I-PrEP Umhlabeni Wonke | Decera Clinical Education

Ukubambisana Ukuze I-PrEP Ifinyelele Umhlaba Wonke: Ukukhetha Okulungile

Released: December 02, 2025

Linda-Gail Bekker, MBChB, DTMH, DCH, FCP(SA), PhD

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Key Takeaways

Ukusungula izingxoxo ze-PrEP mayelana nengozi ye-HIV kubeka i-PrEP inyumbazana futhi akufaki abantu abaningi abangase bangaziboni njengabahlanganyela ekuziphatheni “okuyingozi”.
Ukuvumela abantu ukuthi bakhethe i-PrEP ngokusekelwe ezidingweni zabo kanye nokuthandwayo kunikeza amandla, kunokucwasa, futhi empeleni kwandisa ukutholwa kwe-PrEP nokuphikelela.

Ukufika kwe-pre-exposure prophylaxis (PrEP) esekelwe kumuthi omelene negciwane kushintshe ukuvimbela i-HIV ngokuyinhloko. Lapho isetshenziswa ngokungaguquki nangokwezinga, i-PrEP inamandla okuqeda kakhulu ubhubhane lwe-HIV ngokuncipha okukhulu kwezehlakalo ze-HIV. Kodwa akwanele ukuletha i-PrEP kubantu "abasengozini" kuphela.

Izingcwaningo e-Afrika, lapho lolu bhubhane lusasakazeke kakhulu, kubonise ukuthi ukuhlola ukufaneleka kwe-PrEP kusetshenziswa imibandela yobungozi kungase kwehlise umthelela wayo: Ayibandakanyi abaningi abangazuza, futhi ingase icwase i-PrEP.

Ucwaningo luveze ukuthi emiphakathini lapho i-HIV ivamile khona futhi lapho ukuncishiswa kokwanda kwegciwane kungandile (ukuqokomisa ukudluliselwa kwegciwane), inani elikhulu lokutheleleka nge-HIV liyagwenywa lapho kunikezwa i-PrEP kubo bonke abangazuza. Umthelela wayo uncike ekufinyelelekeni, ekuthatheni, ukusetshenziswa okusebenzayo, kanye nokuphikelela.

Singakwenza kanjani lokhu ukuthi kwenzeke? Ngikholwa ukuthi impilo yezocansi kanye nokuzala iyingxenye ebalulekile yokunakekelwa kwezempilo okuyisisekelo. Uma uhlangana nomuntu ovamise ukuya ocansini, kufanele sihlole ukuthi ukuvimbela i-HIV kungaboniswa yini. Abantu abangathanda ukusebenzisa i-PrEP bangaboniswa izindlela ezihlukene ezitholakalayo ukuze kukhethwe noma yiziphi ezibafanela kangcono. Manje sinezinketho ze-PrEP ezihlanganisa i-Oral PrEP, iringi yesitho sangasese sowesifazane, kanye nezinhlobo ezi-2 ze-PrEP ezijovwa isikhathi eside. Indlela ngayinye inezici ezihlukile, okuhlanganisa indlela yokwenza kanye nekhefu lokuthatha umthamo.

Esimeni sethu, kunikezwa iskripthi sokwelulekwa esihleliwe, esithuthukiswa ngamapheshana namathuluzi edijithali anikeza ulwazi olwengeziwe, ukukala okuhle nokubi kanye nokusiza abangaba abasebenzisi be-PrEP ukuhlonza abakuthandayo ngaphambi kokuthi baxhumane nochwepheshe babo bezempilo (HCP). Lolu lwazi lube seluhlolwa ochwepheshe babo bezempilo ngokwemibandela yokufaneleka ngezinketho zezokwelapha ezahlukene ze-PrEP, ukwenza lula ukuqaliswa kwe-PrEP.

Ukubaluleka Kokukhetha
Idatha evela eMpumalanga Afrika ikhombise ukubaluleka kokunikeza abantu izinketho ze-PrEP ezivumelana nezidingo zabo siqu. Abaphenyi banikeze ababambiqhaza ukukhetha phakathi kwe-long-acting cabotegravir (LA CAB), i-oral PrEP, kanye ne-postexposure prophylaxis, nenketho engashintshwa ngokuhamba kwesikhathi (ukungenelela kokuvimbela ukukhetha okunamandla kwe-SEARCH). Bathole ukuthi ukunikeza izinketho kwandisa ukuchayeka ngokocansi kwe-biomedical isikhathi esihlanganisiwe ngo-69.7%, uma kuqhathaniswa no-13.3% ngokuvikela okujwayelekile kwe-HIV. Kuphinde kwehlise isehlakalo se-HIV ngo-0%, uma kuqhathaniswa no-1.8% yokunakekelwa okuvamile.

