansi oluphephile kuyimpilo futhi kujwayelekile, kodwa uba nabalingani oya nabo ocansini abaningi kwandisa ingozi yokutheleleka njengoba kunamathuba amaningi okuthi ubekeke engozini yegciwane. Uma udlwenguliwe, kubalulekile ukuthi uthole ukwelashwa kwangemuva kokubekeka engozini emahoreni angama-72. Imithi ye-PEP inciphisa ingozi yakho yokuba ne-HIV.

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Uma une-HIV futhi uphuza imithi eyizidambisi gciwane, ukubambelela ekwelashweni okuhle nokunciphisa inani legciwane egazini kuzonciphisa amathuba okuthi uthelele abalingani bakho oya nabo ocansini. Njengoba ingozi encishisiwe inomkhawulo, kusabalulekile ukuthi kusetshenziswe ikhondomu. Funda kabanzi ngokuvikela umntanakho ekhasini 14.

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UKUVINJELWA OKUHLANGANISIWE

Ukusoka kokwelashwa kwamadoda kuqhathaniswa ne-HIV

I-World Health Organization incoma ukusokwa kwamadoda ngokokwelashwa njengengxenye ebalulekile yemizamo yokuvimbela i-HIV.

Isithombe ngu-Aliza Waxman

Amadoda athandana nabobulili obuhlukile asokile ahlala esengozini ephezulu yokuthola i-HIV uma engawasebenzisi amakhondomu lapho eya ocansini. Nakuba ingozi incishisiwe, zonke izindlela zokuvimbela kufanele ziqhuthsekwe zisetshenziswe. Ukusoka kufanele kukhuthazwe ngendlela yokuthi akuholeli amadoda ekucaangeni ukuthi angaya ocansini oluyingozi uma sebesokile.

UKUVINJELWA OKUHLANGANISIWE

Yini ukusokwa kwamadoda ngokokwelashwa?

Ukusokwa kwamadoda inqubo eyenziwayo ukuthi kususwe ijwabu langaphambili lompipi womuntu wesilisa. Lokhu bekwenziwelwa izizathu zezenkolo kanye nesiko izinkulungwane zeminyaka. Ngokusoka ngokokwelashwa sisho ukuthi ijwabu lisuswa ngokuhlinzwa lisuswe ngaphansi kwezimo ezihlanzekile nokwenziwa ukuthi kube ndikindiki ngumuntu oqeqeshiwe kusetshenziswa amathuluzi okuhlinza kanye namasu amukelekile kuphrofeshini yokwelapha. Ukusoka kwabantu besilisa kufanele kuhlukaniswe ekulinyazweni kwezitho zokuzala zabesifazane (female genital mutilation-FGM), okusenziwa kwamanye amazwe. I-FGM ibandakanya ukusikwa kususwe izitho zokuzalana zabesifazane, kubandakanya ubhontshisi wakhe kanye nezindebe ezingaphakathi. I-FGM isolwa njengokuhlukunyezwa kwamalungelo abantu futhi kunomthelela omubi kakhulu empilweni yabesifazane, esithunzini nasekuzimeleni.

e-Afrika, okuhlukaniswa ngokungahleli iqembu elikhulu lamavolontiya amadoda angasokile athandana nabobulili obuhlukile angenayo i-HIV abe ngamaqembu amabili, elinye elabe selisoka ngaleso sikhathi. Kulo lokuthathu ucwaningo amadoda amathathu ayenengozi yokutheleleka nge-HIV ephansana. Ucwaningo lwamanje nalo luphakamisa ukuthi: · Amadoda asokile anamathuba amancane okutheleleka nge-herpes (i-herpes simplex virus uhlobo 2). Amadoda asokile nawo kubukeka sengathi mancane amathuba okuthola ezinye izifo ezisatshalaliswa ngocansi, ezifana nama-ulcer ezitho zokuzalana kanye negonoriya. · Amadoda asokile mancane amathuba okuthi athole umdlavuza wompipi kunamadoda angasokile. · Abafana abasokile mancane amathuba okuthi bathole izifo zomgudu womchamo · Abalingani besifazane bamadoda asokile banamthuba amancane okuthola umdlavuza womlomo wesibeletho. Amadoda asokile mancane amathuba okuthi atheleleke, noma athelele abalingani bawo ngegciwane i-human papilloma virus (HPV). Ezinye izinhlobo ze-HPV zixhumene nomdlavuza womlomo wesibeletho.

Izinzuzo zempilo zokusoka

Ukusoka kunciphisa ingozi yendoda yokuthola i-HIV uma iya ocansini nowesifazane ngo-50%60%. Lokhu kukhonjiswe ngokucacile ezifundweni zocwaningo ezintathu. Lezi zifundo, zonke zenziwa

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Izingozi zempilo zokusoka

Izingxaki zenzeka ngephesenti elincane lokusoka ngokokwelashwa ngoba kuyinqubo yokuhlinza. Ezimeni eziningi kakhulu lezi zingxaki ziyaxazululwa. Ezimeni ezingajwayelekile kakhulu ukufa kwenzekile. · Amanye amadoda asokile athi ukusebenza kwawo kocanssi kwehlile, noma imipipi yawo izwela kancane emva kokusoka. Kodwa-ke amanye amadoda abika ukwaneliseka osekwenzeke ngcono emva kokusoka. · Ngesikhathi umpipi uphola emva kokusoka (lokhu kuthatha amasonto ayisithupha), ingozi yokudluliseka okusuka endodeni ene-HIV kuya kumlingani wesifazane ongenayo i-HIV kungenzeka ibe nkulu kakhulu kuneyendoda engasokile. Kubalulekile ukweluleka amadoda ukuthi angayi ocansini ngalesi sikhathi. Ubufakazi besayensi buyamangalisa: emphakathini lapho kunabantu abaningi khona abane-HIV, kunezinzuzo zempilo ezicacile ekusokeni kwabesilisa. Lezi zinzuzo zedlula izingozi ezincane uma inqubo yenziwa ngokuphepha.

Ikhasi lamaqiniso lasekuqaleni ngu-Nathan Geffen ngosizo oluvela ku-Mark Heywood. Lithathelwe ku-Equal Treatment nguMarcus Low. Imithombo: World Health Organization iphakheji yoKusoka Kwamadoda Ukuze Kuvinjelwe I-HIV (www.who.int/ hiv/topics/ malecircumcision/en/); Auvert et al. `Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial.' PLoS Med. 2(11):e298. (Nov 2005) Epub 25 Oct 2005.

Ukusoka ngokokwelashwa kuqhathaniswa nokwendabuko

Uhlolo olukhombisa ukuthi ukusoka kunciphisa ingozi endodeni yokuthola i-HIV lubheka sengathi ukusoka kwendabuko akunikezi ukuncishiswa kwengozi okufanayo. Esinye isizathu esinokwenzeka ukuthi ijwabu langaphambili alivamisile ukusuka ngokuphelele ekusokeni kwendabuko. Uma ngabe wawusokwe ngokwendlela yendabuko, usangasokwa ngokokwelashwa futhi uqniseke ukuthi uthole ukuvikeleka okwandisiwe. Abafana abaningi kanye nezinsizwa basokwa njengengxenye yenkolo noma yemigubho yendabuko. Lokhu kusoka akuvamile ukuthi kwenziwe ngongcweti bezokwelapha futhi bakwenza kaninggi ezimeni ezingahlanzekile. Akwenziwa ngaphansi kwemithi yokwenza ukuthi kube ndikindiki futhi kube nemibiko eminingi yokungakwazi ukukwenza ngendlela okwaholela ekutheni abafana balaliswe esibhedlela. Imikhuba yokusokwa kwamadoda kwendabuko nokwenkolo kufanele kuvunyelwe, kodwa uhulumeni kufanele aqiniseke ukuthi kwenziwa ngokuphepha nangokuhambisana nemithetho yokusoka. Kufanele kwenziwe ngabantu abaqeqeshwe ngendlela efanele kusetshenziswa impahla yokuhlinza ehlanzekile.

Isithombe ngu- Damien Schumann

kuphela ekusokeni kwamadoda ngokokwelashwa. Ocwaningweni olukhona kubukeka

UKUNCISHISWA kwengozi akusho ukuthi AKUKHO ngozi

Ukuvama ukuya ocansini kubandakanya ingozi encane, kodwa kanjalo nokuqhuba imoto. Ngoba kunengozi ebandakanyeka ekuhambeni ngemoto akusho ukuthi uzoyeka ukuze ubeke umkhawulo engozini yokuba nengozi. Uma ukwazi ukukhetha, ungala ukuhamba ngemoto esesimeni esibi. Futhi ungabopha ibhande njalo. Ungala futhi ukungena emotweni eshayelwa umshayeli odakiwe. Uzoba nokuphepha okukhulu kakhulu um uthatha zonke lezi zindlela zokuqapha. Ucansi luyafana. Uma umthanda umlingani wakho uzofuna futhi abe nokuphepha okukhulu kakhulu. Ukusoka ngokokwelashwa, ukusebenzisa ikhondomu ngendlela efanele nangokungaguquki, nokuhlonipha umlingani wakho oya naye ocansini konke

Isithombe ngu-Jenny Matthews/Panos Pictures

kunganciphisa ingozi yokuthi wena ungatheleleki nge-HIV.

UKUVINJELWA OKUHLANGANISIWE

ukuhamba ngayo. Kodwa-ke, kunezindlela zokuqapha eziphephile ongazithatha

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Ukusoka kwamadoda ngokokwelashwa kusiza wonke umuntu

Ukusoka kwamadoda ngokokwelashwa kwenza ukuthi kube nzinyana ukuthi igciwane lisabalale emphakathini.

Ilmifanekiso ngu-Brice Reignier

UKUVINJELWA OKUHLANGANISIWE

Siyazi ukuthi uma indoda isokwe ngokokwelashwa, amathuba ayo okuthola i-HIV ancishiswe ngo-60%. Kodwa njengoba ukusoka kunciphisa amathuba okuthi indoda ithole i-HIV kowesifazane, akuwanciphis ngokuqondile amathuba owesifazane okuthola i-HIV endodeni. Inzuzo engaqondile, kodwa-ke, inkulu. Kusebenza kanje: ­ ­ _ Njengoba amadoda amaningi esoka ngokokwelashwa, ambalwa amadoda azoba ne-HIV. Lokhu kusho ukuthi uma uya ocansini nendoda esokile, amathuba akho okuthola igciwane azoba phansi ngoba mancane amathuba okuthi atheleleke. Ngakho-ke, ngokusoka kwamadoda ngokokwelashwa, abesifazane abambalwa kanye namadoda ambalwa azotheleleka, kunciphisa inani le-HIV emphakathini.

Lokhu akusho ukuthi kufanele siyeke ukusebenzisa amakhondomu. Khumbula, INGOZI ENCANE AKUSIKHO UKUNGABI BIKHO KWENGOZI!

Amakhondomu kanye nokusoka kwamadoda ngokokwelashwa kunikeza ukuvikeleka okuhle kakhulu.

6

Kwenzekani emtholampilo?

