Iziphumo eziphambili

(1) Ukusetyenziswa kwendlela ye-gastrointestinal njengelungu lokudalwa kwendalo kunxulunyaniswa nemingcipheko yempilo yesifo esosulelayo nesosizi.

(2) phakathi kwabantu abakhokelela kwindlela yokuphila yobungqingili, bobabini abesilisa nabasetyhini, kukho amaxesha amaninzi umngcipheko wokwanda kwezifo ezahlukeneyo, zombini usulelo (i-HIV, isifo sengqondo, intsholongwane njl. Njl.), Unyango noqhaqho.

Intshayelelo

Isiteyitimenti esilandelayo se-LGBT + Iintshukumo- intshukumo sisiteyitimenti sokuba isenzo sesini esifanayo ngesimo sokuziphatha komntu kwaye, ngenxa yoko, asinampembelelo kwimpilo. Iimpawu anatomical kunye neempawu zomzimba zomzimba womntu kunye neziphumo zophando ziyaphikisana. Ukuziphatha kwabantu besini esifanayo kudityaniswa nomngcipheko owandayo we-pathologies eyahlukeneyo, abathi oozwilakhe be-LGBT + bathule cwaka ngabo.

Xa sijonga esi sihloko, siza kuhlalutya le miba ilandelayo: (1) ukophulwa komthetho okubandakanya ubudlelwane bezesini; (2) ukuphazamiseka kobungqingili.

Iimpawu zempilo ngokubanzi

Ngokutsho URuth noSantacruz (2017), inani elikhulu lophando lwezenzululwazi lubonisa ukuba, xa kuthelekiswa nabantu abathandana abathandanayo, abantu abathanda ubufanasini kunye nendlela yokuphila engatshatanga babhale ukungalingani okubonakalayo kwimpilo yomzimba nengqondo. La mava eva iingxaki zempilo ngakumbi ebomini, kubandakanya usulelo, kubandakanya i-HIV emadodeni, isifo sombefu, kunye nesifo seswekile kwabasetyhini (Corliss et al. I-Xnumxkunye nezinye izifo ezinganyangekiyo, umngcipheko wokunyangwa sisifo sentliziyo kunye nomhlaza, amathuba aphezulu okuba ukhubazeke xa umncinci. Iintsana zisemngciphekweni omkhulu wokutshaya kunye nogonyamelo. Kukho ukwanda kwesibalo sokufa, ngakumbi, umngcipheko oswelekayo wokusweleka kwabasetyhini, amadoda nabafazi abathandanayo, ukuzama ukuzibulala, kunye neemeko ezingathandekiyo zengqondo, uninzi lwazo ngokucacileyo kwizengqondo, njengokunyuka kwamanani koxinzelelo, ukuhlaselwa kukothuka, ukuphazamiseka kwengqondo, uxinzelelo kunye ukuphazamiseka okunxulunyaniswa nosetyenziso olwandayo lwezinto ezinokusebenza ngengqondo, isizungu ekukhuleni (URuth et Santacruz 2017; Lick et al. I-Xnumx; Yarns et al. I-Xnumx) Ngaphandle kwento yokuba izenzo zesondo ezinyanzelekileyo ezibangela uxinzelelo lobuqu okanye ukungasebenzi kwengqondo azidweliswanga ngokusemthethweni njengesifo esizimeleyo kuhlelo lwamva nje lokuchongwa kwe-American Psychiatric Association egunyazisiweyo (“DSM-5”), ezinye izigulana kunye noochwephesha zibajonga njengabahlukileyo iziyobisi, ezinje ngomlutha wokungcakaza (Yarns et al. I-Xnumx).

Iingozi ezinxulumene nokulalana kwabantu besini esinye

Amadoda angamafanasini

Ngokwezifundo ezinomtsalane, iintlobano zesini phakathi kwabantu abesilisa ziyahambelana nemingcipheko yempilo. Ukulalana kwabantu besini esifanayo phakathi kwamadoda kukuziqhelanisa nokunxibelelana¹; kuncwadi lwezenzululwazi nakwezomthetho, uqhakamshelwano lobuchwephesha obudibeneyo lubizwa ngokuba sodomy (IFischel xnumx, iphe. 2030; IZhakupova 2015, iphe. A543; Weinmeyer xnumx, iphe. 916; Umthetho wePenal Israeli, ubugcisa. I-347c) Kwinxalenye enkulu yamatyala, i-anal eroticism yenziwa kunxibelelwano phakathi kwabantu besini-i-anus kunye ne-rectum zisetyenziswa ngeendlela ezahlukeneyo. Ngokweziphumo zesifundo saseYurophu samadoda abelana ngesondo namadoda, uqhakamshelwano lobuchwephesha lwenziwa kwi-95% yabo bonke abantu abanxibelelana ngesondo, (I-EMIS 2010, iphe. 113). Olunye uphononongo luvavanye uqhelano lokwabelana ngesondo kwamadoda angatshatanga angenasifo uGawulayo, amaqabane awo ayephethe usulelo lwe-HIV- unxibelelwano lwangasese lwasenziwa kwi-99,7% yabo bonke abantu abanxibelelana ngesondo.URodger 2016, iphe. 177).

Ukongeza, isenzo sokunxibelelana okungakhuselekanga kwi-anal-genital phakathi kwamadoda abelana ngesondo kunye, ngokweemithombo ezahlukeneyo, yi-41% (IValleroy 2000), I-43% (I-Grov 2014), I-56% (UNelson xnumx), I-58% (I-EMIS 2010, iphe. 116). Ukusetyenziswa kweekhondom kwi-anal-genital unxibelelwano phakathi kwamadoda kuye kuncipha kule minyaka idlulileyo (I-Hess 2017, iphe. 2814; Ungayekeli i2017).

