Yakakosha Tsvaga

(1) Iko kushandiswa kwegastrointestinal turakiti sechibereko kunosanganisirwa nenjodzi dzehutano hwechimwe hutachiona uye chinoshungurudza.

(2) Pakati pevanhu vanotungamira mararamiro eungochani, vese varume nevakadzi, kune mikana yakawanda yakawandisa yezvirwere zvakasiyana, zvese zvinotapukira (hutachiona hweHIV, syphilis, gonorrhea, nezvimwewo), nekuvhiyiwa uye kwepfungwa.

Nhanganyaya

Chirevo chinotevera che LGBT + vanoratidzira - kufamba kuri kutaura kuti chiitiko chimwe chete chebonde chinofungidzirwa kuti rudzi rwemhando yemunhu uye, semhedzisiro, haina hutano. Iyo anatomical uye yemuviri maitiro emuviri wemunhu uye yekutsvaga mhinduro zvinopesana nezvirevo zvakafanana. Kuita ungochani kunosanganisirwa nenjodzi yakawandisa yemaitiro akasiyana-siyana, ayo LGBT + varatidziri vakanyarara nezvayo.

Kana tichifunga nezvenyaya iyi, tichaongorora zvinhu zvinotevera: (1) kutyorwa kwakanangana nehukadzi hwepabonde; (2) ungochani.

General zviratidzo zvehutano

Maererano ne Ruth naSantacruz (2017), huwandu hwakakosha hwekutsvagisa kwesainzi hunoratidza kuti, kana tichienzanisa nevarume, vanhu vanoita ungochani uye mararamiro eungochani vakanyora kusaenzana kwakakosha muhutano hwepanyama uye hwepfungwa. Vanopedzisira vasangana nematambudziko ehutano mukati mehupenyu hwese, kusanganisira hutachiona, kusanganisira hutachiona hweHIV muvarume, asthma, uye chirwere cheshuga mumadzimai (Corliss et al. Xnumx) nezvimwewo chirwere chisingaperi, njodzi yakawedzera yechirwere chemoyo uye kenza, yakanyanya mukana yekuremara pazera diki. Vechidiki vari panjodzi huru yekuputa utsi uye chisimba. Kune huwandu hwepamusoro hwevanhu vanofa, kunyanya, njodzi yakawandisa yekufa kwevakadzi, varume nevakadzi vanehukadzi, kuedza kuzviuraya, pamwe nemamiriro asina kufanira epfungwa, mazhinji acho ari pachena mupfungwa mune zvakasikwa, sekuwedzera kwakanyanya kwekunetseka, kutya, kutya kwepfungwa, kushushikana uye kusagadzikana kwakabatana nekuwedzera kwekushandiswa kwezvinhu zvinopa psychoactive, kusurukirwa muchembere (Ruth & Santacruz 2017; Lick et al. Xnumx; Yarns et al. Xnumx) Zvisinei nenyaya yekumanikidza kuita zvebonde izvo zvinokonzeresa kushushikana kana kwepfungwa kusanyorwa zvisina kurongeka sechirwere chakazvimirira mugwaro razvino rekugadziriswa kweanonyanya kuzivikanwa American Psychiatric Association ("DSM-5"), vamwe varwere nevarapi vanovaona sevakasiyana. kupindwa muropa, sekupindwa muropa nokubhejera (Yarns et al. Xnumx).

Njodzi dzakabatana nehukombwe

Varume ngochani

Zvinoenderana nehunyanzvi hwezvidzidzo, kungochani pakati pevanhurume kunoenderana nenjodzi dzehutano. Kuita ungochani pakati pevarume vanoita anal-genital kusangana¹; mune zvesainzi uye zvepamutemo zvinyorwa, anal-genital kusangana zvakare inonzi sodomy (Fischel xnumx, peji. 2030; Zhakupova 2015, peji. A543; Weinmeyer xnumx, peji. 916; Israeli Penal Mutemo, art. 347c) Muhuwandu hwakawanda hwezviitiko, anal eroticism inoitwa mukuita ungochani pakati pevarume - iyo anus uye rectum inoshandiswa nenzira dzakasiyana siyana. Zvinoenderana nezvakabuda muongororo yeEuropean yevanhurume vanoita zvepabonde nevarume, anal-genital kusangana kunoitwa mu95% yevose vanoita zvepabonde, (EMIS 2010, peji. 113). Kumwe kuongorora kwakaongorora tsika yekubatana kwevanhu vanoita zveungochani vasina kutapukirwa nehutachiwana, avo varoorani vavo vakatakura hutachiona hwehutachiona - hukama hwehutachiona hwakaitwa mu99,7% yevose vanobata zvepabonde (Rodger 2016, peji. 177).

Uye zvakare, tsika yekudzivirirwa yekudzivirira-genital kusangana pakati pevanhurume vanoita zveungochani, maererano nezvimwe zvinyorwa, ndeye 41% (Valleroy 2000), 43% (Grov 2014), 56% (Nelson xnumx), 58% (EMIS 2010, peji. 116). Iko kushandiswa kwemakondomu mukuwongorora-genital kusangana pakati pevarume kwave kuderera mumakore achangopfuura (Hess 2017, peji. 2814; Unemo 2017).

Njodzi dzakabatana ne anal eroticism

Iyo rectum - chikamu chekupedzisira chegastrointestinal yemunhu - inowanzoitirwa kuunganidzwa uye kuwanda kwehunyoro nyoro uye hunonamira. Maitiro ekugaya kwevanhu anosanganiswa nekuvapo kwezviratidzo zveiyo micrafic mu lumen yemudumbu inobatsira mukuputsika kwezvinhu zvakasiyana kubva mukudya (Quigley 2013) Hutachiona uhu mumunhu hune hutano hunopinda mukati meropa nekuda kwekuvapo kwechidzitiro chemuviri chinosanganisira mucous layer uye mudumbu remukati.Faderl xnumx) Kupinda kwezvikamu zveiyo zviratidzo mumuviri weropa kunokonzeresa hosha dzakasiyana, kusanganisira sepsis (Takiishi 2017; Kelly 2015).