INingizimu Afrika inikezela ngezinsizakalo zokusokwa kwamadoda ngokwelashwa (VMMC) njengengxenye yomgodla wezinsizakalo zezempilo zamadoda. Nakhu ongakulindela uma uyokwenza i-VMMC. 1. Ukwelulekwa ngokwengqondo: Uma ufika emtholampilo uzonikezwa ulwazi olubalulekile ngokuthi kusho ukuthini ukusoka ngokokwelashwa nokuthi ingaba yini imiphumela yalokho kuhlinzwa. Izinzuzo nezingozi zokusoka kwamadoda ngokokwelashwa (VMMC) kuzoxoxwa ngazo nomsebenzi wokusoka oqeqeshiwe nonolwazi. 2. Imvume enolwazi: Emva kokuthola ukwelulekwa ngokwengqondo, kukuwe ukunquma ukuthi ingabe uzosokwa ngokokwelashwa yini noma cha. Nakuba siwakhuthaza amadoda ukuthi asokwe, asenalo ilungelo lokwala. 3. Umsebenzi wokuhlinzwa ophephile: Emva kokuba unikeze imvume yakho enolwazi, umsebenzi osokayo uzokwenza inqubo mahhala ngesu elihlanzekile ngaphansi kokwenziwa ndikindiki kwalapho okuzohlinzwa khona. Lokhu kusho ukuthi angeke ubuzwe ubuhlungu ngesikhathi senqubo. Umsebenzi uzolisusa ngokuphelele ijwabu langaphambili. Ukususwa ngokuphelele kuphela kwejwabu langaphambili okungaholela ekuncipheni kwengozi yokutheleleka nge-HIV. 4. Ukwelulekwa kwangemuva kokuhlinzwa: Ukwelulekwa ngokwengqondo ezintweni zokunakelwa kwangemuva kokuhlinzwa kuzonikezwa ukuze kuzosheshe kubonakale nanoma yiziphi izinkinga. Emva kokuhlinzwa kubalulekile kakhulu ukuthi ungayi ocansini umsebenzi osokayo aze aqinisekise ukuthi inxeba selipholile ngokuphelele. Ngokujwayelekile, kuthatha amasonto ayisithupha ukuphola. Ukuya ocansini ngaphambi kokuba inxeba liphole kuzokwandisa ingozi ye-HIV kuwe nakumlingani wakho. isibonelo, uma uye ngenxa yezinsizakalo zempilo yamadoda kanye nezokuzalana zocansi, ukuvinjelwa kwe-HIV, ukwelulekwa ngokwengqondo nezinsizakalo zokuhlolwa noma uma wena noma umlingani wakho nifinyelela empilweni kamama nasezinsizakalweni zokuhlela umndeni. Uhulumeni uhlose ukuthi abe nezindawo zosizo eziningi zezempilo kangangoba kunokwenzeka ezinika i-VMMC. Lezi zindawo zosizo, kodwa-ke, kuzodingeka ukuthi zihlangabezane nezindlela ezincane zokukhetha njengoba kweluleke i-World Health Organisation (WHO). Okokuqala okuphambili ohlwini kokuqala kuzonikezelwa i-VMMC ezibhedlela zezifunda. NgoMashi 2010, uNgqongqoshe Wezempilo u-Aaron Motsoaledi wamemezela ukuthi izindawo zosizo lwezempilo zikahulumeni KwaZulu-Natal zizonikezela nge-VMMC ukusuka ngo-Ephreli 2010. Izoba khona i-VMMC eNyakatho Kapa naseMpumalanga ngoDisemba 210 nakuzo zonke izifunda ngo-2011.

Isithombe ngu-Aliza Waxman

NguCatherine Karlsson

Izinsizakalo kakhulu zinikezelwa amadoda aneminyaka eyi-15 -49 ubudala. Ukusoka ngokokwelashwa nakho kuzonikezelwa ngokwenjwayeleo kubabheki bezingane ezisandakuzalwa ezinezinyanga eziyisithupha ubudala. Futhi, amadoda asokwe ngokwendlela yendabuko kufanele acabange ngokuyosoka ngokokwelashwa (bheka `ukusoka ngokokwelashwa kuqhathaniswa nokwendabuko' ekhasini 5). Amadoda atheleleke nge-HIV angeke alelwe ukusoka ngokokwelashwa.

Ngingayithola kuphi i-VMMC?

Iziqondiso zoMnyango Wezempilo zithi izinsizakalo ze-VMMC kufanele zihlinzekwe ngendlela ehlangene enamaphuzu amaningi okudluliselwa nawokuthintana. Lokhu kusho ukuthi i-VMMC ingaphakanyiswa kuwe,

UKUVINJELWA OKUHLANGANISIWE

Ubani ongayithola?

7

Indaba kaThabo

Embuzweni othi ngabe amadoda ayaqonda yini ukuthi kusafanele asebenzise amakhondomu ngisho ngabe asokile, uThabo uphendule wathi, "amanye amadoda ayaqonda, amanye awaqondi. Kusenamadoda akholelwa ukuthi uma usokile kungenzeka ungazitholi izifo ezithelelana ngocansi (STI), kubandakanya i-HIV. Kubalulekile njalo ukusebenzisa amakhondomu ngisho ngabe usokile ukuze unciphise izingozi futhi uthokozele izinzuzo." Amadoda afana noThabo akhulela emalokishini angazange asoke ngokwendabuko ngezinye izikhathi abizwa ngokuthi "inkwenkwe" (abafana

Isithombe nguLefa Tlhame

abancane). Uthi, "Lokhu [....] kungiphatha kabi ngoba ngafundiswa ukuthi [....] ubahlonipha kanjani bobabili abantu besilisa nabesifazane futhi [mina] ngaba uba ophumelele." UThabo uyawahlonipha amagugu amasiko abanye abantu kanye nezinkolelo zabo kodwa uyakukhuthaza ukwenza okuphephile. "Futhi ngisacabanga ukuthi ukusoka ngokwendabuko ngaphandle kwemvume kudelela amalungelo ocansi kanye nawokuzalana [...] amadoda. [Abanye] abazali bayaziphoqa izingane zabo ukuthi ziyosoka ngenxa nje [...] yenkolo yomndeni noma yezinkolelo zamasiko." UThabo uthi, ekhomba ukuthi kuphephaphephile, kubuhlungu kancane futhi kwenziwa ngaphaansi kwezimo ezihlanzekile ngodokotela abaqeqeshiwe, akufani nokusoka okuningi kakhulu kwendabuko "Ngifuna ukukhuthaza amanye amadoda ukuthi acabange nge-MMC." Okokugcina, ngifuna ukukhuthaza amanye amadoda ukuthi asebenzise amakhondomu noma nini uma eya ocansini.

UThabo uneminyaka engama-34 ubudala ohlala eKatlehong. Akasilo ilungu le-Treatment Action Campaign (TAC) kodwa weseka umsebenzi we-TAC. Akanayo i-HIV futhi unobudlelwano obuqinile nomlingani one-HIV. UThabo wasokwa ngokokwelashwa eminyakeni engama-20 eyadlula lapho wayeneminyaka eyi-14. "Nganginesifo somgudu womchamo ngase nginquma ukukhuluma nonesi wesilisa engangimazela ngasekhaya. Wangiihlelela ukuthi ngiyolaliselwa i-MMC. Yenziwa ngaphansi kokwenza ndikindiki eduze kwalopho eyayenziwa khona ngudokotela oqeqeshiwe okwavimbela ubuhlungu [ngase ngithola] ukweluleka ngokwengqondo ngobuhle bakho". "Kufanele ngisho ukuthi nganginenhlanhla ukuthi ngelashwe kanjalo. Kodwa-ke, ngaqala ngezwa ubuhlungu emva kosuku [kodwa...] ngasinda kahle emva kwwamasonto ambalwa".

Acabangani amadoda nge-MMC

UKUVINJELWA OKUHLANGANISIWE

U-December Madonsela. indoda eneminyaka yobudala engama-31 evela eMzinoni elokishini, eGert Sibande. Uyisekela sihlalo legatsha lakhe le-TAC. U-December uyacabanga nge-VMMC. A: (Uhleko) Ha ha! Yebo, ngiyaqonda ukuthi ukusoka akungeni esikhundleni sokusetshenziswa kwamakhondomu. Kodwa-ke, kuyenzeka ukuthi kwenze ukuthi abanye bangasanaki ukusebenzisa amakhondomu. Kodwa ngicabanga ukuthi izinhlangano ezifana ne-TAC zingasebenza kakhulu ngokusabalalisa ulwazi emiphaakathini, ukuze abantu bethu bezokwazi kakhudlwana.

Ingabe uyakuqonda ukuthi ukusoka akungeni esikhundleni sokusebenzisa amakhondomu?

8

U-K owesilisa oneminyaka engama-37 ubudala owasoka ngendlela yendabuko. Wacela ukuthi ubuyena bugcinwe buyimfihlo ngokwesaba ukuthi abaholi bomphakathi nabendabuko bangahle bamhluphe. U-K ukhathazeke ngokuthi bangamhlawulisa izinkomo eziningi futhi babe belokhu beqhubeka nokumhlupha. Uvele esikweni lamaNdebele lapho ukusoka kugunyaziwe kubafana abasebencane asebengena ebudodeni.

ukuthi sinikwe ukudla ngesitsha esisodwa esizokudla sonke, sidle ngazo lezo zandla ezingcolile. Impahla eyayisetshenziselwa ukusika ijwabu yayisetshenziswa kubantu abangaphezu koyedwa. Kwakungekho zihlanzisisi njengoba ngitshelwa ukuthi zikhona ezindaweni eiyizibhedlela, uhlelo lonke lwalungcolile nje.

Lwalunjani ulwazi lwakho lokusoka kwendabuko?

A: Uma sengibheka emuva ngiyabona ukuthi uhlelo lwaluyingozi kakhulu futhi lungaphephhile. Kodwa yisiko. Lapho besusa ijwabu langaphambili, kwakufanele sisebenzise amanzi afanayo ukuzigeza. Lapho sihlezi sasilokhu sithinta imipipi yethu ngokwejwayelekile, siyihlanza ngezandla zethu bese kuthi ngokushesha emva kwalokho, kwakungenzeka

Kungani ucabanga ukuthi abantu besiko lakho bancamela ukusoka kwendabuko?

A: Siya ekusokeni kwendabuko ngoba, okokuqala, uma ukugwema, kungenzeka ukuthi ungemukelwa emndenini wakho nasemphakathini njengendoda. Okwesibili uyatshelwa ukuthi kungenzeka ukuthi ube nobunzima namadlozi akho, kangangokuba ungaba nezinselele empilweni yakho uqobo. Amadlozi akho ayokulahla kuze kube wenze lolo hlelo lwendabuko.

U-Carlton Malinga indoda eneminyaka engama-30 ubudala engasokile evela elokishini laseMzinoni eBethal, eGert Sibande. Ucabanga ngokwenza i-VMMC.

Kwakuyini izizathu ezazikwenza ukuthi ungasoki esikhathini esidlule?

A: Bekubngelwa ukuthi ngesiko lami (Swati), [...] bekungasokwa. Ababaningi emndenini wami noma kubangani bami ebebekhuluma ngokubaluleka kwakho. Ngenxa yalezi zizathu bekungesiyona into ehamba phambili ohlwini.

Isithombe nguMalusi Mbatha

USibusiso Mnisi owesilisa oneminyaka yobudala engama-27 ovela elokishini laseMzinoni eBethal Village, eGert Sibande. Wasoka ngokokwelashwa ngonyaka ka-1998 eSibhedlela i-Bethal ngenxa yokuthi wayene-STD.

Siyini iseluleko sakho emadodeni angasokile?

Iseluleko sami "Emajitheni" (amadoda) ukuthi kufanele benze i-VMMC ukuze bagweme ama-STI. Siphila ezikhathini ezinzima lapho kune-HIV/AIDS khona. Ukusoka kuzosiza ukuqeda lesi siqalekiso esibulala abantu abaningi elokishini lami.

Isithombe nguMalusi Mbatha

UKUVINJELWA OKUHLANGANISIWE

9

kuseyisivikeli sakho esingcono kakhulu:

Ngu-Catherine Karlsson

amakhondomu

Yisiphi isivimbeli nzalo esivimbela izifo ezisatshalaliswa ngocansi (kubandakanya i-HIV) kanye nokukhulelwa ngempumelelo yama-95%? Eminye imikhondo: 1. Ungawathola mahhala. 2. Akunamiphumela emibi ngokwezokwelapha ngaphandle nje kokuzwela kwe-aleji okuncane. 3. Enza ukuthi ucansi lungabi ubudlabha kakhulu. 4. Adingeka kuphela uma uya ocansini ngempela, akufani nezinye izivimbeli nzalo okufanele uziphuze ngaphambi kwesikhathi. La mathuluzi wusizo lokuya ocansini okuphephile anomlando omude kabi owawukhona nale emuva ngo-1000 BC. Kukholelwa ukuthi amaGibhithe akudala ayesebenzisa ishidi lelineni ukuzivikela ezifeni Ukuze asebenze ngempumelelo ngokunokwenzeka, amakhondomu kufanele asetshenziswe kahle futhi kungaguquki. Amakhondomu asebenza ngempumelelo engama-95% kuphela uma esetshenziswa njalo uma uya ocansini. Woza ku-Equal Treatment sizokukhombisa ukuthi ukwenza kanjani ukusetshenziswa kwekhondomu ukuthi kusize, kube yimpumelelo futhi kube kuhle. ezithathelana ngocansi. Ngenhlanhla mina nawe, isimo sawo nesokwakheka sasaguquka emva kwamakhulukhulu eminyaka. Abenzi bamakhondomu bayaqhubeka nokuhlola futhi nokulinga ngezimo zokwakheka zamakhondomu, osayizi kanye nezinto zokwakha ukuze kuqinisekiswe ukuthi amakhondomu anakho kokubili ukuthokozisa nokunikeza ukuvikeleka okuphezulu kakhulu kangangoba kunokwenzeka. Amakhondomu angasetshenziswa ngesikhathi socansi lwasendunu, lomlomo kanye nolwasesithweni sowesifazane sangasese.

