{"id":1632,"date":"2019-06-18T00:58:08","date_gmt":"2019-06-17T21:58:08","guid":{"rendered":"http:\/\/blog.ulubat.org\/?p=1632"},"modified":"2019-06-18T00:58:10","modified_gmt":"2019-06-17T21:58:10","slug":"kullanilan-dogum-kontrol-yontemi-hiv-riskini-etkiler-mi","status":"publish","type":"post","link":"https:\/\/blog.ulubat.org\/index.php\/gunceller\/kullanilan-dogum-kontrol-yontemi-hiv-riskini-etkiler-mi\/","title":{"rendered":"Kullan\u0131lan do\u011fum kontrol y\u00f6ntemi HIV riskini etkiler mi?"},"content":{"rendered":"\n<p class=\"has-medium-font-size\">HIV enfeksiyonu cinsel yolla, kan ve kan \u00fcr\u00fcnleri ile, enfekte damar i\u00e7i enjekt\u00f6rlerle bula\u015fabilen ve intrauterin veya emzirme d\u00f6neminde anneden bebe\u011fe ge\u00e7ebilen bir vir\u00fcs tipidir. <\/p>\n\n\n\n<p class=\"has-medium-font-size\">D\u00fcnyada ilk HIV vakas\u0131 1981 y\u0131l\u0131nda saptanm\u0131\u015f ve bu tarihten sonra say\u0131 katlanarak artm\u0131\u015ft\u0131r. E\u011fitim seviyesi y\u00fcksek, geli\u015fmi\u015f \u00fclkelerde verilen e\u011fitimlerin etkisiyle say\u0131 kontrol alt\u0131na al\u0131nsa da G\u00fcney Afrika gibi geli\u015fmemi\u015f \u00fclkelerde hastal\u0131\u011f\u0131n \u00f6n\u00fc al\u0131namam\u0131\u015ft\u0131r. <\/p>\n\n\n\n<p class=\"has-medium-font-size\">\u015eu an d\u00fcnya\n\u00e7ap\u0131nda HIV ile enfekte 37 milyon ki\u015fi vard\u0131r ve bu say\u0131n\u0131n yar\u0131s\u0131ndan fazlas\u0131\nkad\u0131nlara aittir. <\/p>\n\n\n\n<p class=\"has-medium-font-size\">Y\u00fcr\u00fct\u00fclen hi\u00e7bir resmi \u00e7al\u0131\u015fma olmamas\u0131na ra\u011fmen \u00e7e\u015fitli \u015fartlarda 30 y\u0131ld\u0131r yap\u0131lan epidemiyolojik \u00e7al\u0131\u015fmalar kad\u0131nlar\u0131n kulland\u0131\u011f\u0131 hormonal kontraseptif \u00e7e\u015fitlerinin baz\u0131lar\u0131n\u0131n HIV duyarl\u0131l\u0131\u011f\u0131n\u0131 art\u0131rabilece\u011fini g\u00f6steriyordu. 2015 ve 2016\u2019da yay\u0131mlanan iki meta-analiz verisinde DMPA kullanan kad\u0131nlarda hi\u00e7 kontraseptif kullanmam\u0131\u015f kad\u0131nlara oranla HIV edinim riskinde % 40-50 art\u0131\u015f saptand\u0131. Bununla birlikte bu \u00e7al\u0131\u015fmalar\u0131n tasar\u0131m\u0131ndaki k\u0131s\u0131tlamalar nedeniyle HIV enfeksiyonlar\u0131n\u0131n kullan\u0131lan kontraseptif y\u00f6ntem t\u00fcr\u00fcnden mi yoksa di\u011fer fakt\u00f6rlerden mi kaynakland\u0131\u011f\u0131n\u0131 belirlemek m\u00fcmk\u00fcn de\u011fildi.<\/p>\n\n\n\n<p class=\"has-medium-font-size\">Ayr\u0131ca bu g\u00f6r\u00fc\u015fe kar\u015f\u0131 \u00e7\u0131kan pek \u00e7ok \u00e7al\u0131\u015fma da var. 13 Haziran\u2019da Lancet\u2019te yay\u0131mlanan bir makalede, kullan\u0131lan kontraseptif y\u00f6ntem \u00e7e\u015fidi ile HIV edinim riski aras\u0131nda anlaml\u0131 bir ili\u015fki bulunmad\u0131\u011f\u0131 a\u00e7\u0131kland\u0131.<\/p>\n\n\n\n<p class=\"has-medium-font-size\">Ara\u015ft\u0131rma, HIV insidans\u0131n\u0131n y\u00fcksek g\u00f6r\u00fcld\u00fc\u011f\u00fc b\u00f6lgeler olan eSwatini, Kenya, G\u00fcney Afrika ve Zambiya\u2019da yap\u0131ld\u0131.<\/p>\n\n\n\n<p>Not: D\u00fcnyada\nHIV ile enfekte kad\u0131nlar\u0131n yar\u0131s\u0131ndan fazlas\u0131 Afrikada ya\u015f\u0131yor ve bu gruba her\ny\u0131l 600 000 den fazla Afrikan kad\u0131n\u0131 dahil oluyor. <\/p>\n\n\n\n<p class=\"has-medium-font-size\">Hamile olmayan, 16-35 ya\u015f aras\u0131, kontraseptif kullan\u0131m\u0131n\u0131 arzu eden ve bu metodlara kar\u015f\u0131 bir yan etki g\u00f6stermeyen, cinsel olarak aktif 7829 kad\u0131n se\u00e7ildi ve kullanaca\u011f\u0131 kontraseptif metoduna g\u00f6re 3 gruba ayr\u0131ld\u0131. 1. Grup DMPA-IM, 2. Grup bak\u0131r IUD ve 3. Grup LNG implant\u0131 kulland\u0131.