Iyo anatomical dhizaini uye basa remuviri rectum haripi kupa kushandiswa kwaro mukuita zvepabonde: kududzirwa kweanobatana-genital kusangana sekuenzana neyechikadzi coitus inopesana neatomiki uye yemweya yekubereka yemuviri wemunhu. Kunyangwe kushandisa kondomu, kusangana-nehunhu kusangana kunoisa njodzi huru, kunyanya kune unogamuchira. Ikavhurwa ne rectum panguva yekutanga kuita zvepabonde, nhengo dzayo dzakapfava dzinokuvara. Aya matishu anoshanda kuti aunganidze akapfava fecal masase paanovagadzirira iwo excretion nekuda kwekufamba zvishoma kwekuzvimiririra contraction mudumbu. Kufananidza kweiyo rectum neyevakadzi haina basa: iyo tishu yeiyo rectum haina kumbobvira yakasimba senge tishu dzemukati memurume, nhengo inogadziriswa ino shanduka yekubereka. Mukuwedzera, iyo nharaunda yevakadzi pachayo yakachena kwazvo kupfuura nharaunda yerectum. Bonde rine mafuta akasarudzika emafuta uye anotsigirwa netiweki yemasuru. Rutivi rwomukati rwevakadzi rwakavharirwa nehupamhi mucous membrane, inosanganisira yakawanda masheya epithelial masero, ayo anotendera iwe kutamisa kupokana pasina kukuvadzwa uye uchirwisa zvinogumburwa nemhedzisiro yemurume. Rutivi rwomukati rwe rectum rwakavharwa nehupamhi hutete hwakaumbwa nekaitiro rimwechete remasero epithelial. Iyo mitezo ye rectum inogara ichinyanyisa kana kushomekana mukati mekuita zvepabonde kurara. Kunyangwe pakusava nekukuvara kunoonekera, ma microcracks nema microcracks e mucosa anobatsira kuti apinde mukati memececic microparticles, mapuroteni embeu nehutachiona mumuropa.

Nyanzvi dzakacherekedza kuti varume vanoita zveungochani vane hunhu hwekuremara kwekoloni uye rectum, nekuda kwekushandiswa kusiri kwepanyama kwemitezo iyi (Kazal 1976) Kuomarara kweizvi pathologies kwakatonzi huchingochani hwekuzeya matumbo.²; yakanyorwa mukuderera kwehurongwa hwekufamba-famba: conical condylomatosis, hemorrhoids, proctitis, rectal fissures uye fistulas, pararectal abscesses, amoebiasis, polyps, hutachiona hepatitis, gonorrhea, syphilis, rectal kukuvara, miviri yekune imwe nyika mune rectum, shigellosis, ulcers rectum uye lymphogranulomatosis (Owen xnumx; Kazal 1976) Vamwe vanyori vakatsoropodza izwi rekuti "ungochani bowel syndrome" pahwaro hwekuti zvimwe zvezvirwere izvi zvinowanikwa mumatumbo evakadzi, asi ruzhinji rwevarwere vane chirwere ichi nevarume vanoita anal erismism nevamwe varume (Glenn 1994; Markell 1983).

Mukuwedzera kumadziro erectum, iyo anal sphincter, iyo annular muswe, zvakare inorwara nekuda kwekudzikiswa kweiko, kunze kwekugadzirisa, mafuru anoitwa mu rectum. Iyo anal sphincter ine imwe nhanho yezwi uye elasticity, inokwanisa kutambanudza zvishoma zvishoma kuti ubvise zvakapfava ndove. Nekukuvara kwakadzokorora, kukakavara uye kushushikana, iyo sphincter inorasikirwa inzwi rayo uye kukwanisa kuchengetedza kuvharwa kwakasimba.

Kubva pane zvataurwa pamusoro apa, isu tinofunga matambudziko anotevera anokonzerwa ne anal-genital kusangana: (A) kupinza kwehutachiona uye mavhairasi kubva ku rectal cavity kupinda muropa nekuda kwekunetseka kushungurudzika; (B) fecal incontinence nekuda kwekutambanudza kwe anal sphincter, uye kukuvara kumadziro ematumbo; (B) kusagadzikana kunokonzerwa nemhinduro yekudzivirira kumurume.

A. Njodzi dzezvirwere

AIDS pakati pevanhurume

Ne anal-genital kusangana, njodzi yekutapukirwa kwehutachiona hwehutachiona hwehutachiona hwehutachiona (HIV / AIDS) inowedzerwa zvakanyanya, iyo zvakare yakafambiswa nekusakwana kwehurefu hwerectal mucosa (Baggaley 2010; Belec 1995; Levy 1993) Hutachiona hweHIV / AIDS pahwakatanga kuwanikwa muUnited States, mu1981, hwakatanga kunzi ngochani immune system, "gay-immune immune defficiency (GRID)"³sezvo ngochani dzakawedzera kupfuura 90% yezvese zviitiko zvichangobva kuwanikwa (Altman 1982) Sekureva kweUS National Center yeChirwere chekuDzivirira uye Kudzivirira (NCHP) ye 2015 yegore, varume vanoita zvepabonde nevarume vanoita 67% yehutachiona hutsva hweHIV muUSA ne82% yezvirwere zvese zvitsva zveHIV muvakomana nevarume. pamusoro pemakore 13 (CDC 2015) Kuwedzeredzwa kweAIDS pakati peboka revanhu iri 50 nguva zhinji kuwedzeredza mune mamwe mapoka (Bagby 2009). Njodzi yekutapukirwa nehutachiona nehutachiona husina kudzivirirwa kubatana kwepamuviri ndeye 17,25 nguva yakakwira kupfuura nepadziviriro yebonde.Patel 2014).