Izinto zihamba kahle kakhulu kuSipho. Ngiyamthanda ngempela. Ngicabanga ukuthi sesikulungele ukungena esigabeni esilandelayo, uma uzwa ukuthi ngisho ukuthini.

UKUVINJELWA OKUHLANGANISIWE

Nomalanga, ngempela? Awu ntombazane, kwakuhle! Ekugcineni usuzowuthola umnyakazo wakho. Qiniseka nje ukuthi awuzehlisi izinto ngokuthi ube nengane engahlelelwe noma okubi kakhulu, ungcolise ubumnandi bakho ngama-STI angasile.

Heyi, izinto zihamba kahle kakhulu noNoma. Siphumile izikhathi ezimbalwa, futhi ngicabanga ukuthi sesikulungele ukuthi siye ekhaya sobabili. Angikwazi! Kwenze ndoda! Ufuna ikhondomu, noma sewuvele unayo?

10

Yini ikhondomu yabesilisa?

Ikhondomu yabesilisa ishidi eliyirabha le-latex elipetepetekayo, elenzelwe ukumboza umpipi ngesikhathi socansi lomlomo, lwendunu noma lwesitho sowesifazane sangasese. Ngiyisebenzisa kanjani? 1. Hlola ukuthi alikadlulelwa yini isikhathi sokusebenza. 2. Vula iphakethe lamakhondomu ngokucophelela; ukuze ugweme ukudabula ikhondomu ngokwayo, iphakethe ungalivuli ngamazinyo akho. 3. Qiniseka ukuthi ikhondomu isesimeni esihle. Amakhondomu ayaphazamiseka ukushisa nokukhanya. Ngakho-ke, musa ukusebenzisa ikhondomu ebeyigciniwe, isibonelo, ephaketheni lakho elingemuva, kuwalethi noma endaweni yamagilavu emotweni. Uma ikhondomu izwakala inamathela noma yome kakhulu akufanele isetshenziswe njengoba kungenzeka ukuthi iphakethe selimoshekile. 4. Beka ikhondomu eligoqiwe phambili empipini oqinile. Qiniseka ukuthi ichopho lompipi libheke ngaphandle ukuze ikhondomu izogoqeka yehle kalula. Uma ufaka ikhondomu uyiphendukezela, ngokushesha ilahle esikhundleni sokuyisebenzisa uyizame futhi, njengoba uketshezi oluphuma ngaphambi kokuchama kanye nolunye kungenzeka ukuthi sekuvele kukukhondomu. 5. Mpintsha ichopho lekhondomu ukuqinisekisa ukuthi umoya wonke uyaphuma. Amabhamuza omoya kungenzeka ukuthi aqhumise ikhondomu.

6. Uma umpipi ungasokile, ijwabu lidonsele emuva ngaphambi kokuba ufake ikhondomu. 7. Bamba ichopho lekhondomu ngesandla esisodwa bese ulivula ulifake empipini ngesinye isandla. 8. Uma ufuna ukuthamba okwengeziwe, kufake ngaphandle kwekhondomu. Njalo sebenzisa isithambisi esinamanzi kumakhondomu e-latex njengoba ezinguwoyela njenge-baby oil noma uVaseline kungalimaza i-latex. 9. Uma injabulo seyiphelile, ngokushesha khipha umpipi esithweni sowesifazane sangasese ubambe ichopho lekhondomu ngesinye isandla. 10. Ikhiphe ikhondomu, bopha ekugcineni, bese uyilahla emgqonyeni kadoti. Ungayifulashi ethoyilethi njengoba ilimaza imvelo futhi ingabanga ukubhlokheka kwamapayipi amanzi.

Bhanqa amakhondomu noma iphutha abe mabili, uvikeleke ngokuphindwe kabili? Akusilo yini iqiniso ukuthi ukusebenzisa ikhondomu elingaphezu kwelilodwa kuzoqinisekisa ngisho ngokunye ukuvikeleka okuthe xaxa? IPHUTHA. Ukusebenzisa amakhondomu angaphezu kweyodwa kwenza ukuhhudlana, okubangela ukuthi amakhondomu adabuke kalula. Lokhu empeleni kunikezana ukuvikeleka okuncane. Abalingani kufanele basebenzise kuphela ikhondomu yabesifazane noma yabeilisa, hhayi omabili! Udinga eyodwa ngesikhathi.

Iqiniso

Amaqiniso enjabulo:

Ikhondomu yabesilisa efakwe emgodleni ingahlala okungenani iminyaka emihlanu. Ikhondomu yabesilisa ngokujwayelekile iyakwazi ukugcina amalitha ayi-18 omoya. Ingaphatha amalitha ayisikhombisa amanzi.

Yebo, yebo, kodwa ukusebenzisa ikhondom njalo kuphazamisa izinto. Ngifuna ukuqhubeka nesimo, uyabona?

Hhayi-ke, indlela kuphela yokuthokozela ivosi, ntombi, yilapho iminsimithi ifakwe ngaphakathi ethunjini, kungenjalo angeke lelo vosi libe mnandi futhi lingakunika ushevu otholakala ekudleni okonakele ... kuphela nje ukuthi angeke kube yisisu sakho esizokunika izinkinga!

Yebo, kukhona engiwathole emtholampilo, kodwa angazi ... uyazi ukuthi angakuphatha kabi kanjani. Ngezinye izikhathi awengeneli, uyazi ukuthi ngisho ukuthini.

Yebo, ngiqinisekile umkhulu kangako! Hhayi bo, ngezwa kuthiwa amakhondomu angaphatha amalitha amanzi ayi-7 kanye namalitha ayi-18 omoya. Ngimkhulu nami, kodwa akekho umuntu omkhulu kangako.

11

Yini ikhondomu yabesifazane?

Ikhondomu yabesifzane ikhava ye-polyurethane encane egqokwa ngabesifazane ngesikhathi socansi lwesitho sabesifazane sangasese. Ivala isitho sangasese sowesifazane ngokuphelele futhi isize ukuvimbela ukukhulelwa kanye nezifo ezithathelana ngokocansi kubandakanya i-HIV. Ikhondomu yabesifazane indlela kuphela yokuvimbela ekhona eyenzelwe ukuthi owesifazane aqale. Amakhondomu abesifazane avumela abesifazane ukuthi bahlale belawula imizimba yabo, bangathembeli endodeni ukuthi izoza nekhondomu futhi iyisebenzise ngendlela efanele. Ngiyisebenzisa kanjani? 1. Vula iphakheji ngokucophelela futhi uqiniseke ukuthi ikhondomu ithanjisiwe ngokwanele ukuthi ingafakwa ngaphandle kokukuphatha kabi noma ngobunzima. 2. Qiniseka ukuthi isiphetho sekhondomu sabesifazane neringi evalekile kungena ngaphakathi kowesifazane. Ikhava ibambe indawo evulekile ilengele ngaphandle. 3. Cindezela iringi engaphakathi ngesithupha nomunwe

Iqiniso noma iphutha

4. Faka ngesineke iringi engaphakathi esithweni sowesifazane sangasese uyizwe ikhuphuka. 5. Beka umunwe oyinkomba ngaphakathi kukhondomu bese uyifuqa iringi engaphakathi iye kude kangangoba ingakwazi. 6. Qiniseka ukuthi ikhondomu ifakwe yaqonda futhi ayisongene. Iringi engaphandle kufanele ihlale ingaphandle kwesitho sowesifazane sangasese bese ikhava ingxenye yesitho engaphandle. 7. Emva kocansi, susa ikhondomu yabesifazane bese uyilahla emgqonyeni kadoti.

Yini ubuhle bekhondomu yabesifazane?

· · Ivumela abesifazane ukuthi balawule imizimba yabo. Izovikela ekukhululweni nakuma-STI uma isetshenziswe ngendlela efanele futhi isetshenziswa njalo. · Ikhondomu yabesifazane ingafakwa ukufika kumahora ayisishiyagalombili ngaphambi kocansi. Ngamanye amazwi, ayifani nekhondomu yabesilisa, akukho khefu okufanele lithathwe ngalesi sikhathi sekuxinekiwe. · I-polyurethane mancane amathuba okuthi abange ukuzwela kwe-aleji kune-latex. Kwabathandanayo abane-aleji ku-latex, amakhondomu abesifazane enye indlela esebenzayo.

ophakathi nendawo (ukuze ibe yinde futhi ibe ncane).

Kuyalimaza ukusebenzisa ikhondomu.

IPHUTHA. Amakhondomu akhiqizwa ngokucophelela ukuze kungabi bikho nanoma yibuphi ubuhlungu ngesikhathi esetshenziswa. Uma uzwa ubuhlungu uma usebenzisa ikhondomu kungenzeka ukuthi uyezwela ku-latex. Kuleso simo ungashintshela kumakhondomu angenayo i-latex. Uma inkinga isalokhu ikhona emva kokushintsha amakhondomu, kungenzeka ukuthi ikulimaza ngoba unesifo. Kuleso simo kufanele ubonane nodokotela.

Kwenzekani uma ecabanga ngami ngendlela ehlukile? Uyazi ukuthi abanye abantu baba njani ­ bayaxaka nje uma ubacela ukuthi basebenzise ikhondomu. Ngiyamthemba uSipho, uyindoda elungile. Angeke enze lutho engangilimaza.

UKUVINJELWA OKUHLANGANISIWE

Lokhu akuhlangene nalutho nokuthi ungumuntu omuhle yini noma cha! Kungenzeka nokuthi akazi ukuthi uthelelekile! Futhi uma eyindoda enhle kanjalo, uzofuna ukukuvikela wena uqobo kanye naye azivikele futhi. Umzimba wakho ntombazane nempilo yakho!

Kulungile, kulungile kodwa ngifuna ukumuzwa nje, ungakhathazwa yikho konke lokho. Ngiyacabanga ukuthi ufuna ukuzwa futhi lapho into yakho seyiluma isigcwele izinsumpa ezibangwa ama-STI! Khuluma ngokukhathazeka, eyishi! Ngempela, Sipho ungamuzwa ngezindlela eziningi ezinye, ikhondomu akusilo ubala! Futhi ngiqinisekile ukuthi nina nobabili ningathola izindlela ezinhle zokuthi yena akufake lona.

12

Iqiniso noma iphutha

Ukusoka kufana`nekhondomu engabonakali' ­ akusilo yini iqiniso ukuthi akufanele ngifake ikhondomu uma sengisokile?

Izaba nezimpendulo

Kungenzeka ukuthi uzithole usesimeni lapho umlingani wakho ezama "ukuphuma" ekusebenziseni ikhondomu. Khumbula, yilungelo lakho ukugcizelela ekusebenziseni ikhondomu kanti ngokuyisebenzisa uvikele nina nobabili wena nomlingani wakho. Ucansi luthokozeleka kakhulu uma ngabe bobabili abalingani bephatheke kahle futhi bethokozile; ucansi oluphephile luyingxenye enkulu yalokhu. Ungamvumeli umlingani wakho ukuthi abeke ikusasa lenu nobabili engozini. Bheka ikhathuni ubone izaba ezinye ezejwayelekile. Khumbula: Nangale kokuthi uyayisebenzisa yini ikhondomu yabesifazane noma yabesilisa, qiniseka ukuthi uyisebenzisa esenzweni socansi lonke. Lokho kusho ukuthi, ngokushesha emva kokukhunyulwa kwezimpahla ­ kufanele kugqokwe amakhondomu. Futhi, qiniseka ukusebenzisa ikhondomu entsha esenzweni esisha ngasinye. Zithokozise!

IPHUTHA. Nakuba ukusoka kowesilisa ngokokwelashwa kunciphisa amathuba amadoda okutheleleka ngama-60%, kusenengozi enkulu yokutheleleka. Ngakho-ke, ukusoka kukunika ukuvikeleka okunccane kuphela. Ukusoka akusiyo `ikhondomu engabonakali' futhi amadoda kusafuneka ukuthi bawagqoke amakhondomu ukuze bazivikele kanye nabalingani babo.