Sifunde namaphuzu athile abalulekile ezinhlengelweni zethu zokusebenzisa i-PrEP ezindaweni zamazinga aphansi ngokomnotho, nezindawo ezigcwele kakhulu e-Cape Town.

Ukunikeza ukukhetha kuyenzeka ngokwelulekwa okuhlelekile okufaka phakathi umbuzo wokuzihlola ojabulisayo wokulinganisa okuncamelayo. Ukwelulekwa ngokukhetha kungasebenza uma kwenziwa abeluleki abaqeqeshiwe ngokuhlolwa kokugcina okuholwa unesi ukuze kuqinisekiswe ukungabi nayo i-HIV. Kuphrojekthi yethu, sinikeze i-LA CAB, ringi ye-dapivirine yesitho sangasese sowesifazane, kanye ne-PrEP yomlomo. Iningi labantu abasha abaneminyaka engu-16-29 ubudala bakhetha i-PrEP yomjovo, futhi abambalwa bakhetha iringi yesitho sangasese sowesifazane. Izizathu eziyinhloko kwakuwukucatshangelwa kwendlela yokuphila futhi ukubaluleka okuncane kubhekiselwe kwimithelela emibi kanye nempumelelo.
Ukukhetha kuyaguquguquka, hhayi nje kuphela esikhathini eside kodwa nangesikhathi esifushane. Sithole ukuthi ngemva kwamasonto ambalwa, abantu abaningi basuka ekukhetheni i-PrEP yomlomo baya ekufuneni ukujovwa i-PrEP, mhlawumbe lapho bezizwa bekhululeke kakhudlwana ngomqondo we-PrEP.
Ukukhetha kwandisa ukutholakala nokufinyeleleka. ENingizimu Afrika, sikhombisile ukuthi ukwengeza ukukhetha kwe-PrEP kunyuse ukutholwa kwe-PrEP kukonke njengokuvimbela.
Ukukhetha kuholelela ekuphikeleleni okungcono: lapho abantu beqiniseka ngokukhetha kwabo, banokuphikelela okungcono ekukhetheni kwabo i-PrEP.
Amathuluzi edijithali angandisa ukuthathwa kwezinqumo futhi anciphise umthwalo kubeluleki nabahlengikazi.
Kungase kube nezinketho zokuhwebelana ezihambisana nezindlela zokuhambisa. Isibonelo, umsebenzisi we-PrEP ofuna ngempela ukuqonda nobumfihlo angase akhethe i-PrEP yomlomo noma yeringi, engalethwa endaweni yangasese, ngaphandle kokuya emtholampilo noma indawo yokuthola umjovo, odinga ukulawulwa i-HCP.

Ekugcineni, ukusungula izingxoxo ze-PrEP mayelana nengozi kubeka i-PrEP inyumbazana futhi akufaki abantu abaningi abangase bangaziboni njengabahlanganyela ekuziphatheni “okuyingozi”. Ngaphandle kwalokho, Ama-HCP kufanele ethule i-PrEP njengesici esivamile sokunakekelwa kwezempilo kokuvikela. Ukuvumela abantu ukuthi bakhethe ngokusekelwe ezidingweni zabo kanye nokuthandwayo kunikeza amandla, ngaphandle kokucwasa. Kukho konke, ukubambisana ukuthi i-PrEP ibe eyawo wonke umuntu, okusekelwe ekukhetheni komuntu siqu nokukhetha esikhundleni sobungozi, kubalulekile ekwenzeni umthelela obalulekile kubhubhane lwe-HIV.

Imicabango Yakho
Uziqala kanjani izingxoxo nge-PrEP emsebenzini wakho? Ucabanga ukuthi iyiphi indlela engcono yokuxoxa nge-PrEP nomuntu ocabanga ukuthi akayidingi? Phawula ukuze ujoyine ingxoxo!

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