Mu2007, NCHP yakaburitsa chirevo chakapa huwandu hwehuwandu hwekufa uye zvinhu zvine njodzi zvekufa (CDC 2007) Pakati pehuwandu hwehuwandu hwekufa kubva kuAIDS, njodzi dzakatungamira kuchirwere cheAIDS (semuenzaniso, kuwedzerwa ropa, ungochani, kupindwa muropa nezvinodhaka, nezvimwewo) zvakaverengerwa. Sekureva kwe2007 mushumo, kusangana kweungochani ndiyo yega nzira yekutapukirwa nehutachiona hweHIV mu59,2% yerufu rwese rwe AIDS.CDC 2007, p. 19), uye mu2015 nhamba yakasvika 66,8% (CDC 2015, peji. 18). Iyo data yakaratidzwa kuNational NCHP Musangano mu2010 yakaratidza kuti huwandu hwehutachiona hutsva hwekuongororwa kwehutachiona pakati pevanhurume nevarume vanoita zvehurume hwakawanda kudarika nguva dze44 hwakanyanya kupfuura hwevamwe varume (CDC 2010; CDC Press Sunungura xnumx) Zvinoenderana neshumo yeNCHP yegore re2010, varume vanoita ngochani vakaita 63% yezvese zviitiko zvitsva zvehutachiona hwakanyorwa (CDC 2012) uye 67% - yezvese zviitiko zvitsva zveHIV mugore re2015 (Nelson xnumx) MuAustralia, varume ngochani vanoverengera 80% yevatsva utachiona hweHIV mune 2017 gore (Kirby Institute 2017).

Zvinonakidza kuti, maererano neiyo NCHPZ yemakore 2010-2016 makore, huwandu hwehutachiona pakati pevachiri kurovana unoderera gore rega rega (mu2015, nezve 3 000 pagore), nepo pakati peungochani inoramba isina kuchinjika - anenge 26 000 pagore (CDC 2016) Tichifunga kuti muUnited States ngochani dzinoita chete 2.3% yehuwandu (Ward et al. Xnumx), Utachiona hweHIV pakati pavo hunoitika kanenge ka375 kakawanda kupfuura pakati pevachati. Parizvino, chete 9% yehutachiona muUnited States inoitika kuburikidza nehukama, asi ngochani, kunyangwe huwandu hwadzo hushoma, ndiyo inokonzeresa 67% yevese utachiona hweHIV, uye ne83% pakati pevanhurume.

Mufananidzo wakafanana unoonekwa mune dzimwe nyika.

Zvakare, nekuda kwekuwanda kwakanyanya kwehutachiona hweAIDS pakati pevakomana nevarume, vanorambidzwa kupa nhengo neropa, kunyangwe munyika umo ungochani hwakaiswa muhupenyu hweveruzhinji (semuenzaniso USA, Germany kana Netherlands) (FDA 2017).

Zvakare, chirwere cheAIDS pamwe nekunetsekana nekudzivirirwa kwekudzivirira muviri ndechimwe chezvikonzero zvekutanga kwechironda cheganda chakashata chinonzi Kaposi's sarcoma: muUSA, Kaposi's sarcoma inosanganiswa neAIDS inoonekwa zvakanyanya pakati pevaya vanoita zvepabonde nevarume (Kumar 2016; PDQ 2015).

HIV / AIDS handiyo yega chirwere chinotapuriranwa pabonde (STD) chinozivikanwa kune varume vanoita ngochani. Maererano nemishumo yakasiya-siyana, varume ngochani vane njodzi yakawandisa yeanotevera STDs: syphilis (Mataundi 2017, gonorrhea (Fairley 2017b), chlamydia uye venereal lymphogranulomatosis (Saxon xnumx; Annan 2009viral hepatitis (CDC 2015; Lim xnumx), cryptosporidiosis (Hellard xnumx), Epstein-Barr hutachiona (Hsu xnumx; Van Baarle 2000; Naher 1995), shigellosis (Danila xnumx; Thorpe in Holmes xnumx, peji. 549), salmonellosis uye typhoid (Batsira 2003; Boka xnumx), papillomavirus (Patel 2017) Pazasi isu tizocherekedza zvakadzama mamwe emamwe STD akanyorwa.

Syphilis

Vamwe vanyori vanodana syphilis chitsva (mushure mehutachiona hweHIV) denda pakati peungochani (Spornraft-Ragaller 2014) Semuenzaniso, maererano neKing County yeWashington State muAmerica kwegore re1999, 85% yezviitiko zve syphilis zvakataurwa pakati pevaya ngochani (CDC 1999) Padanho renyika muAmerica, zviitiko zveprimary nemasekonzi syphilis pakati pevanhurume nevarume vanoita zvengochani zvakatopfuura nguva dze46 zvakakwirira kupfuura izvo zvevatechani.CDC 2010) Pakave nekuwedzera kwezviitiko zvitsva zve syphilis pakati pevanhurume pakati pemakore gumi apfuura (Meya 2017; Abara xnumx, peji. 9).

Gonorrhea

Iko kune kuwedzera kwehuwandu hwegonorrhea pakati pevarume vanoita ngochani (Fairley 2017b) Chiitiko chekuti gonorrhea pakati pevanorara nevarume chakapetwa kagumi pane chiitiko chehuronono mukupindirana kwevanhukadzi, kunyange munyika dziine hurongwa hwehutano hwakagadziridzwa (Fairley 2017a) Mune varume ngochani, gonorrhea kutapukira kunobata kunyanya pharynx uye rectum, uye hutachiona hunopfuurira nezviratidzo zvakajeka, kana kazhinji asymptomatic (Barbee 2014).

B. Njodzi yekukuvara kune anal sphincter

Maererano nekudzidza kukuru kweAmerica, kugara uchingoita anal-genital kuita zvepamberi kunotungamira mukusagadzikana kwean anal sphincter uye fecal incinuence - encopresis (Markland xnumx).

Kuongorora kwacho kwaisanganisira data kubva kuvanhu 4 vane makore 170-20 makore (vakadzi 69 nevarume 2) ... Mushure mekugadziriswa kwakawanda kwezvinhu zvimwe zvine chekuita nekusakwana kwemucheka, kusangana pabonde nekurara kwevanhukadzi kwakaramba kuri chirevo chekufungidzira kusagadzikana muvarume (huwandu hwehuwandu: 070 , 2, ine 100% nguva yekuvimba: 2,8-95) uye vakadzi (huwandu hwehuwandu: 1,6, iine 5,0% nguva yekuvimba: 1,5-95) ... Mhedziso: mhedzisiro yakawanikwa inotsigira chirevo icho anal-genital kusangana ndicho chinhu chinotungamira mukusaziva kusakwana kwevanhu vakuru, kunyanya muvarume (Markland xnumx).