Izinga lokuhambisa amakhondomu abesilisa 2007/08

Insumansumane

5 and nangaphansi 6­7 8­9 10­11 12 nangaphezulu

Amakhondomu wonke asehanjiswe eNingizimu Afrika:

Angaphezu kwezigidi ezingama-350 zamakhondomu abesilisa ahanjiswa ngonyaka ngokufuneka kwawo eMnyangweni Wezempilo. Nangale kokuhanjiswa okusezingeni eliphezulu kwamakhondomu engxenyeni yezempilo kahulumeni, kuyenzeka ngezinye izikhathi ukuthi imitholmpilo iphelelwe yisitokwe. Lena inkinga enkulu kanti i-Treatment Action Campaign (TAC) izoqhubeka nokukhankasela ukutholakala kwamakhondomu okungcono.

Le mephu ikhombisa inamba yamakhondomu ahanjiswa kumuntu ngamunye ngonyaka ezifundeni ezahlukene eNingizimu Afrika ngonyaka ka-2007-2008. Kukhombisa ukuthi sisahambisa amakhondomu ambalwa kakhulu eNingizimu Afrika. Sidinga ngokushesha ukuthi sikhuphule izinga lokufinyelela kumakhondomu ukuze kusize ukunciphisa izifo ezintsha. Umthombo: Day C. et al. The District Health Barometer 2007/08. Durban: Health Systems Trust; June 2009. Imithombo: Abrahamson and Pinkerton, `Effectiveness of Condoms in preventing HIV transmission', Social Science and Medicine, Volume 44, Issue 9 (1997); www.hst.org.za; www.avert.org; www.hst.org.za; www.rfsu. se; www.kondom.nu. (Iwebhusayithi kwafinyelelwa kuyo ngoMeyi 2010.)

Ikhathuni yenziwe ngu-Brice Reignier

Yebo, ngiyikhathalela kakhulu impilo yami neyakhe ukuthi ngingazibeka engozini kanjalo. Ngiba nesitresi ngocabanga ngakho nje! Unayo ikhondomu engingayisebenzisa? Sawubona, Sipho. Bengikhuluma ngawe. Kukhona engisiphathele khona namhlanje ebusuku. Into yami nawe. Kunjalo Noma? Bengikhuluma ngawe nje, nami. Kukhona engisiphathele khona namhlanje ebusuku futhi. Ngiyethemba angeke ucabange ukuthi sengiphambili kakhulu, kodwa...

Yebo, uqinisile! Ngiyamthanda, uyangithanda futhi silungile, izithandani ezihamba phambili ­ yini ebalulekile ngekhondomu? Singavele sigxile ekudlaleni-ke

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Isithombe nguFrancesco Zizola/Noor, ngosizo lwe- MSF

UKWELAPHA

UKUVINJELWA OKUHLANGANISIWE

UKUVIMBELA

Kubo bonke abantu abelashwa ngezidambisi gciwane, abantu abayishumi bavikelekile! Ngamazinga okuvikeleka angama-90%, uzobona inamba efanayo yokudluliselwa kwegciwane phakathi kwabantu abayikhulu abangelashwa abaphakathi kwabantu abayi1,000 abelashwayo.

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Ucwaningo olusha luthola ubufakazi bokuthi ukwelashwa ngezidambisi gciwane (ART) kuyasiza ekuvimbeleni ukutheleleka nge-HIV okusha. Ngokukubeka ngokulula nje, lokhu kusho ukuthi abantu abaku-ART abathelelani kakhulu. Isizathu salokhu ukuthi ukwelashwa kwehlisa inani legciwane egazini kumuntu one-HIV. Ezingeni lomuntu ngamunye, inani legciwane egazini mhlawumbe into eyodwa eyingozi ebonakalayo kunanoma yiluphi uhlobo lokudluliselwa kwegciwane. Nanoma ngabe ukudluliselwa kwegciwane kwenziwa ngokwebolekana ngezinalithi, kubelethwa, ekunceliseni ibele noma ekulimaleni okubanga yizinalithi, uma izinga lenani legciwane egazini liphezulu ingozi yokutheleleka iphezulu kanye uma inani legciwane egazini liphansi, ingozi iphansi. Ingozi akwenzeki iqedwe nya, noma ngabe inani legciwane egazini alibonakali, ukuthi kungenzeka kube nokutheleleka kusalokhu kukhona. Okwatholakala ocwaningweni olwaziwa ngokuthi Ucwaningo Lwabalingani kwakhombisa ukuthi i-ART seyivele iyasiza ekunciphiseni ukutheleleka okusha. Lolu cwaningo, lwenziwa emazweni aseningizimu ne-Afrika ayisikhombisa, abandakanya izithandani eziyi-3, 381 lapho umlingani oyedwa wayene-HIV omunye engenayo. Ekuqaleni lolu cwaningo lwalwenzelwe ukubona ukuthi i-acyclovir, umuthi wokwelapha i-herpes, ungakunciphisa yini ukudluliselwa kwe-HIV kwabanye. Nakuba i-acyclovir ingakunciphisanga ukutheleleka ngeHIV, abantu abane-HIV abangama-350 ababambe iqhaza kulolu cwaningo okwakudingeka ukuthi baqale ukuphuza ama-ART benzela izimpilo zabo. Izinga lokutheleleka okusha laliphansi ngama-92% phakathi kwabalingani babantu abasebenzisa ama-ART kunabalingani balabo ababengelashwa. Ekuthelelekeni okungama-103 phakathi kwabalingani, kwakukukodwa kuphela okwakuvela kumuntu owayelashwa. Lokhu kudluliseka okukodwa nakho kwenzeka ngokushesha emva kokuba lo muntu eqale ama-ART, lapho okwakungenzeka khona ukuthi inani legciwane egazini lalisephezulu. Ukwengeza, isibonelo sakamuva nje socwaningo saphakamisa ukuthi ukuhlinzeka ngemithi yokwelapha kuwo wonke umuntu one-HIV eNingizimu Afrika onesibalo se-CD4 esingaphansi kwama-200 kunganqamula ukudluliselwa okusha eminyakeni emihlanu kuya kweyishumi. Njengoba abantu bezoba namanani aphansi egciwane egazini, kuzoba nokutheleleka okusha okumbalwa kanye nezinga lokusabalala kwe-HIV lizohamba kancane. Okwamanje, uhhafu kuphela wabantu bonke baseNingizimu Afrika abane-HIV abanezibalo ze-CD4 ezingaphansi kwama-200 abathola ama-ART. I-Treatment Action Campaign (TAC) izoqhubeka nokufuna ukuthi bonke abantu baseNingizimu Afrika abane-HIV banikezwe ama-ART uma isibalo se-CD4 yabo singama-350. Ubufakazi obusha buphakamisa ukuthi ukwenyuka kokwelashwa ngale ndlela angeke kusize abantu nje kuphela, kodwa futhi kuzosiza, kanye kanye namanye amasu okuvimbela, ukunciphisa ukutheleleka okusha kuphendule isimo sobhubhane lwe-AIDS.

Inani legciwane egazini

Inani legciwane egazini PHEZULU

Inani legciwane egazini PHANSI

Inani legciwane egazini lakho inani le-HIV egazini lakho. Uma unenani eliphezulu legciwane egazini, kuneHIV eningi egazini lakho, kanti lokhu kwenza ingozi yokudluliselwa komunye umuntu kube phezulu nakho. Uma welashwa, inani legciwane egazini lakho liphansana ngoba kune-HIV ephansi egazini lakho futhi amathuba akho okuthi ulidlulisele komunye umuntu mancane.

Esinye isizathu sokubambelela okuhle

Ukuze ugcine inani legciwane liphansi egazini lakho, kufanele uphuze imithi eyizidambisi gciwane njengoba uyalelwe ngudokotela noma unesi. Hhayi ukuthi lokhu kuzokusiza kuphela ukuthi uhlale uphilile, kuzokwenza ukuthi ungatheleli kakhulu futhi amathuba okuthi uthelele umlingani wakho noma ingane yakho engakazalwa uma ukhulelwe. Ngale ndlela, ukubambelela okuhle kuba yingxenye yokuvimbela. Kubalulekile ukukhumbula ukuthi i-HIV ayikwazi ukwelapheka. Kuyohlala njalo kunengozi yokutheleleka. Ngisho ngabe inani legciwane egazini lakho alibonakali, kusenegciwane elicashe emzimbeni wakho, elilinde ukubuya uma sewuyeke ukuphuza imithi. Ngisho ngabe inani legciwane egazini lakho alibonakali, kusafanele uwasebenzise amakhondomu uma uya ocansini.

Le athikili iguqulwe ngu-Marcus Low ekhasini lamaqiniso elikhiqizwe yi-HIV I-Base lase libukezwa ngu-Simon Collins we-HIV I-Base.

UKUVINJELWA OKUHLANGANISIWE

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Ukukhulelwa ne-HIV

Ukwazi isimo se-HIV sakho kuyadingeka uma kufanele uthole ukwelashwa okulungile ekukhulelweni kwakho konke ukuze kuvikelwe impilo yakho kanye nempilo yomntanakho.

By Catherine Tomlinson

ENingizimu Afrika, amazinga okutheleleka nge-HIV phakathi kwabesifazane abasebancane beminyaka yokuthola abantwana aphezulu kakhulu. Uhlolo lwemitholampilo yangemuva kokubeletha lwakhombisa ukuthi ama-29.3% abesifazane abakhulelwe bane-HIV. Lokhu kusho ukuthi abathathu kwabesifazane abayishumi abakhulelwe eNingizimu Afrika bane-HIV.

Uma ukhulelwe futhi une-HIV yini okudingeka ukuthi uyenze?

Ukuthola ukuthi une-HIV lapho ukhulelwe kungesabisa kakhulu, ikakhulukazi uma ungenalo ulwazi olulungile nge-HIV. Kubalulekile ukufunda kabanzi kangangokuba kunokwenzeka nge-HIV nokudluliswa kwayo. Khumbula, ikhona imithi yokwelapha yokusiza ukuthi ube nokukhulelwa kanye nomntwana onempilo. Abesifazane abane-HIV igciwane bangaledlulisela ngezindlela ezintathu ebantwaneni babo. I-HIV ingedluliselwa emntwaneni wakho ngesikhathi ukhulelwe, ubeletha noma lapho uncelisa ibele. Uma ukhulelwe futhi une-HIV kufanele unikezwe izidambisigciwane (ama-ARV) ukuvimbela ukulidlulisela emntwaneni wakho osandakuzalwa. Owesifazane okhulelwe one-HIV ongawaphuzi ama-ARV ngesikhathi ekhulelwe unethuba elingama-30% lokudlulisela i-HIV emntwaneni osandakuzalwa ngesikhathi ekhulelwe noma ebeletha. Ngama-ARV le ngozi ingancishiswa ibe ngaphansi kwe-1%. Uma une-HIV futhi ukhulelwe, into yokuqala okufanele uyenze ukuthi uhlolwe ukuze uthole ukuthi sithini isibalo se-CD4 yakho. Isibalo se-CD4 yakho sizokutshela ukuthi uyakudinga yini ukuqala imithi yokwelashelwa ukutheleleka kwakho nge-HIV yini noma uphuze i-prophylaxis (umuthi wokuvimbela ukuze kuncishiswe ingozi yokudlulisela kwabanye) ukuze uvikele ingane yakho.

ABESIFAZANE, UKUKHULELWA

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Isithombe ngu-Giacomo Pirozzi /Panos Pictures

Iziqondiso ezintsha

Ngo-Ephreli 2010 uhulumeni wafaka ulwazi olusha kuziqondiso zokwelapha zabesifazane abakhulelwe abaphila ne-HIV. Ukwenziwa ngcono okuningi okubalulekile kuchaziwe kule athikili. Iziqondiso ezigcwele, Clinical Guidelines: PMTCT (Prevention of Motherto-Child Transmission) 2010, ingatholakal ku- http://www.sanac. org.za/resources/art-guidelines.

Isithombe ngu-Julian Harneis

Isibalo se-CD4 yami singaphansi kwama-350 ­kusho ukuthini lokhu?