<\/p>\n\n\n\n<ul><li>Not: IUD (intrauterin device) Rahim i\u00e7i Ara\u00e7lar: rahme yerle\u015ftirilen T \u015feklinde bir cisimdir. Spermin fallop t\u00fcp\u00fcne ge\u00e7i\u015fini \u00f6nleyerek veya d\u00f6llenmi\u015f yumurtan\u0131n rahme yerle\u015fmesini engelleyerek etkisini g\u00f6sterir.<\/li><li>DMPA: ovulasyonu \u00f6nleyerek etki g\u00f6steren intram\u00fcsk\u00fcler uygulanan ila\u00e7lard\u0131r.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/li><li> LNG implant\u0131: cilt alt\u0131na yerle\u015ftirilen ve levonorgestrel salg\u0131layan cihazlard\u0131r. Bu madde ise hipofizden LH sal\u0131n\u0131m\u0131n\u0131 bask\u0131lar.\u00a0 <\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image\"><img loading=\"lazy\" width=\"1024\" height=\"1024\" src=\"https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/ria-1024x1024.jpg\" alt=\"\" class=\"wp-image-1634\" srcset=\"https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/ria-1024x1024.jpg 1024w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/ria-150x150.jpg 150w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/ria-250x250.jpg 250w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/ria-125x125.jpg 125w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/ria-110x110.jpg 110w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/ria-768x768.jpg 768w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><figcaption>Rahim i\u00e7i ara\u00e7 (spiral)<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image\"><img loading=\"lazy\" width=\"1024\" height=\"1024\" src=\"https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/aile-planlamasi-1-1024x1024.jpg\" alt=\"\" class=\"wp-image-1638\" srcset=\"https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/aile-planlamasi-1-1024x1024.jpg 1024w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/aile-planlamasi-1-150x150.jpg 150w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/aile-planlamasi-1-125x125.jpg 125w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/aile-planlamasi-1-110x110.jpg 110w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/aile-planlamasi-1-420x420.jpg 420w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/aile-planlamasi-1-400x400.jpg 400w, https:\/\/blog.ulubat.org\/wp-content\/uploads\/2019\/06\/aile-planlamasi-1-768x768.jpg 768w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><figcaption>LNG implant\u0131<\/figcaption><\/figure>\n\n\n\n<p class=\"has-medium-font-size\">&nbsp;18 ay boyunca yap\u0131lan g\u00f6zlemler sonucunda:<\/p>\n\n\n\n<p class=\"has-medium-font-size\"><strong>DMPA kullanan grupta HIV insidans\u0131 4,19 (100 kad\u0131nda)<\/strong><\/p>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Bak\u0131r IUD kullanan grupta HIV insidans\u0131 3,94 (100 kad\u0131nda)<\/strong><\/p>\n\n\n\n<p class=\"has-medium-font-size\"><strong>LNG implant\u0131 kullanan grupta HIV insidans\u0131 3,31 idi. (100 kad\u0131nda)<\/strong><\/p>\n\n\n\n<p class=\"has-medium-font-size\">G\u00f6r\u00fcld\u00fc\u011f\u00fc \u00fczere oranlar birbirine \u00e7ok yak\u0131n. Bu k\u00fc\u00e7\u00fck oran farkl\u0131l\u0131klar\u0131, metodlar\u0131n HIV insidans\u0131n\u0131 de\u011fi\u015ftirdi\u011fine y\u00f6nelik bir yorumlama yapmak i\u00e7in olduk\u00e7a yetersizdir.<\/p>\n\n\n\n<p class=\"has-medium-font-size\">T\u00fcm\ngruplar\u0131n ortalama HIV insidans\u0131 ise yine 3,81 (100 kad\u0131nda) gibi y\u00fcksek bir\norand\u0131. Bu y\u00fcksek rakam, HIV in bu \u00fclkelerde bir\u00e7ok kad\u0131n i\u00e7in \u00f6nemli bir\nki\u015fisel risk ve halk sa\u011fl\u0131\u011f\u0131 sorunu oldu\u011funu kan\u0131tlar nitelikteydi. <\/p>\n\n\n\n<p class=\"has-medium-font-size\">WHO HIV ve\nHepatit departman\u0131ndan Dr. Rachel Bagggaley: \u201cBu \u00e7al\u0131\u015fma \u00f6zellikle kad\u0131nlar\ni\u00e7in bu t\u00fcr \u00fclkelerde HIV korumas\u0131nda bir ad\u0131ma ihtiya\u00e7 oldu\u011funu vurguluyor.