Fecal incontinence inoreva kusarongeka kwemukati memukati (mudumbu, mvura, magasi) uye kusakwanisa kunonoka defecation kusvika wasvika kuchimbuzi (Paquette xnumx) Fecal incontinence inotakura njodzi yechipiri matambudziko, inogona kukonzera kuremara uye zvakakomba matambudziko emunhu ega evarwere, uye kurapwa kwaro ibasa rakaoma kwazvo (Saldana Ruiz 2017) Kukuvara kwakanyanya kwemukati kunoda kupindira kwekuvhiya kunogona kunge kuri mhedzisiro yekusangana pabonde, "kunoitwa nekubvumirana kwakanyanya"Altomare 2017, peji. 372). Anal-genital kusangana mune dzakawanda kesi kunotungamira kurwadziwa kwakanyanya (Rosser 1998; Damon 2005; Hollows xnumx; Hirshfield xnumx)

B. Njodzi dzakabatana neKutadza Kwemhinduro Kumurume

Maantisperm masoja ekudzivirira chirwere (ASA) - ma antibodies anogadzirwa nemuviri wemunhu achipesana nembeu antijeni (Krause 2017, peji. 109). Kuumbwa kwe ASA ndechimwe chezvikonzero zvekudzikira kwekusabereka kana autoimmune kusabereka: ASA inokanganisa basa re spermatozoa, kukanganisa manyowa maitiro (shandura nzira ye acrosomal reaction), kumisikidzwa uye kukura kwe "embryo"Kudzorera 2013) Zvidzidzo pamhando dzakasiyana dzemhuka dzakaratidza hukama pakati peASA uye kuumbika kushanduka (Krause 2017, peji 164) Cui et al. Takaita ongororo yemeta kudzidza kushamwaridzana pakati peASA uye kusabereka kwechirume, tichivhara nyaya dze1167 dzekusabereka kwechirume, takawana kuti mune 238 kesi (20,4%) ASA inoonekwa mune varume vasina kubereka (Cui xnumx), uye Restrepo uye Cardona-Maya vanoratidza mukuongorora kwavo kuti ASA ndiyo chikonzero chekusabereka mu 10 - 30% infertile vakaroora (Kudzorera 2013) Maererano naFijak et al, chiratidzo ichi chinogona kunge chakanyanya kukwirira, nekuti mu31% yemhosva zvinokonzeresa kusagadzikana zvinoramba zvisingataurwe, uye ASA inokwanisawo kutora nzvimbo mune idzi mhosva dzisina kutaurwa (Fijak xnumx, 2018) Mhedzisiro yekuzvidzivirira kweASA iri kuongororwa panguva yekuvandudzwa kweanodaidzwa dziviriro yekudzivirira kubata mbichana kwevanhu (Krause 2017, p. 251), pamwe nekudzora uye kudzora huwandu hwemhuka dzesango (Krause 2017, peji. 268).

Huwandu hwevanyori hunoratidza kuti sperm ichipinda mu rectum panguva yekusangana-genital kusangana kunokonzeresa ASA muvasikana vaviri (Rao 2014Tom. 1, peji 311; Lu 2008; Bronson xnumx) Wolff et al. Akawana kuti mafambiro ekuwongorora ASA muhurume varume vanoita zveungochani anosvika 28,6% (Wolff xnumx) Kuongororwa kwakaitwa naWitkin nevamwe vake kwakaratidza kuwirirana pakati pekuvapo kwehutachiona hwehutachiona uye kutenderera kwezvirwere zvehutachiona mumuropa revarume vane ngochani vachienzaniswa nevechirume.Witkin 1983a) Mune ongororo yakaitwa naMulhall nevamwe vake, chiyero chekuonekwa kweASA mune varume vaive vasina kuchengetedzwa kugamuchira anal-genital kubata mumwedzi yekupedzisira ye6 yaive 17%, uye 0% mune varume vasina kuita zvakadaro kutaurirana.Mulhall 1990) Nekudaro, kuongororwa kwakaitwa naSands et al. Hazvina kuratidza hukama pakati pehukama hwehukama uye ASA titers mune varume (Sands xnumx) Zvakangodaro, nyanzvi dzinotungamira mune zvekusabereka hutachiona dzinotenda kuti, kunyangwe huwandu husina kukwana hwezvidzidzo zvekupedzisa, mukana weASA muvanhurume vanogamuchira vehukama mukubatana-kwepedhi hukama hwakanyanya (Krause 2017, peji. 142).

ASA inogonawo kuumbwa mumuviri kana ropa-testicular barriers rikatyorwa (ropa rinosangana neanenge maserogenic) nekuda kwezvirwere zvinotapuriranwa pabonde (ona pamusoro: gonorrhea, nezvimwewo) - kuumbwa kwemasoja ekudzivirira maantisperm kune maantrogen masero embeu yavo (Jiang xnumx; Kudzorera 2013; Francavilla xnumx, peji. 2899).

Zvinofadza, spermatozoa inosanganiswa neASA inogona kukonzera kuumbwa kweASA muvakadzi (Krause 2017, peji. 166). Ichi chokwadi chakanyanya kufarira kwesainzi uye yekiriniki, zvichifunga nezve data iro kubva ku45,6% kusvika ku73% yevanhurume nevarume vanoita zvebonde nevarume (Tao xnumx; Larmarange xnumx) Fethers uye vanobatana vanyori vanotaura zvakafanana data mukudzidza kwavo kuita zvepabonde muvakadzi vanoita zveungochani: kwavari, mukana wekurara nemurume nemurume ngochani waive wakawanda kakawanda kupfuura kune vakadzi vanoita chipfambi.Fethers xnumx, mapeji 347 - 348).