Ngaphansi kweziqondiso ezintsha zokwelapha, bonke abesifazane abanesibalo se-CD4 esingaphansi kwama-350 bazonikezwa ukwelashwa ngezidambisi gciwane ezintathu, futhi ezaziwa ngokuthi ukwelapha ngezidambisi gciwane okusebenza ngezinga eliphezulu (highly active antiretroviral therapy ­ (HAART)). INingizimu Afrika inezinga eliphezulu lokufa komama okuphathelene ne-HIV. Uguquko eziqondisweni zokwelapha kuzonciphisa ukufa komama eNingizimu Afrika ngoba ukufa okuningi komama okuphathelene ne-HIV kwenzeka kwabesifazane abanesibalo se-CD4 esingaphansi kwama-350. Uma isibalo se-CD4 yakho singaphansi kwama-350 uzodinga ukwelashwa ngama-ART amathathu kwenzelwa impilo yakho uqobo futhi kuzodingeka ukuthi uwaphuze impilo yakho yonke. Lokhu kwelashwa kwempilo yakho yonke kungakuvumela ukuthi uthokozela impilo ende nempilo kanjalo nokukusiza ukuthi ulwe nezifo eziphathelene ne-AIDS kanye nezifo ezingena ngentuba njengesifo sofuba. Lokhu kwelashwa nakho kubaluleke kakhulu ekuvimbeleni ingozi yokudluliselwa kwe-HIV emntwaneni wakho osandakuzalwa.

Isibalo sami se-CD4 singaphezu kwama-350 ­kusho ukuthini lokhu?

Uma isibalo se-CD4 yakho singaphezu kwama-350 asikho isidingo sokuthi uqale ukwelashwa kwempilo yonke yakho uqobo. Kodwa-ke kuzodingeka ukuthi uphuze umuthi wokuvimbela wama-ARV ngesikhathi sokukhulelwa sonke nasekubeletheni ukuze kuncishiswe ingozi yokuthi umntwana wakho azalwe ene-HIV. (Emva kokuba umntanakho ezelwe kunezinye izinyathelo ongazithatha ukuvimbela ukudluliselwa ngokumfida.) Umuthi wokuvimbela wama-ARV waziwa ngokwejwayelekile njengokuvinjelwa kokudluliselwa okusuka kumama kuye emntwaneni (PMTCT). Ngaphansi kweziqondiso ezintsha uzoqalwa ngamaPMTCT uma usunamasonto ayi-14 okukhulelwa. Ngezinye izikhathi onesi batshela iziguli ukuthi kufanele zivakashele izindawo zosizo lwezempilo uma sezinamasonto angama-24 okukhulelwa. Uma lokhu kwenzeka kufanele ufune ukubonwa ngaphambi kwamasonto ayi-14 ukuze uthole ukwelashwa masinyane. Ukusuka emasontweni ayi-14 uzophuza i- zidovudine (AZT) zonke izinsuku uze ubelethe. Uma usuhelelwa kufanele unikwe umthamo owodwa we-nevirapine (NVP) kanye ne-AZT njalo emahoreni amathathu. Emva kokubeletha uzonikezwa umthamo owodwa we-tenofovir (TDF) + emtricitabine (FTC) ­ lokhu kwaziwa `njengokucophelela.' Lokhu ukwenziwa ngcono okubalulekile eziqondisweni ezintsha ngoba kunciphisa ingozi yokungezweli kwe-NVP okungenzeka , ngomthamo owodwa we-NVP Ukungezweli ku-NVP . kungenza ukwelashwa kwakho ukuthi kungasebenzi ngempumelelo uma udinga ukuqala ukwelashwa i-ART impilo yonke empilweni yakho uqobo.

Uma ukhulelwe futhi ungenayo i-HIV kuqaphela kuni osakudinga?

Uma wahlolwa usephansi nokukhulelwa kwakho kwatholakala ungenayo i-HIV kuwumqondo omuhle ukuthi wenze okunye ukuhlolelwa i-HIV ekuhambeni kwesikhathi nokukhulelwa kwakho. Ukuhlolwa futhi kubalulekile ngoba kunesikhathi emva kokuba umuntu etheleleke nge-HIV okokuqala (esaziwa ngokuthi isikhathi sewindi) lapho angahlolwa atholakale engenayo ngisho enayo (lokhu kubizwa ngokuthi ukuba negethivu okuyiphutha). Kunconywa ukuthi uhlolwe futhi emva kwezinyanga ezintathu uphinde uhlolwe futhi emasontweni angama-32. Kubalulekile futhi ukuthi uqhubeke nokusebenzisa amakhondomu ekukhulelweni kwakho konke ukuze ungabi nayo i-HIV ngesikhathi ukhulelwe. Emva kokuba utheleleke nge-HIV okokuqala, ngesikhathi sewindi, umzimba wakho ungena ohlelweni olubizwa ngokuthi i-seroconversion. Ngalesi sikhathi kuyingozi kakhulu ukudluliselwa kwe-HIV, kubo bobabili ingane yakho wakho, ngoba nge-seroconversion inani legciwane egazini liphezulu kakhulu.

ABESIFAZANE, UKUKHULELWA

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esandakuzalwa kanye nomlingani

Ukufida umntwana osandakuzalwa

Ngaphansi kweziqondiso ezintsha, abesifazane abazikhethelayo bazokwazi ukuncelisa abantwana babo abasandokuzalwa ibele. Ngezansi kunezincazelo zezingozi ezahlukene nokukhathazeka okufanele ukwazi uma unquma ukuthi umntwana wakho umupha

Photo by Mikkel Ostergaard/Panos Pictures

ingabe uhlobo lwemithi yama-ART emithathu noma i-nevirapine yabantwana abasandakuzalwa isebenza ngempumelelo kakhulu yini ekunciphiseni ukudluliswa kwe-HIV ngesikhathi sokuncelisa ibele.) Omama abakhetha ukungancelisi ibele kufanele banikezwe ubisi lwefomula olwanele izinyanga eziyisithupha yingxenye yezempilo kahulumeni. Ubisi lwefomula luyisusa ngokugcwele ingozi yokudlulisela i-HIV kodwa lungaba nezinye izingozi. Isibonelo, abantwana abancela ifomula banengozi ephezudlwana yesifo sohudo, okungenzeka ibabulale. Ingozi yemiphumela emibi ehambisana nokuncelisa ifomula kuncike esimeni. Omama abakhetha ukuncelisa ifomula kufanele bathole amanzi ahlanzekile futhi bakwazi ukuhlanzisisa yonke impahla yokuncelisa ukuze bakwazi ukuhlinzeka ngokuphepha ubisi lwefomula ebantwaneni babo. Omama abane-HIV kufanele bakhethe ukuthi bancelisa ibele yini, ukusebenzisa ama-ARV kunciphisa ingozi yokudluliselwa kwe-HIV, noma ukuncelisa abantwana babo ifomula. Omama akufanele ukuthi izingane bazincelise baxube. (Ukuncelisa ngokuxuba kulapho umama encelisa umntwana wakhe kokubili ubisi lwebele nobisi lwefomula.) Abantwana abanceliswa kuxutshwe banengozi ephezulu kakhulu yokuba ne-HIV ngesikhathi sokuncelisa umntwana osandakuzalwa. Amazinga e-HIV aphezulu emitholampilo yokubeletha kwenza ukuthi kucace ukuthi uhulumeni kufanele acabange izindlela zokusiza abesifazane abasebancane ukuthi bakhulelwe ngaphandle kokuba ne-HIV. Kuze kube manje izinsizakalo zokunciphisa izingozi zokudlulisela ngesikhathi sokukhulelwa zisalokhu zinomkhawulo.

ibele yini noma ifomula.

Abesifazane abaqalwa ngohlobo lwemithi oluthathu lwama-ART bazoqhubeka nokuphuza le mithi emva kokubeletha njengoba kuwukwelapha kwesikhathi eside abakudingela izimpilo zabo. Kodwa la ma-ARV futhi anciphisa ingozi yokudlulisela i-HIV ebantwaneni abasandakuzalwa ngobisi lwebele. Izifundo zikhombisile ukuthi abesifazane abasohlotsheni lwama-ART oluthathu abancelisa ibele kuphela banethuba elingaphansi kwama2% lokudlulisela i-HIV kubantwana babo abasandokuzalwa. Zonke izingane ezisandakuzalwa zizonikwa umthamo owodwa we-nevirapine amasonto ayisithupha. Kodwa-ke abantwana abasandakuzalwa omama babo abangakaqaliswa ku-ART yempilo yonke kodwa kunalokho bethola uhlobo lwemithi ye-PMTCT kufanele zonke izinsuku banikwe umthamo owodwa we-nevirapine ukunciphisa ingozi yokudlulisela i-HIV ngesikhathi sokuncelisa ibele. Uhlolo lokwelapha lukhombisile ukuthi i-nevirapine yezingane ezisandakuzalwa inganciphisa ingozi yokudlulisela ibe ngaphansi kwama-2%. Ucwaningo ( i-PROMISE (Promoting Maternal Infant Survival Everywhere) lwaqalwa ngoJanuwari ukuhlola ukuthi

ABESIFAZANE, UKUKHULELWA

Imithombo: Chasela C et al. `Both maternal HAART and daily infant nevirapine are effective in reducing HIV-1 transmission during breastfeeding in a randomized trial in Malawi: 28 week results of the Breastfeeding, Antiretroviral and Nutrition (BAN) Study.' 5th IAS Conference on HIV Treatment, Pathogenesis and Prevention, Cape Town, abstract WeLBC103 (2009).

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Yini engenziwa ngabathandanayo abangama-sero-discordant ukuze

banciphise ingozi

yokudluliswa kwe-HIV uma bezama ukukhulelwa?

(Abathandanayo abangama-Sero-discordant yilabo lapho umlingani oyedwa ene-HIV bese kuthi omunye angabi nay i-HIV.)

Uma wena nomlingani wakho nihlela ukukhulelwa ngocansi kunezindlela eninganciphisa ngazo ingozi yokudlulisa i-HIV. Kodwa-ke, kufanele nikhumbule ukuthi kubantu abathandanayo omunye one-HIV omunye engenayo njalo kuba nengozi encane yokudlulisa i-HIV ngesikhathi socansi olungavikelekile.

Wena nomlingani wakho ningakunciphisa kanjani ukudluliswa kwe-HIV ngesikhathi sokukhulelwa?

Ninganciphisa ithuba lokudlulisela i-HIV ngokwenza imizamo yokukhulelwa enomkhawulo uma ingozi yokudlulisa iphansi. Inani legciwane egazini likhonjwe njengengozi ebalulekile ekudluliseni i-HIV. Uma wena nomlingani wakho nihlose ukukhulelwa ngocansi olungavikelekile kufanele nihlele ukukwenza lokhu uma ngabe umlingani one-HIV elashwa futhi inani legciwane egazini lingatholakali. Imizamo yokukhulelwa enomkhawulo kufanele yenziwe kuphela uma ngabe owesifazane enza amaqanda. Ukwenziwa kwamaqanda kuvamise ukwenziwa ezinsukwini eziyi-14 ngaphambi kokuya esikhathini. Umsebenzi wakho wezempilo angakusiza ukubala uma wenza amaqanda. Gwemani ucansi olunendluzula ngoba lungabanga ukudabuka okungandisa ingozi yokudlulisela. Kubalulekile futhi kungabi bikho kubalingani onanoma yiziphi ezinye izifo ezithathelana ngocansi noma izilonda ezingandisa ingozi yokudlulisa i-HIV. Ukusoka kwamadoda ngokokwelashwa nakho kuzonciphisa ukudluliswa kwe-HIV uma owesifazane ene-HIV indoda ingenayo. (Bheka ikhasi 4-7 ukuze uthole kabanzi ngokusoka kwamadoda ngokokwelashwa). Ukuhlela imizamo yokukhulelwa kwakho kungawanciphisa amathuba okudlulisela i-HIV kodwa akuyiqedi ngokuphelele ingozi. Wena kanye nomlingani wakho kufanele niqhubeke nokusebenzisa amakhondomu ngazo zonke ezinye izikhathi

Kwenzekani uma owesifazane ene-HIV bese kuthi indoda ingabi nayo i-HIV?

Uma owesifazane ene-HIV bese kuthi indoda ingabi nayo i-HIV kunezindlela zokuqeda izingozi zokudlulisa i-HIV ngesikhathi sokukhulelwa. Ungakwenza lokhu ngokuqoqa isidoda somlingani wakho, kungenzeka ngekhondomu, bese uzifaka wena uqobo isidoda esibelethweni. Ungazifaka usebenzisa isirinji yeplastiki engenanalithi ngaphambili umtholampilo ozokunika yona. Isirinji uyifaka njenge-tampon bese uyikhipha uma isidoda sesifakiwe.

Kwenzekani uma indoda ine-HIV bese kuthi owesifazane angabi nayo i-HIV?