\u201d\ndiyerek bu konuya dikkat \u00e7ekti. <\/p>\n\n\n\n<p class=\"has-medium-font-size\">Ara\u015ft\u0131raman\u0131n ba\u015f\u0131ndaki be\u015f ki\u015fiden biri olan Witwatersrand \u00dcniversitesi Wits \u00dcreme Sa\u011fl\u0131\u011f\u0131 \u0130cra Direkt\u00f6r\u00fc Profes\u00f6r Helen Rees Johannesburg ise \u201cOn y\u0131llarca s\u00fcren belirsizlikten sonra, nihayet hormonal kontrasepsiyon ile HIV riski aras\u0131ndaki muhtemel ili\u015fki hakk\u0131nda g\u00fc\u00e7l\u00fc bilimsel kan\u0131tlara sahibiz\u201d diyerek ara\u015ft\u0131rman\u0131n \u00f6nemini vurgulad\u0131. <\/p>\n\n\n\n<p class=\"has-medium-font-size\">Kaynak\u00e7a ve ileri okuma i\u00e7in:<\/p>\n\n\n\n<ul><li><a href=\"https:\/\/www.who.int\/news-room\/detail\/13-06-2019-new-study-finds-no-link-between-hiv-infection-and-contraceptive-methods\">https:\/\/www.who.int\/news-room\/detail\/13-06-2019-new-study-finds-no-link-between-hiv-infection-and-contraceptive-methods<\/a><\/li><li><a href=\"http:\/\/www.hatam.hacettepe.edu.tr\/Epid_web_09.pdf\">http:\/\/www.hatam.hacettepe.edu.tr\/Epid_web_09.pdf<\/a><\/li><li><a href=\"http:\/\/www.istanbulsaglik.gov.tr\/ahweb\/belge\/ap\/spiral.pdf\">http:\/\/www.istanbulsaglik.gov.tr\/ahweb\/belge\/ap\/spiral.pdf<\/a><\/li><li><a href=\"http:\/\/www.mhcs.health.nsw.gov.au\/publicationsandresources\/pdf\/publication-pdfs\/8695\/oth-8695-tur.pdf\">http:\/\/www.mhcs.health.nsw.gov.au\/publicationsandresources\/pdf\/publication-pdfs\/8695\/oth-8695-tur.pdf<\/a><\/li><li><a href=\"https:\/\/www.jinekolognet.com\/norplant.asp\">https:\/\/www.jinekolognet.com\/norplant.asp<\/a><\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\">G\u00f6rseller: <\/p>\n\n\n\n<ul><li> <a href=\"http:\/\/www.populermedikal.com\/2005\/10\/20\/hormonlu-rahim-ici-arac\/\">http:\/\/www.populermedikal.com\/2005\/10\/20\/hormonlu-rahim-ici-arac\/<\/a> <\/li><li> <a href=\"http:\/\/yeniblogaile.blogspot.com\/2017\/10\/deri-alt-implantlar.html\">http:\/\/yeniblogaile.blogspot.com\/2017\/10\/deri-alt-implantlar.html<\/a> <\/li><li><\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\">Orijinal makale:<\/p>\n\n\n\n<p><a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(19)31288-7\/fulltext\">https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(19)31288-7\/fulltext<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>HIV enfeksiyonu cinsel yolla, kan ve kan \u00fcr\u00fcnleri ile, enfekte damar i\u00e7i enjekt\u00f6rlerle bula\u015fabilen ve intrauterin veya emzirme d\u00f6neminde anneden<\/p>\n","protected":false},"author":57,"featured_media":1642,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[165],"tags":[155,156],"acf":[],"views":1106,"_links":{"self":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/1632"}],"collection":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/users\/57"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/comments?post=1632"}],"version-history":[{"count":4,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/1632\/revisions"}],"predecessor-version":[{"id":1645,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/1632\/revisions\/1645"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media\/1642"}],"wp:attachment":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media?parent=1632"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/categories?post=1632"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/tags?post=1632"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}