Pamusoro pemhedzisiro yenguva refu yeASA mudambudziko rekusabereka, Kirilenko et al kunyora:

"... Mumakore achangopfuura, zvave pachena kuti kushata kwemurume ndiko kunokonzeresa kusavapo kwekuzvitakura, asi zvakare nekutyora kwekukura kwembeu, kubereka kuberekwa, uye kunyange kenza muvana." Pakati pezvakawanda zvinokurudzirwa zvinokonzeresa kusava kwemurume basa, yenyukireya kukuvadzwa kweDNA ndiyo inonyanya kudzidza uye kuwedzera kuzivikanwa sechinhu chakakosha chinobata mhando yembeu, kukura kwayo nekusimudzirwa. Meta-inoongorora nezve basa reDNA kupatsanurwa kwakaratidza kuti njodzi yekuzvimba kwemimba nekukanganiswa kwekukura kwe fetus inowedzera kusvika mana nekuwedzera sperm DNA kupatsanurana (15-30% yakajairwa, zvichienderana nenzira dzinoshandiswa), kunyangwe nzira dzekushandisa mu vitro fetiraiza uye intracytoplasmic sperm jekiseni. Iyo inotungamira pathogenetic mechanism yekukuvadza kwakadaro inoonekwa seyekuwedzeredza kwezvinhu zvinoshanda zveoksijeni marudzi - ozone, hydrogen peroxide, nitric oxide, inotungamira kune spermatozoa OS. Chinhu chinonyanya kukonzera kushungurudzika kwe oxidative muhurongwa hwekubereka kwechirume chirwere chinotapukira nechirwere chechirwere cheshuga uye ASA mudumbu rechirume ...Kirilenko 2017).

Ehezve, kudzidza kuongororwa kwehukama nevarume vanovata nevarume seyengozi yekuzvara kwevakadzi kunojekesa nyaya iyi.

Kuwedzera kune matambudziko ekubereka, rectal management yehunhu hunogona kunge iri chikonzero chehumwe kusagadzikana. Kuongorora kunonakidza kwakaitwa naWitkin et al.: Vhiki resectal insemination yeanhurume ehurume ane sungura sperm kwemavhiki e15 akatungamirwa kuoneka kwemasoja ekudzivirira chirwere kune GM1 gangliosides. Mamwe ma antibodies akawanikwa muvarwere vane ngochani dzeAIDS (Witkin 1983b), zvisinei, mune iyi kesi, kumwe kutsvakwa kunodiwa kune mimwe mhedzisiro isingaanzwisisike.

Ngochani vane autoimmune thrombocytopenic purpura, kusanganisira yakaoma mafomu (Bender xnumx; Goldsweig 1986; Morris xnumx) Morris nevamwe vake vakakurudzira kuti hematologic nhumbu dzakakonzerwa nemhinduro dzekudzivirira kwomuviri (Morris xnumx).

Njodzi dzinosanganiswa nedzimwe nzira dze anal eroticism

Anal uye bhuku kupinza kana chibhakera⁴ - tsika yekubatana pabonde nekusvitswa kweruoko murectum (Holland xnumx, peji. 34). Maererano neongororo yezvekunze kwenyika dzekuEurope, pakati pevachingochana vanoita zvepabonde nevasina kujairana navo gore rapfuura, 17,1% yaidzidzira kupinza bhuku mune basa rinoshanda, uye 10,5% mune yekugamuchira chinzvimbo (EMIS 2010, peji. 116). Zvinoenderana nekuongororwa kwakaitwa pakati pevanhurume, 7% yevakabvunzwa muLos Angeles, USA inodzidzira kuroveraNTS 1998) uye 8% yevakabvunzwa muSydney, Australia (Richters xnumx).

Anal-bhuku kupinza (zvese nechisimba uye nekubvumidza) kunotungamira kune yakawanda yeakakosha anatomical uye inoshanda kukuvadzwa kumatumbo ekugaya (Capeletti 2016) Mune imwe ongororo yakaitwa pakati pevanorara nevarume, 14% yaidzidzira chibhakera. Zvakare, hukama pakati petsiva uye hutachiwona uye hutachiona hwehutachiona hwakaonekwa (Rice xnumx) Ongororo yakaitwa pakati pevanhurume nevarume vane hutachiwana yakaratidzawo kuti kurova chibhakera ndechimwe chezvinhu zvakakonzera utachiona hweHIV.Callander 2016).

Kuongorora-kutaura nemuromo kana kukwiridzira⁵ -Kuita kwekusangana pabonde nekusimudzira kweusito nerurimi nemiromo. Maererano neongororo yezvekunze kwenyika dzekuEurope, pakati pevanochingochani vakaita zvepabonde nevasina kujairana navo gore rakapfuura, 64,6% vakaita anal-muromo vachisangana uye 76,0% mune yekugamuchira chinzvimbo (EMIS 2010, peji. 116).

Mune imwe ongororo yakaitwa pakati pevanorara nevarume, rimming yaiitwa ne85%, uye hukama hwakavhenekeswa pakati pemba uye STD (Rice xnumx) Mune ongororo yakaitwa naKingstone nevamwe vake (1980), matumbu ematumbu akaonekwa mu67,5% yevarume vanoita ngochani uye 16% yevanhurume vanoita zvehuchani, kusanganisira matumbo amoebiasis (27% uye 1%, zvichiteerana) uye giardiasis (13% uye 3%, zvichiteerana) (Keystone 1980) Sezvineiwo, 17% yevanochinjika mune iyi sampuli vaiita anilingus, asi vasina matumbo ematumbo (Keystone 1980) Kuongorora kwakadaro kunoratidza kuti matumbu eparamende pakati pechingochani anopindirana kwete nehunhu hweanoroticism, asiwo nenyaya yekuti anoshanda sechibvumirano chematumbu ematumbu, izvo zvinosimbiswa neanopfuura anodzora kudzidza (Ezeh 2016) Kuongorora-muromo kunosangana zvakare nehukwikwidzi hwepamusoro hwekutapukira kwegonorrheal ye pharynx mune varume vanoita zvepabonde nevarume (Chow xnumx, 2016; Templeton xnumx).