Uma indoda ine-HIV bese kuthi owesifazane angabi nayo i-HIV ingozi nanoma iyiphi yokudlulisa i-HIV ningayiqeda nya ngokusebenzisa uhlelo olubizwa ngokuthi ukugeza isidoda. Ngeshwa lolu hlelo lutholakala kuphela ezingxenyeni ezizimele futhi lusalokhu lubiza kakhulu. Ukugeza isidoda inqubo eyenziwayo emtholampilo ukuze kwehlukaniswe isidoda oketshezini oluphuma nesidoda olune-HIV. Isidoda esingenayo i-HIV sibe sesijovelwa esibelethweni sowesifazane. Izithandani ezihlela ukukhulelwa lapho omunye ene-HIV omunye engenayo zinezindlela ezingakhetha kuzo ukunciphisa ingozi yokudlulisa i-HIV. Wena nomlingani wakho kufanele nixoxe ngokhetho lokuhlela umndeni nomsebenzi wenu wezempilo.

Ibukezwe nguPolly Clayden of HIV i-Base. U-Clayden wasiza naye ukubhala `Pregnancy in Our Lives', okuncike kuyo izingxenye zale athikili.

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Abesifazane abasebencane

kanye ne-HIV

Ngu-Mary-Jane Matsolo

Abesifazane abancane abaningi bazi kahle kakhulu uma kuza ezindleleni zokuvimbela i-HIV. Kodwa kwabanye inselele ukuthi balusebenzisa kanjani lolu lwazi kanye nokuxoxa ngocansi oluphephile ngaphakathi ebudlelwaneni babo. Sakhuluma nabesifazane abancane abangama-20 eKhayelitsha Youth Clinic.

ABESIFAZANE, UKUKHULELWA

Isithombe nguSam Reinders

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Ukuvinjelwa kwe-HIV/AIDS phakathi kwabantu abasebasha kubandakanya okungaphezu kokusabalalisa ulwazi. Abadala abasebasha babhekana nezinselele eziningi kanye nezingxaki uma bebhekene nezinqumo ngocansi. Izinto eziphathelene namandla phakathi kwabalingani abaya ocansini, ingcindezi evela kontanga, izinjwayelo zesiko kanye nemithelela eminye konke kuneqhaza.

Uma sibuza ukuthi bangaki kubo abasebenzisa ulwazi ngempilo yokuya ocansini ezimpilweni zabo, iningi laphendula ngamahloni ukuthi abakwenzi.

Ngaphezu komlingani owodwa

Abaningi babahlanganyeli bakuvumile ukuthi banobudlelwano bocansi nabalingani abaningi, kaningi ngaphandle kokusebenzisa amakhondomu. Ezinye zezizathu abazinikayo zibandakanya: ukulinga, ukuduma, ukubukeka kwabalingani babo, noma "ukufuna ukuya ocansini nje".

Akulula ukukhuluma ngakho

Amanye amantombazne anamahloni kakhulu noma awakhululeki ukucela amasoka awo ukuthi asebenzise amakhondomu. Enye intombazane yathi kunezinga elithize elingayiphathi kahle uma kuza ekuxoxeni ngokusetshenziswa kwekhondomu ngakho-ke kungcono isinqumo sokusebenzisa ikhondomu isishiye nesoka layo. Enye intombazane yazizwa ingakhululekile ngisho ukubiza igama elithi "ikhondomu".

Uzongishiya?

Amantombazane amaningi athi ayesaba ukukhuluma ngamakhondomu ngoba ayesaba ukuthi amasoka awo azocasuka bese ewashiya. Amantombazane amaningi abika ukuthi eyenobudlelwano obuhle, obuqinile nabalingani abaya nabo ocansini, kodwa kwakungekho ukukhulumisana uma kuza ezindabeni ezifana nokusetshenziswa kwekhondomu kanye nokuhlolelwa i-HIV. Ukukhulelwa okungafuneki kwakungesinye isihloko esenza kube lula kwabesifazane abasebancane ukuthi bacele amadoda ukuthi asebenzise amakhondomu. Omunye wesifazane eqenjini wathi ubesebudlelwaneni iminyaka eyishumi kanti yena nomlingani wakhe njalo basebenzisa amakhondomu. Kodwa-ke, isizathu akamnika sona sokusebenzisa amakhondomu kwakuwukuvimbela ukukhulelwa okungahlosiwe hhayi ukuvimbela i-HIV kanye nama-STI. ·

I-Equal Treatment yakhuluma nabesifazane abasebasha e-Khayelitsha Youth Clinic ukuzwa imicabango yabo egqamile ngocansi, i-HIV kanye nokuvinjelwa. Isithombe ngu-Mary-Jane Matsolo.

Yini okudingeka ukuthi kwenzeke?

Ukubukezwa okusandakushicilelwa kwahlola ubufakazi bezindlela eziyisishiyagalombili bokuvimbela i-HIV phakathi kwabantu baseNingizimu Afrika abaneminyaka eyi-15-24. Ukubukeza kwenza izincomo ezilandelayo: · Kufanele seqele ngale kwezinga lomuntu ngamunye ukubhekana nezindaba zomphakathi ngobubanzi. Lokhu kubandakanya izindlela zokucabanga ngobulili, abantu abaphoqelelwa ukuya ocansini ngale kokufuna kwabo, ukusetshenziswa kotshwala kanye nokuthi isimo somnotho somuntu siyithinta kanjani ingozi yabo yokutheleleka nge-HIV. Sidinga izindlela eziningi ezihlosiwe zokuvimbela i-HIV. Isibonelo, kufanele sinike abantu abasha izindlela zokukhetha ezingcono zesikhathi sabo sokuphumula kanye nokubahlinzeka ngamathuba okufunda impilo noma amakhono omsebenzi. · Kufanele sihlose ukushintsha izimo zomphakathi ezizungeze ingozi ye-HIV, olungavikelekile. · Imfundo ye-HIV ezikoleni ibalulekile, futhi kufanele yethulwe ngabasebenzi bezempilo, hhayi othisha.

Umthombo: Abigail Harrison et al. `HIV prevention for South African youth: which interventions work? A systematic review of current evidence.' BMC Public Health, February 2010.

Kukubafana?

Lapho bebuzwa ukuthi bangaki kubo abangayeka ukusebenzisa ikhondomu uma amasoka abo ebacela, abayishumi nambili emantombazaneni angamashumi amabili baphakamisa izandla zabo bathi bangahambisana nesinqumo salo, angeke babuze mbuzo. Lapho sibuza ukuthi kungani, enye intombazane yaphendula yathi, "Ngoba sifuqwa uthando." Amantombazane amathathu kuphela athi angeke ayeke ukusebenzisa ikhondomu, noma ngabe kwenzekani.

ABESIFAZANE, UKUKHULELWA

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ikakhulukazi phakathi kwamadoda, njengezindlela zokucabanga ukuya ocansini

Ukukhuluma

nge-PeP

Ngu-Rebecca Hodes

Iphuzwa nini i-PEP?

Isithombe ngu-Aliza Waxman

I-PEP imele i-Post-Exposure Prophylaxis

Post = emva kokubekeka engozini ye-HIV, kungenzeka ukuthi kube ngokudlwengulwa, noma ezindaweni zokunakekela impilo. Exposure = ukukwazeka ukubekeka engozini ye-HIV. Uma kwenzeka ukudlwengulwa kaningi kuba nomonakalo emlonyeni, endunu noma esithweni sowesifazane sangasese kanti lokhu kungandisa ingozi yokubekeka ku-HIV egazini, i-semen noma uketshezi lwesitho sangasese sowesifazane. Abasebenzi bezempilo kungenzeka nabo babekeke engozini ngenxa yokuthintana noketshezi lomzimba. Prophylaxis = ukuvimbela. I-PEP ivimbela umuntu ekutheni engatheleleki nge-HIV ngokushesha emva kokuba ethintene negazi, i-semen, uketshezi lwesitho sangasese sowesifazane, noma ubisi lwebele lomuntu okungenzeka ukuthi une-HIV.

I-PEP kufanelwe iqalwe ngokushesha okunokwenzeka, uma sekwephuze kakhulu okungenani emahoreni angama-72 okubekeka engozini ye-HIV. Ngakho-ke kubalulekile ukuthi labo ababekeke engozini bafune ukunakwa ngokoekwelashwa ngokushesha. Abasinde ekudlwengulweni nasekuhlaselweni ngocansi badinga ukwesekwa okuvela emndenini, kubangane nabeluleki abaqeqeshiwe ukuqinisekisa ukuthi bayakwenza lokhu futhi bayiphuza yonke imithi yokwelashwa.

Ingabe isebenza ngempumelelo kangakanani i-PEP?

Yize i-PEP ingasebenzi ngempumelelo ewu-100%, ingayinciphisa kakhulu ingozi yokudluliswa kwe-HIV. Uma isheshe yaphuzwa i-PEP, izosheshe isebenze ngempumelelo kakhulu. Futhi isebenza ngempumelelo kakhulu uma iphuzwe izinsuku eziphelele ezingama-28. Uma imithamo yeqiwe lokhu kwandisa amathuba okutheleleka.

Inani i-PEP?

I- Post-exposure prophylaxis noma i-PEP umuthi omfushane wezinsuku ezingama-28 wezidambisi gciwane (ama-ARV) eyenzelwe ukusiza abantu abangenayo i-HIV ababekeke engozini yegciwane ukuvimbela ukutheleleka. ENingizimu Afrika, i-PEP iyatholakala kubasebenzi bezempilo ababekeke engozini emsebenzini kanye nabasinde ekudlwengulweni. Amazinga aseNingizimu Afrika okudlwengulwa kanye nokuhlaselwa ngocansi aphezulu kakhulu emhlabeni, kanti bambalwa kakhulu abesifazane ababika ukudlwengulwa noma abafuna izinsizakalo zokunakekelwa ngokwezempilo emva kokuhlaselwa. Abasindile ngokomthetho banelungelo lokuthola i-PEP kanye nemithi yokwelashwa ezosiza ukuvikela impilo yabo yomzimba neyengqondo, njengoba kushiwo kuMthetho Wamacala Ocansi (2007). Bayakhuthazwa ukufuna imithi yokwelashwa kanye ne-PEP ngokushesha. Uma umuntu engazi ukuthi angayithola kuphi i-PEP, bangabika emaphoyiseni, lapho banelungelo lomthetho lokudluliselwa emtholampilo ohlinzeka nge-PEP. Uma osindile eya ngqo esikhungweni sezempilo, kufanele anikezwe i-PEP noma uma ingekho, adluliselwe kwesinye isikhungo sezempilo esinikana i-PEP. Uhlobo lwemithi ye-PEP lunenhlangansiela yama-ARV. Umnyango Wezempilo uncome uhlobo lomuthi i- zidovudine (AZT), lamivudine (3TC) kanti, ezimeni zokubekeka engozini kakhulu, umuthi owengeziwe (lopinavir/ritonavir). Ukuze uthole i-PEP emitholampilo, abasinde ekudlwengulweni kufanele bahlolelwe i-HIV. Uma osindile esevele eseneHIV, angeke ayithole i-PEP kodwa kusafanele awathole ama-antibhayothiki ukuze avimbele izifo ezithathelwana ngocansi (STI) kanye nokuhlolwa kokukhulelwa. Uma ukuhlola ukukhulelwa kuthi awukhulelwe, osindile kufanele athole okokuvikela ukukhulelwa kwesimo esiphuthumayo. Kungenzeka badluliselwe ekwelashweni kwama-ARV uma isibalo se-CD4 yabo siphansi noma uma begula. Uma osindile engenayo i-HIV, kufanele aphuze imithi ephelele ye-PEP, amaantibhayothiki ukuvimbela ama-STI, ukuhlolwa kokukhulelwa futhi, uma ungakhulelwe, uthole isivimbeli kukhulelwa sesimo esiphuthumayo. Uma ngabe osindile kusafanele ukuthi alinde imiphumela yokuhlolwa kwe-HIV; ekhetha ukungahlolwa ngokushesha; engakulungele ukwamukela imiphumela ngokushesha noma engakwazi ukunikeza imvume ngokushesha ngenxa yamandla okulimala noma ukuphatheka kabi kakhulu ngemuva

IZINTO EZIPHATHELENE

NOMPHAKATHI KANYE NE-HIV

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kwesehlakalo, kufanele anikezwe ipaki lokuqalisa lezinsuku ezintathu le-PEP. Uma isiguli sihloliwe sase sibuya sizolanda imiphumela yaso, sizonikezwa mhlawumbe uhlobo lwemithi izinsuku ezingama-28 eziphelele uma singenayo i-HIV, noma sedlulielwe okunye ukwelashwa uma sine-HIV. Emva kokuqeda i-PEP, osindile kufanele abuyele endaweni yosizo lwezempilo ayokwenza ukuhlolwa kokulandela kanye nokwelulekwa ngokwengqondo amasonto ayisithupha, izinyanga ezintathu, izinyanga eziyisithupha kanye nonyaka emva kokudlwengulwa noma kokuhlaselwa okuphathelene nocansi.