Ngochani vakadzi

Mhedzisiro yehutano hweungochani hwevakadzi yakatsanangurwa nekudzidziswa kusvika padiki pane kuvarume - izvi zvinokonzeresa nenyaya yekuti hutachiona hweHIV pakati pevanhurume nevarume vakwezva chikamu cheshumba chekutarisirwa kurapwa. Zvakare, kuoma kwekufunda njodzi dzehutano pakati pevakadzi vanoita zvevakomana nevarume vanoita zvevakomana nevarume vanoita zvevakomana nevarume vanoita zvevakomana nevarume vanoita zvevakomana nevarume vanoita zvevakomana nevarume, uye vanosvika ku30% vanoramba vachiita bonde.Marrazzo xnumx; Solarz 1999; O'Hanlan 1996; Skinner 1996; Ferris xnumx; Einhorn xnumx; Johnson 1987) Semuenzaniso, mune imwe ongororo mukiriniki yeAustralia STD kiriniki, 7% chete yevakadzi vanoita ungochani vakati havasati vamboita hukama hwepfambi.Fethers xnumx, peji. 348). Kuongororwa uku kwakaongororawo huwandu hwevakadzi vehukama pamusoro pehupenyu hwese: kwaive nevakapfupika vakadzi vakadzi nevarume kana vakadziFethers xnumx, peji. 347). Mikana yekurara nevarume vanopfuura 50 yaive 4,5 nguva yakakwira kune vakadzi vanoita zveungochani kupfuura vakadzi,Fethers xnumx, mapeji 347 - 348).

Kuwedzera kune STDs, kune njodzi yekutapurirana kwehutachiona hwematumbu uye kukuvara mukuita ungochani pakati pevakadzi. Sekutsvagurudza kwevakadzi vanoita zveungochani kuMichigan, kusangana kwevakadzi kungochani kunosanganisira: kusimudzira-gomarara mumuromo panguva yekuenda kumurume wemunhu anogamuchira - 38,1% yemakesi, anal-muromo kukurudzira - 16,9%, kupinda mukati (neruoko kana zvinhu) nekubuda ropa kana kushungurudzika - 2,4%, jekiseni rewaini kana tsvina mumuromo kana mumukadzi - 1,7% (Bybee xnumx) Muongororo yakaitwa muTaliyandi Turin, 95,1% yevakadzi vanoita zvepabonde nevakadzi yakaratidza kuti vakaita zvepabonde panguva yekuenda kumwedzi (Raiteri 1994, p. 202), uye 46,1% ita manusulation mukubata kwepabonde (Raiteri 1994, peji. 202). Mune kumwe kuongorora, 7% yevakadzi vanoita zveungochani yakaratidza kuti vanga vachiita ongororo yemuromo-mumasvondo maviri apfuura (Russel 1995) Maererano neimwe ongororo, 17% inoita yekunyorwa-mukati memukati mechikadzi - kuiswa kweruoko mukati mechikadzi kana mutsipa wechikadzi, 29% - anal-muromo kusimudzira uye 3% - anal fisting (Bailey 2003, peji. 148). Mune ongororo yakaitwa naSchick nevamwe vake, kurova kwemurume mumwedzi wapfuura kwakaitwa ne14,5% yevakadzi vanoita zvepabonde nevakadzi (Schick xnumx, peji. 409).

Maererano nezvidzidzo, vakadzi vanoita ngochani, kana vachienzaniswa nevakadzi vanoita zvechisikana, huwandu hwakawanda hwehutachiona hwehutachiona (Bailey 2004; McCaffrey 1999; Skinner 1996; Berger 1995; Edward 1990), 2,5 nguva yakakwira kupfuura iya yevakadzi vanoita zvechirikadzi (Evans 2007).

Njodzi dzakabatana neanosangana nedambudziko repfungwa

Mu2017, boka revatsvaga kubva kuYunivhesiti yeSeattle rakaburitsa ongororo yedata kubva kuNational Health Interview Survey (2013 - 2014)Fredriksen-Goldsen 2017). Kuongorora kwacho kwaisanganisira makumi matatu nemakumi matatu nematanhatu varume nevakadzi vane makore makumi mashanu zvichikwira, avo 33% vakadzi ngochani uye 346% varume ngochani (Fredriksen-Goldsen 2017, peji. 1335). Vanyori vakawona kuti ungochani uchienzaniswa neanopindirana nevakadzi vakapindura zvakanyanya mararamiro asina hutano, vakatambura nezvirwere zvakasiyana siyana, kusanganisira kusagadzikana mumuviri, kushungurudzika kwemhirizhonga, kurohwa, kurwara kwepfungwa, nezvimwe.Fredriksen-Goldsen 2017).

Mu meta-ongororo dzakagadzirirwa kuongororwa kwemubvunzo wekuti pane hukama pakati peungochani uye psychopathology pakati pevechidiki nevakuru, iyo yakaburitswa mudura renhoroondo Archives of General Psychiatry, iyo inotevera data yakawanikwa:

Zviratidzo zvengozi yekuzviuraya yakanyatsoenderana nekukwezva ungochani (Herrell 1999, peji. 873). Hazvibviri kuti njodzi yakawedzera yekuzviuraya muvanhurume nevarume vangangove nekuda kwekushungurudzwa kwezvinodhaka kana kumwe kurwara kwepfungwa kwepfungwa (Herrell 1999, peji. 867).

Mhedzisiro yacho inosimbisa humbowo hwekuti vechidiki ngochani uye vanozvibata vari panjodzi yakawedzera yezvinetso zvehutano hwepfungwa, kunyanya kuzviuraya.Fergusson 1999, peji. 876).

Zvichienderana nechimiro chisina kujekesa chevakabvunzwa, Gilman nevamwe vake (2001) vakaverenga kuwanda kwemwedzi yapfuura ye12 ("12 mwedzi yakawanda") uye nehupenyu hupenyu njodzi ("yeupenyu njodzi") mumapoka evanhurume uye ngochani (Gilman xnumx).

Kufananidza kwezviratidzo zvikuru zvekushushikana kwepfungwa pakati pevakadzi vanoita zvechisikana uye ngochani (Gilman xnumx).

Psychopathology	Prevalence: ngochani / murume kana murume anopindura	Hupenyu Hwenguva Njodzi: Ungochani / Hterochani Vanopindurwa
Post-zvinoshungurudza kusagadzikana kusagadzikana	21% / 6%	2,7
Kunetseka kusagadzikana	40% / 22,4%	1,8
Kushungurudzika kunetseka	34,5% / 12,9%	1,9
Zvirwere zvinokanganisa	35,1% / 13,9%	2,0
Kupindwa muropa nezvinodhaka	19,5% / 7,2%	2,4

Chidzidzo chakaitwa naJorm nevamwe vake (2002) vakawana data rakafanana pamusoro pehuwandu hwakanyanya pakati pevechingochani vanopindura pathologies dzakadai sekushushikana kusagadzikana, kushushikana, kuzviurayaJorm xnumx).