Omunye wesifazane wabhekana kanjani nokudlwengulwa kwakhe futhi wasinda

Njengoba ixoxwa nguThandeka Vinjwa

Elokishini laseSphezini, eLusikisiki, owesifazane oneminyaka engama-40 ubudala wadlwengulwwa ngoMeyi 2007 yindoda eneminyaka eyi-18 ubudala wagqekeza endlini yakhe ebusuku wayesephoqelela ukuya ocansini naye. Wazama ukumnqanda kodwa wamesabisa ngokumbulala ngomkhonto. Emva kwalokho wabaleka. Wamemeza ecela usizo wavusa udadewabo, owabiza omakhelwane. Abantu baqoqana ndawonye enkundleni ngesikhathi owesifazane echaza ukuthi kwenzekeni. Amaphoyisa afika ntambama ngakusasa amthatha aya naye esiteshini samaphoyisa, lapho akenza khona isitatimende wayesemvulela icala umdlwenguli. Kanti ngaleso sikhathi, amalungu omphakathi ayesembambile umsolwa amletha esiteshini samaphoyisa. Emva kokuthatha isitatimende, amaphoyisa amphelekezela amusa esibhedlela ukuthi ayohlolwa. Udokotela waqinisekisa ukuthi wayedlwenguliwe, futhi wamhlola i-HIV wamelapha nama-STI. Yonke imiphumela yokuhlolwa yayingenalutho kanti udokotela wamnika i-PEP , iphilisi eliphuzwa ekuseni emva kocansi lokuvimbela ukukhulelwa kanye nama-antibhayothiki. Wadluliselwa nakusonhlalakahle ukuthi ayokwelulekwa ngokwengqondo. Emva kokuba esinde kulesi sigameko esibi kangaka wajoyina igatsha le-Treatment Action Campaign (TAC) e-Xurhana. Wazizwa enamandla okubhekana nezindaba zamalungelo abantu nomthetho kubandakanya udlame oluncike ebulilini (GBV). Wafunda ngokwelashwa ngezidambisi gciwane. Nge-TAC wathola ukwazi ngokuthi ubasiza kanjani abanye ukuze asize abanye besifazane nabo ebabedlwenguliwe.

Ngingayithola kuphi i-PEP?

Abasinde ekudlwengulweni ngokwejwayelekile bangathola i-PEP ezikhungweni zokunakekela ezempilo zikahulumeni. ENtshonalanga Kapa kanye naseMpumalanga Kapa zonke izibhedlela ziyayinika i-PEP kwabasinde ekudlwengulweni. Ezinye izifundazwe zikhethe izindawo zosizo lokunakekelwa kwezempilo ezithize ukuthi zihlinzeke i-PEP. Akudingeki ukuthi osinde ekudlwengulweni avule icala lobugebengu ukuze athole i-PEP. Kwanele ukubika ukudlwengulwa esibhedlela. Kodwa-ke oqeqeshelwe umsebenzi wezempilo unesibopho somthetho sokubika icala eliphathelene nocansi uma osinde ekudlwengulweni engaphansi kweminyaka eyi-16 ubudala. Amaphoyisa kanye nabasebenzi bezempilo kudingeka ngokomthetho ukuthi bazise abasindile ngamalungelo abo ku-PEP kanye nokunye ukwelashwa okuphuthumayo. Abasebenzi bezempilo ebebebekeke engozini bangathola i-PEP ngokusebenzisa izindawo zabo zomsebenzi noma ngokudluliswa emsebenzini wabo.

Izinkinga zokufinyelela ku- PEP

Umbiko ka-2004 owenziwa yi-Human Rights Watch wathola ukuthi izinkinga eziningi zivimbela abasinde ekudlwengulweni nabahlaselwe ngokocansi ekutheni bathole i-PEP. Lokhu kubandakanya ukungabi bikho kolwazi nge-PEP phakathi kwabasebenzi bezempilo kanye nabasindile, inhlamba ehambisana nokuhlola i-HIV, ubunzima bokuthola izithuthi emahoreni angama-72 zokuya emtholampilo ohlinzeka i-PEP.

Ibukezwe ngu-Dkt Stefanie Röhrs of the Gender, Health and Justice Research Unit e- University of Cape Town. Okwamanje ungumcwaningi oholayo kuphrojekthi eqondene nokufinyelela ku-PEP kwabasinde ekudlwengulweni eNingizimu Afrika. Imithombo: Jewkes R., and Abrahams N., `The epidemiology of rape and sexual coercion in South Africa: an overview', Soc Sci Me 2002; 55 (7): 1231­1244 (2002); Gender Based Violence In Our Lives. (July 2009); Christofides, N., Muirhead, D., Jewkes, R., Penn-Kekana, L., Conco, D., `Women's experiences of and preferences for service after rape in South Africa: interview study, BMJ, 332: 209­213 (2006); Human Rights Watch, `Deadly Delay: South Africa's Efforts to Prevent HIV in Survivors of Sexual Violence, Vol. 16, No. 3, March 2004. Itholakala kuleli kheli: http://www.hrw.org/ reports/2004/southafrica0304/index.htm (Site accessed May 2010).

Isithombe nguThandeka Vinjwa

Uthi, "Abesifazane le ngaphandle: ningazithwaleli izinkinga nodwa enihlangabezana nazo empilweni, khulumani sishiyelane ngomthwalo ukuze sikhululeke."

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IZINTO EZIPHATHELENE

NOMPHAKATHI KANYE NE-HIV

Izinto eziphathelene nomphakathi ezokutheleleka nge-HIV

Ngu-Mara Kardas-Nelson, Catherine Karlsson no-Andrea Zeelie

IZINTO EZIPHATHELENE

NOMPHAKATHI KANYE NE-HIV

Isithombe ngu-Damien Schumann

"Ngaphakathi emazweni kunomehluko omkhulu empilweni oxhunywe kakhulu namazinga okuhlupheka komphakathi...Ubulili, imfundo, umsebenzi, imali engenayo, [iqembu lobuzwe], kanye nendawo yokuhlala konke kuxhumene kakhulu nokufinyelela kwabantu, ulwazi kanye nezinzuzo zokunakekela impilo .... Uma isimo senhlalo emphakathini nomnotho kuphansi, impilo iba yimbi kakhulu ."­ I-World Health Organization

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Ngisho ngabe silokhu sifunda kakhudlwana ngesayensi ye-HIV kanye nokusebenza ngempumelelo kokunye ukungenelela--njengokuhlola okukhulile, ukwelashwa, ukusetshenziswa kwamakhondomu, kanye nokuvinjelwa kokudlulisela okusuka kumama kuye enganeni (PMTCT)-- amazinga okutheleleka asalokhu ekhula ezindaweni eziningi. Kwenzekelani lokhu?

Ukuze uphendule lo mbuzo, sidinga ukuthi sibheke lokho okwenza umuntu abekeke engozini ye-HIV. Ngisho nangokungenelela okuhle kakhulu, isimo somuntu enhlalweni yomphakathi, imali engenayo, ubulili, kanye nokufinyelela emfundweni kanye nezinye izinsizakalo eziyisisekelo kungabenza ukuthi babe namathuba amaningana okuthola igciwane. Yize kunezinto eziphathelene nenhlalo yomphakathi Treatment ibheka okune: ukungalingani kobulili kanye nodlame oluncike ebulilini; ubumpofu; ukufinyelela emfundweni; kanye nenhlamba nokubandlululwa.

Isithombe ngu-Jodi Bieber

eziningi ngemuva kokutheleleka nge-HIV, i-Equal

Ukungalingani kobulili kanye nodlame oluncike ebulilini

Ukungalingani kobulili kukhona kuwo wonke amazinga omphakathi kanye nakuzo zonke izinkomba zesiko nezomnotho, ukusuka ekufinyeleleni emfundweni nasekwazini inhlamba kanye nokubandlululwa. Emhlabeni omkhulu, abesifazane babhekene nekusasa elingelihle kunabalingani babo besilisa. Ngokweathikili eyashicilelwa ku- Social Science & Medicine, abesifazane bamelele ama-70% omhlaba ampofu ngempela. Ngokujwayelekile bafinyelela kancane emfundweni kunamadoda, basebenza amahora amade, futhi banezinga lempilo eliphansi. Udlame oluncike ebulilini (Gender-based violence ­ (GBV)) luxhunywe nokubekeka engozini ye-HIV. E-Afrika yonke abesifazane ababe sodlameni oluncike ebulilini manamathuba afika kwamathathu okutheleleka nge-HIV kunalabo abangakaze babe kulo. Udlame olubhekiswe kwabesifazane lukhulisa ukubekeka engozini ye-HIV ngezindlela ezintathu: ngoba i-HIV idluliseka kalula kakhulu ngocansi oluphoqiwe, njengokudlwengula; ngokukhulisa ukwenzeka kwengozi yesikhathi esizayo yokuziphatha kocansi, efana nabalingani abakhona njengamanje abaningi noma ukuzibandakanya ocansini lwebhizinisi; nokunciphisa amandla abesifazane okusebenzisa izindlela eziphephile zocansi ngoba abanakho

ukulawula ekwenziweni kwezinqumo zocansi noma besaba olunye udlame. Ezinye izinto ezifana nobumpofu kanye nendlala, kubeka abesifazane engozini yakho kokubili udlame ne-HIV. Abesifazane abancike emadodeni ngokomnotho anokuba sodlameni futhi azibandakanye endleleni yokuziphatha eyingozi. Ucwaningo lwango2007 olwenziwa yi- Physicians for Human Rights (PHR) lwaqaphela ukuthi abesifazane ababengenakho ukudla okwanele babenamathuba amaningi okuthi bangabi nakho ukulawula ebudlelwaneni; ukubandakanyeka ocansini lwebhizinisi; futhi baye ocansini olungavikelekile ­ zonke izinto eziyingozi ye-HIV. Ukungalingani kobulili kuxhunyaniswe nokusetshenziswa kwamakhondomu okuphansi, ikakhulukazi uma kuza ekutheni ngubani owenza izinqumo maqondana nocansi. Ngokocwaningo lwePHR, olwenzeka eBotswana naseSwazini, ama-22% babengenakho ukulawula ngokuthi kusetshenziswe ikhondomu yini noma ingasetshenziswa. Ama-53% kulabo babeye ocansini olungavikelekile onyakeni owedlule base bethi abalingani babo bala ukusebenzisa ikhondomu. Ngokwejwayelekile, inkolelo ezindleleni zokucabanga ezibandlululayo kwabesifazane kuhlanganiswe nendlela yokuziphatha ocansini okuyingozi.

NOMPHAKATHI KANYE NE-HIV

abesifazane baseBotswana ababuzwa imibuzo bathi

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IZINTO EZIPHATHELENE

Ubumpofu

Ucwaningo lukhombisa ukuthi i-HIV isabalala ikakhulukazi ngokushesha kubantu abampofu abaphila le phansi emiphakathini. Ubumpofu into ebalulekile ejubaneni ubhubhane olubhebhetheka ngalo esub-Saharan Afrika. Ukuba mpofu kwenza ukuthi kube nzima ukuxoxisana ngocansi oluphephile; kwenza ukuthi abe mancane amathuba okuthi abantu banolwazi kahle nge-HIV; futhi kwenza ukuthi abantu abe mancane amathuba okuzimela ngokwezimali ­ zonke izinto eziyingozi zokubekeka engozini ye-HIV. Ngomthelela wobumpofu, isibonelelo somphakathi sesifakazele ukuba wusizo ekunciphiseni imiphumela ye-HIV. Izibonelelo zomphakathi ngendlela engaqondile zibe nomphumela omuhle obhubhaneni njengoba zenza ngcono ukufinyelela emfundweni nasekudleni okunempilo okuhle. Ucwaningo olwenziwa nguMnyango Wokuthuthukiswa Komphakathi lwaqaphela ukuthi uhlelo lwezibonelelo zomphakathi eNingizimu Afrika lunciphise indlala futhi lubambe indima yokuthuthukisa ekuphakamiseni imindeni empofu. I- Treatment Action Campaign (TAC) iyakuthanda ukwandiswa kosizo lomphakathi kubantu abampofu. Besikhankasela ukwethulwa kwesibonelelo sezifo ezingelapheki okuphilwa nazo (chronic illness grant ­ CIG-isibonelelo sabo bonke abantu abagula bengelapheki, kubandakanya abantu abane-HIV) kanye neSibonelelo Semali engenanyo Eyisisekelo (Basic Income Grant-BIG ­ inkokhelo encane kuzo zonke izakhamuzi, nangale kokuthi yimalini onayo)

Isithombe nguJodi Bieber

Imfundo

Ukufinyelela emfundweni ingxenye ebalulekile yokuqonda ukubekeka engozini ye-HIV. Ngokocwaningo luka-2008 olubheka amazwe aseAfrika ayi-11, "kwenziwe ukuxhumana okucacile phakathi [kwempumelelo] yemfundo kanye nengozi yokutheleleka nge-HIV ... amazinga emfundo aphezudlwana aholela ekwenzekeni kwe-HIV okuphansi." Ucwaningo olwenziwa eZambia lwakhombisa ukuthi amazinga okwenzeka kwe-HIV ayephansi kakhulu entsheni ephakathi kwe-15-19 aqede amazing aphakathi nendawo ukuya kwaphezudlwana emfundo kunalabo abaqede imfundo eyisisekelo kuphela. Ukungalingani ngokobulili kubalulekile kuwo omabili

IZINTO EZIPHATHELENE

amazinga emfundo ephansi namazinga aphezulu

Isithombe ngu-Kresta Vetting

NOMPHAKATHI KANYE NE-HIV

e-HIV. Amazwe asathuthuka anamagebe emazingeni emfundo phakathi kwabesilisa nabesifazane kuvamise ukuthi kube namazinga aphezudlwana e-HIV. Ngokwe- United Nations Development Programme (UNDP), emazweni angathuthukile, amantombazane angama-11% mancane amathuba okuthi baye esikoleni samabanga aphansi kunabafana, kanti emazweni athuthukile kancane le namba iyakhula ifike kuma-19%. Ucwaningo luka-2006 lukhombisa ukuthi amantombazane aqeda imfundo yasesekhondari aphakathi kwezikhathi eziphindwe kane nakasikhombisa ukuthi angasebenzisa amakhondomu kunalawo angaqedanga, futhi mancane amathuba okuthi batheleleke nge-HIV.

26

Isithombe nguDamien Schumann

Inhlamba nokubandlululwa

Singenzani ukushintsha lokhu?

Ucwaningo olwenziwa kokusho i-HIV emphakathini lukhombisa ukuthi izindlela zokuvimbela ezigxile ekushintsheni indlela yokuphila yomuntu ngamunye azisebenzi ngempumelelo uma kunezinkinga ezinkulu zomphakathi, umnotho kanye namasiko. Izindlela ezingcono kakhulu zokuvimbela ezikhona namhlanje, njengokusebenzisa amakhondomu, ukuhlola kanye nokubambelela ekwelashweni, kudinga ukwenza komuntu ngamunye. Ukuchitha imali okwandile ezinkingeni zenhlalo yomphakathi nomnotho sekunomthelela omkhulu ezinkombeni zempilo kunokubeka imali ezinhlelweni zezempilo zodwa. Ukuze kubhekwane ngqo ne-HIV, amazwe kufanele angachithi nje kuphela ngokuvimbela nokwelapha kodwa kubhekane nezinkinga zenhlalo yomphakathi, yesiko kanye nezomnotho. Kufanele sitshale izimali ezikoleni, ezindlini kanye nasezinhlelweni zomsebenzi kanye nokususa izinhlelo zomthetho nezesiko okukhuthaza ukungalingani kobulili, inhlamba kanye nokubandlululwa.

Imithombo: Butler, C `HIV and AIDS, Poverty and Causation.' The Lancet, Volume 356, Issue 9239 (2000); Dunkle, K et al. `Gender-Based Violence and HIV Infection among Pregnant Women in Soweto.' AUSAid (June 2003); 'Epidemic of Inequality: Women's Rights and HIV/AIDS in Swaziland.' Physicians for Human Rights (2007); Gilbert, L and Walker, L. `Treading the path of least resistance: HIV/AIDS and social inequalities--a South African case study.' Social Science & Medicine, 54, 1093-1100 (2002); `Girl Power: girls' education, sexual behaviour, and AIDS in Africa.' United Nations Girls' Education Initiative (28 August 2006). http://www.ungei.org/news/247_1061.html; Hargreaves, JR et al. 'Systematic review exploring time trends in the association between educational attainment and risk of HIV infection in sub-Saharan Africa.' Global Health Sciences Literature Digest (6 May 2008) http://hivinsite.ucsf.edu/InSite?page=jl-30-02; Ki-Moon, Ban. `Op-Ed: The Stigma Factor.' The Washington Times, (6 August 6 2008); Peltzer, K et al. `Determinants of knowledge of HIV status results in South Africa: results from a population-based survey.' BMC Public Health, 9:174 (2009); Sayles, Jennifer et al. `The Association of Stigma with Self-Reported Access to Medical Care and Antiretroviral Therapy Adherence in Persons Living with HIV/AIDS.' Journal of General Internal Medicine 24:10 (2009); Wilkinson, R and Marmot, M (eds). `Social determinants of health: The solid facts, Second edition.' World Health Organization, (2003); `Education and HIV/AIDS: a window of hope.' The World Bank (2002); '2008 Report on the global AIDS epidemic.' UNAIDS; www.irinnews.org - http://www.irinnews.org/ report.aspx?reportid=52401 (Kufinyelelwe kuwo wonke amasayithi ngoMeyi 2010)

UNobhala-Jikelele Wezizwe Ezihlangene u-Ban Ki Moon uthi "inhlamba isalokhu iyisithiyo esisodwa esibaluleke kakhulu ekwenzeni komphakathi. Isizathu esikhulu sokuthi abantu abaningi basabe ukubona udokotela ukuze asho ukuthi banalesi sifo yini, noma sifune umuthi wokumelapha uma kunjalo. Kusiza ukwenza i-AIDS umbulali othule, ngoba abantu basaba ihlazo emphakathini lokukhuluma ngakho, noma ukuthatha izindlela zokuqapha ezikhona. Inhlamba isizathu esikhulu sokuthi ubhubhane lwe-AIDS luqhubeke nokucekela phansi imiphakathi emhlabeni wonke. Ocwaningweni olungaziwa lwabantu abangama-200 abane-HIV, labo ababika ukuthi babhekene nezinga eliphezulu lenhlamba ayemakhulu amathuba okuthi babike ukufinyelela ekunakekelweni okungekuhle. Inhlamba nayo yayihlanganiswe nokubambelela okubi ekwelashweni ngezidambisi gciwane. Inhlamba ebhekene ne-HIV yavela ngesikhathi kwakunolwazi oluncane ngesifo. Namhlanje, sazi kakhulu impela nge-HIV, kodwa inhlamba iyaqhubeka. Ngeshwa abantu abaningi basabhekene nobandlululo ezandleni zikahulumeni wabo, emphakathini, ezikhungweni zezenkolo, emsebenzini noma emndenini. Ingxenye eyodwa kokuthathu yamazwe ayinamithetho evikela amalungelo abantu abane-HIV.

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IZINTO EZIPHATHELENE

NOMPHAKATHI KANYE NE-HIV

IZINDABA zegatsha

I-tAC Lusikisiki yeseka ukumiswa kwe-hCt

I-TAC ihambisa izinto zokufunda ezifana nephephabhuku le-Equal Treatment, HIV ebomini bethu, HIV in Our Lives, kanye nezincwajana ezineziqondiso zokwelapha ngezidambisi gciwane ezifakwe ulwazi olusha. Amalungu ethimba nawo anikezele amakhondomu amadoda ayi-147,000 kanye nayi-4,000 amakhondomu abesifazane Ihola ngokuba yisibonelo, uNdunankulu waseMpumalanga Kapa uNoxolo Kiviet kanye noNgqongqoshe waseMpumalanga Kapa Wezempilo uPhumulo Mosuale kwakungabokuqala ukuhlolelwa i-HIV. Amanesi angamaphrofeshinali kanye nathathe umhlalaphansi kwakufanele babuyiswe ukuze bezosiza ngokufuneka okuphezulu kokwelulekwa ngokwengqondo nokuhlola. Abesifazane abangama-356 kanye namadoda ayi-194 bathola ukwelulekelwa i-HIV ngokwengqondo, abesifazane abangama-326 kanye namadodo angama-90 bahlolelwa i-HIV, kanye nabantu abayi-151 abahlolwa

Ngenhla: Imigqa emide eyenziwe e- Holy Cross Hospital eMpumalanga Kapa, nabantu abamile emgqeni ukuze babambe iqhaza ekuhlolweni okuhlinzekiwe ngomkhankaso we-HCT owethuliwe. Phezulu kwesokudla: UNdunankulu waseMpumalanga Kapa uNoxolo Kiviet ohlanganyele obala ku-HCT. Phansi kwesokudla: Abasebenzi be-TAC namalungu ehambisa izimpahla ekumisweni kwe-HCT yaseMpumalanga Kapa. Zonke izithombe nguThandeka Vinjwa.

Umkhankaso kazwelonke woKwelulekwa Ngokwengqondo kanye Nokuhlolwa kusanda kumiswa eMpumalanga Kapa, kumasipala we-Ingquza Hill. Umkhankaso we-HCT uhlose ukukhuthaza abantu ukuthi bazi isimo sabo se-HIV ne-TB. Ingquza Hill yakhethwa ukuthi isingathe umkhankaso we-HCT ngenxa yokwenzeka kwe-HIV okuphezulu kuyo (28.6% kubantu), inamba yabashonile okuphathelene nokusoka kwendabuko, kukhuphule amazinga e-STI kanye nezehlakalo zokuntshontshwa kwezingane. Ukwethulwa kwenzeka mhla ka-10 Ephreli 2010 e-Holy Cross Hospital e-Flagstaff, kwakuze abantu cishe abayi-3,000. Ukwelulekelwa i-HIV ngokwengqondo nokuhlolwa kanye neziteshi zokuhlolwa i-TB zazikhona.

i-TB.

IZINDABA

I- Treatment Action Campaign's (TAC's) Lusikisiki Community Health Advocates yaba yingxenye ekuqwashiseni nge-HIV eMalangeni A/A, Magwa A/A and Goso Forest A/A. Ithimba le-TAC Lokufunda Ngokuvimbela kanye Nokwelapha lavakashela imitholampilo lapho abenza khona amaseshini emfundo ubuso nobuso ukugqamisa umkhankaso we-HCT.

28

1 3

2

4 5

Last month's winner will be announced in a future issue.

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7

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Fax or post your completed crossword, with your name, address and contact number. Address: Equal Treatment, PO Box 2069, Cape Town 8001 Fax: 021 422 1720 The crossword winner for Equal Treatment 32 is Mrs. Mantsie Motloung from Nigel

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11

12

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3 5 6 8

Couples where one partner is HIV-positive and the other HIV-negative are called sero-____ What does the second `P' in PEP stand for? HIV can be passed on to a baby during pregnancy, in ____ or while breast-feeding. Using more than one condom at once creates ____, causing condoms to break easily.

1

When we talk about using all the evidence-based prevention methods together, we call it ____ prevention. What are most male condoms made of? What does the `V' stand for in VMMC? Sperm____ is a procedure carried out in a clinic to separate sperm from seminal fluid containing HIV. Before being medically circumcised, a man has to give _____ consent.

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10 Medical circumcision involves the surgical removal of the ___ under hygienic conditions and anaesthetic. 11 Findings from the ___ Study, conducted in seven African countries, show that ART is helping to reduce new infections. 12 Even when medically circumcised, men should still use ____ to protect themselves and their partners.

equal treatment's

Across

Down

Crossword Puzzle

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We will give a R200 Pick n Pay gift voucher for the first crossword drawn from a hat with all the correct answers. The answers can be found in this issue of Equal Treatment.

For more information about the One Man Campaign, contact Sonke Gender Justice on 011 339 3589 or 021 423 7088, email [email protected] or visit our website at www.genderjustice.org.za

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