Zvidzidzo zvakasiyana zvakaratidza kukwidziridzika kwezvirwere zvepfungwa pakati pechingochani (King xnumx; Bradford xnumx; Mbiru 1988).

Kushungurudzika uye Kushushikana Matambudziko

Ron Stoll, anove achitungamira mutsvagurwi weAmerican AIDS kwemakore, anoti "kune matambudziko akakosha epfungwa nepfungwa pakati peungochani" (Yakakora xnumx). Sangano reAmerican "Gay & Lesbian Medical Association" muzvinhu zvaro rinoratidza kuti ngochani varume vanowanzo shungurudzika nekushushikana uye kusagadzikana kwepfungwa (Silenzio 2010), iyo inosimbiswa muhuwandu hwezvidzidzo (Cochran xnumx; King xnumx, 2008; Meyer 2003; Jorm xnumx; Gilman xnumx; Sandfort 2001; Fergusson 1999; Hershberger 1995; Berg 2008; Bostwick xnumx) Mune imwe kudzidza muNetherlands, pakati pevanhurume vechingochani, kuitika kwekushungurudzika kushungurudzika mukati megore rose yaive 2,94 nguva dzakakwira kupfuura pakati pevanhurume, uye chiitiko chekushushikana kwekunetseka kwaive 2,61 nguva yakakwira (Sandfort 2001) Vamwe vatsvagiri vanofunga kuti varume vanoita ungochani vanogadzira hafu yezvinoitika zvechirwere chepfungwa - 42 - 49% (Yambiro xnumx).

Kuzviuraya

Vanhu vevasikana vaviri vane hungochani vanomiririra boka rine njodzi yepamusoro yekuzviuraya (Voroshilin 2012, peji. 40). Kuongororwa kwakaitwa naHerrell nevamwe vake (1999) kwakawana kuti kukwezva ngochani kwakabatana zvikuru nezvakasiyana zvinofungidzirwa zvinoratidza nezvekuzviuraya: kune varume vanoita zveungochani, njodzi yekuda kuzviuraya yaive 4,1 nguva yakakwira, njodzi yekuzviuraya yaive 6,5 nguva yakakwira (Herrell 1999) Mushure mekugadziriswa kwehuwandu hwekuongorora mhedzisiro yezvinhu zvakadai sekushandiswa kwezvinwiwa uye zviratidzo zvinoshungurudza, zvese zvekuzviuraya zvakange zvichiri kukosha. Zvidzidzo zvakaitwa pakati pevechidiki vanozvizivanisa sevachingochani zvakaratidza huwandu hwakanyanya hwevanhu vanozviuraya uye kuedza kuzviuraya pakati pavo (Mathy xnumx) pane pakati pevechidiki vanoita zvepabonde. Mugore re2008, mhedzisiro yehungwaru meta-ongororo yakadhindwa, panguva iyo pamusoro pe13 yemakumi ezviuru ezvinyorwa pane ino nyaya yakagadziriswa, semhedzisiro iyo zvidzidzo zvakanyatsoitwa zvakasarudzwa uye zvakadzidzwa ne25 (King xnumx) Izvo zvakaonekwa kuti kana tichienzanisa nehuwandu hwevanhu vari muhupombwe, kune kuwedzera kunowedzera kaviri panjodzi yekuzviuraya; njodzi yekushungurudzika uye kusagadzikana kusagadzikana, doro nekudhakwa kwezvinodhaka kwaive kamwe chete nehafu nguva (King xnumx) Kunyanya, kudzikiswa kwemapoka enjodzi nevechirume kwakaratidza kuti, kana ichienzaniswa nehuwandu hwehuwandu, pakati pevanhurume vanoita zveungochani, njodzi yekuzviuraya yaive 4,28 nguva yakakwira; pakati pevakadzi vanoita zveungochani, njodzi yekumirira doro yaive 4 nguva dzakakwira, uye kupindwa muropa nezvinodhaka kwakange kuri 3,5 nguva dzakakwira (King xnumx) Mune imwe ongororo yakakura yekuAmerica, zvakaonekwa kuti njodzi dzekuzviuraya, kushungurudzika uye kuzvisarudzira (kuzvikuvadza) pakati pevechidiki vane ungochani dzinopfuura njodzi dzakafanana pakati pevechirikadzi, zvisinei nedzinza revakabvunzwa (Lytle 2014) Njodzi dzekunetseka kwepfungwa uye kuzviuraya pakati pevechingochani dzinoonekwa mune zvidzidzo muAustralia (Swannell xnumx; Skerrett 2015), muEngland (Chakraborty xnumx), in New Zealand (Skegg 2003), muSweden (Björkenstam 2016) LGBT + vatsigiri venzvimbo dzimwe nguva vanokoshesa data rakadai kusarura. Nekudaro, tinocherekedza kuti ongororo dziri pamusoro dzakaitiswa munyika umo vanhu vane ungochani vanofarira rutsigiro nekudzivirirwa kwezvinhu zvehurumende.

Kupindwa muropa kwezvinodhaka

Maererano nekumwe kuongorora kwakasiyana, huwandu hwekupindwa muropa nezvinodhaka pakati pevanhurume nevanhukadzi hwakanyanya kupfuura pane ruzhinji, pamwe nekuenzanisa nevanhu vanoita zvechirume.Padilla 2010; Halkitis 2009; Cochran xnumx; King xnumx, 2008; Meyer 2003; Jorm xnumx; Gilman xnumx; Sandfort 2001; Yakakora xnumx; Fergusson 1999; Hershberger 1995), maererano nemimwe mishumo, 2 - 3 nguva yakakwira kupfuura pakati pevanhurume vanoita zvepabonde (Cochran xnumx; Ryan xnumx; Skinner 1994; Green xnumx). Sekureva kwesangano reAmerican Gay & Lesbian Medical Association, varume vane ngochani vane mukana wekupindwa muropa nezvinodhaka (Silenzio 2010) Sekureva kwaGrant nevamwe vake, varume vanoita zveungochani vangangove nekutambura nekumanikidzwa-nekumanikidzira kushushikana uye kutarisirwa kwezvinodhaka kupfuura varume vanochata.Grant xnumx) Kune vakadzi vanoita ngochani, njodzi yekushandiswa kwezvinhu mukati megore yaive 4,05 nguva yakakwira kupfuura yevakadzi vanoita zvechisikana (Sandfort 2001).

Kudhakwa

Sangano reAmerican "Gay & Lesbian Medical Association" rinoratidza kuti pakati pevane ngochani pane huwandu hwekudhakwa (Silenzio 2010) Varume ngochani vane huwandu hwepamusoro hwekudhakwa kana vachienzaniswa nevechirikadzi (Irwin 2006; Wong xnumx; Yakakora xnumx) Kwemakore, zvidzidzo zvakaratidza rakanyanya kukwirisa doro pakati pevakadzi ngochani zvichienzaniswa nevakadzi vanechani (Cassidy mu McElmurry 1997; Eliason xnumx; Drabble 2005; Skinner 1996, 1994; Haa mukati Dhani xnumx; O'Hanlan 1995; Rosser 1993; NGLTF 1993; Cabaj in Lowinson xnumx, Cabaj 1996; Hall 1993; Finnegan mu Engs 1990; Glaus xnumx).

Zvirwere zve oncological

Pane ufakazi hwakasimba hwekuti zviitiko zvegomarara zvakakwira pakati pe "LGBT +" vagari (Boehmer naRonit 2015). Ongororo yakaitwa naZaritsky naDibble vakaongorora sampuli yevakadzi vanoita zvechingochani nevanun'una, vakaonekwa kuti vakadzi vanoita ungochani vaine mukana wakakura wekukonzera chirwere chegomarara pachibereko zvichienzaniswa nehanzvadzi dzavo - vanyori vakataura kuti izvi zvakakonzerwa nenyaya yekushaya vana uye kufutisa. pakati pechingochani vakadzi vari pamusoro (Zaritsky 2010) Anal carcinoma kenza ye rectum yakabatana ne papillomavirus (Breese xnumxkupesana neshure kwehutachiona hweHIV (Hleyhel xnumx) Iyo frequency ye anal carcinoma mune varume vanoita anal-genital kusangana yakakwira zvakanyanya kupfuura kugara kwayo muhuwandu hwevanhu (Siegenbeek van Heukelom 2017; Chin-hong xnumx, 2005; Tseng 2003; Willett xnumx) Mune chidzidzo chakakura chakaitwa naDaling uye pamwe nevamwe panjodzi yekutanga cancer cancer pakati pevanhurume, kufukidza nguva kubva ku1978 kusvika ku1985, tsika yekuita ungochani yakawedzera ngozi ne 50 nguva, uye tsika yekubatanidza zvakananga anal-genital kusangana yakawedzera ne 33 nguva (Kudonha xnumx) Ongororo yakarongeka uye kuongorora meta-kudzvanywa naMachalek et al. Yakawana kuti zviitiko zvegomarara rean anal pakati pevanhurume vane hutachiona hweHIV zviitiko zve45,9 muhuwandu hwe100 000, pakati pevanhurume vasina hutachiona - 5,1 muhuwandu hwe100 000 (Machalek xnumx), muhuwandu hwehuwandu - kubva ku1 kusvika 2 pahuwandu hwe100 000 (Grulich xnumx).

Ruzivo rwekuwedzera

Rumwe ruzivo neruzivo zvinogona kuwanikwa mune zvinotevera zvinyorwa:

1. Massresistance. Njodzi dzeHutano hweungochani. Izvo Zvinotsanangurwa neZvekurapa uye Zvepfungwa. MassResistance, 2017
2. Katz KA, fanish TJ. Dermatology-Inoenderana Epidemiologic uye Clinical Kunetseka kweVarume Vanovata NaVarume, Vakadzi Vanorara Nevakadzi, uye Transgender Munhu Mumwe nemumwe. Archives e dermatology. Gumiguru 2005, Vol 141, mapeji. 1303 - 1310
3. Boehmer U, Ronit U. Kenza uye iyo LGBT Nharaunda. Maonero Akasarudzika kubva kuNjodzi kuenda kuSapukunyuki. Springer, 2015.
4. Wolitski RJ, Stall R, uye Valdiserri RO. Mukana mukana. Kusagadzikana kwehutano kunobata varume ngochani nevarume vanehurume muUnited States. New York: Oxford University Press; 2008. Xnumx p
5. Holland E. Unhu hweungochani: Kusungirwa kwevanochata nevarume uye kodzero yechitendero. iUniverse. New York-London-Shanghai. 2004. Zvitsauko 2, 3, 6
6. Phelan JE, et al. Izvo Zvinotsvagurwa Zvinoratidza: NARTH Mhinduro kune APA Zvikumbiro paungochani Rugwaro rweSainzi Advisory Committee yeNational Association yekutsvaga uye Kurapa kweungochani. Nhoroondo Yezve DzeBonde Zvevanhu. Xnumx; Vhoriyamu 1. Peji 53.
7. Sprigg P., et al. Kuzvitora zvakananga: izvo zvinotsvaga zvinoratidza nezve ungochani. Washington: Family Research Council (2004)

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Notes

1 kuisirwa kwepenisi yemushandi anoshanda murectum yemumwe anogamuchira

2 Chirungu: "gay bowel syndrome"

3 Parizvino, pasi pekumanikidzwa kwemasangano eruzhinji LGBT + kufamba, madudziro akadai sekusabatiswa kweungochani uye ungochani intestinal syndrome inoonekwa seyerusarura. Kuedza kukuru kubvisa izwi rekuti "kusakosha kwengochani" kubva mukushandiswa kwakaitwa neye biologist uye muratidziri Bruce Weller, muvambi weThe National Gay Task Force (Chuck 2003, peji 168).

4 kubva kuChirungu Chibhini chibhakera

5 kubva kuChirungu "Rim" - rim

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Laser Proctology Center "ATLANTiK" anopa kurapa kwe gay bowel syndrome (gay bowel syndrome):

Lesbianism: zvikonzero uye mhedzisiro

Jan Goland pakurapwa kweungochani (kipekee vhidhiyo kubvunzurudzwa)