Umngcipheko onxulumene ne-eroticism

I-rectum - icandelo lokugqibela lendlela ye-gastrointestinal yomntu - lijolise ekuqokeleleni nasekufumeni izinto zokuthambisa kunye nezihlanganisi. Inkqubo yokugaya ukutya komntu inxulunyaniswa nobukho bee-microorganic ze-Symbiotic kwi-lumen ye-intestine enegalelo ekuqhekekeni kwezinto ezahlukeneyo zokutya (IQuigley 2013) Ezi ntsholongwane zisemzimbeni osempilweni azikaze zingene ekuhambeni kwegazi ngenxa yobukho besithintelo somzimba esiqulathe ungqameko lwe-mucous nodonga lwamathumbu (I-Faderl xnumx) Ukungena kwezifo ze-typiotic egazini kubangela izifo ezahlukeneyo, kubandakanya i-sepsis (I-Takiishi 2017; UKelly 2015).

Ukwakheka komzimba kunye nokusebenza komzimba wethambo akuboneleli ukuba usetyenziswe kunxibelelwano lwabelana ngesondo: ukutolikwa konxibelelwano lobuchwephesha njengolungelelwaniso lobufazi kuyangqubana nezinto zomzimba nezomzimba. Nokuba usebenzisa ikhondom, unxibelelwano lobuchwephesha lunobungozi obukhulu, ikakhulu kulowo ulufumana. Xa ityhilwe kwi-rectum ngexesha lesondo elichazwe ngaphambili, izicubu zalo ezithambileyo ziyalimala. Ezi zihlunu zisebenza ukuba ziqokelele imithambo emnyama ethambileyo xa ilungiselela ukuhamba kwazo ngenxa yokuhamba kancinci kwesisu emathunjini. Ukuthelekisa i-rectum kunye ne-vagina akuchaphazeleki: izicubu ze-rectum azikaze zomelele njengezicubu zesitho sangasese sowesifazane, ilungu elenzelwe umsebenzi wokuzala. Ukongeza, ubume bendalo ngokwayo icocekile ngakumbi kunommandla we-rectum. Ilungu lobufazi linezithambiso ezizodwa zendalo kwaye lixhaswa yinethiwekhi yezihlunu. Icala elingaphakathi lobufazi ligubungele nge-membrane ye-mucous enobunkunkqele, equlathe izingqimba ezininzi zeeseli ze-epithelial, ezikuvumela ukuba udlulise ukuxabana ngaphandle komonakalo kwaye ukwazi ukumelana nemiphumela yesimilo. Icala elingaphakathi le-rectum ligutyungelwe ngumbane omncinci oqulathe ungqameko olunye lweeseli ze-epithelial. Izicubu ze-rectum zihlala zihlala zixinekile okanye zingaphantsi komzimba kwinkqubo yokulalana ngokwesondo. Nokuba akukho monakalo uqaphelekayo, ii-microcracks kunye nee-microcracks ze-mucosa zinegalelo ekungeneni kwee microparticles ze-fecal, iiproteni zesidala kunye neentsholongwane kwigazi.

Iingcali zaphawula ukuba amadoda athandana nabantu abathandana ababhinqileyo banesimo esibonakalayo sekolon kunye ne-rectum, ngenxa yokungasebenzisi komzimba kwezi zixhobo (IKazal 1976) Ubunzima kwezi pathologies bude babizwa ngokuba kukukrexeza kwamathumbu esini.²; idweliswe ngokuhla kweendlela zokuhamba rhoqo: i-conical condylomatosis, hemorrhoids, proctitis, reissal fissures kunye ne-fistulas, i-pararectal abscesses, i-amoebiasis, i-polyps, i-viral hepatitis, i-gonorrhea, i-syphilis, ukulimala komhlaza, imizimba yangaphandle kwi-rectum, shigellosis, ulcers i-rectum kunye ne-lymphogranulomatosis (Owen xnumx; IKazal 1976) Abanye ababhali bagxeka ibinzana elithi "isini esijongene namathumbu esini" ngesiseko sokuba ezinye zezi ziphazamiso zikwafumaneka namathumbu ababhinqileyo, kodwa uninzi lwezigulana ezinolu phawu ngamadoda enza ubuchwephesha be-anal eroticism namanye amadoda (Glenn 1994; UMarkell 1983).

Ukongeza kwiindonga ze-rectum, i-anal sphincter, umsipha we-annular, nawo uhlupheka ngenxa yokuncitshiswa, ngaphandle kwenkqubo yokuyekiswa, iifatata zibanjwa kwi-rectum. I-sphincter ye-anal inenqanaba elithile lethoni kunye nobungqingqwa, iyakwazi ukwelula kuphela kancinane ukuze isuse amachaphaza athambileyo. Ngokulimala okuphindaphindiweyo, ukuxabana kunye nokuxinana, i-sphincter ilahlekelwa yithoni kunye nokukwazi ukugcina ukuvalwa okuqinileyo.

Ngokusekwe koku kungasentla, sijonga ezi ngxaki zilandelayo zibangelwa kukudibana kohlaziyo lobuchwephesha: (A) Ukungena kwezinto ezintsholongwane kunye neentsholongwane ezivela kumngxunya wethambo ukuya kungena egazini ngenxa yokothusayo; (B) ukungahambelani komzimba ngenxa yololiseko lwe-anal sphincter, kunye nokwenzakala kudonga lwamathumbu; (B) ukuphazamiseka okubangelwa kukuphendula komzimba kwisidoda.

A. Ingozi yosulelo

Isifo sikagawulayo phakathi kwamadoda athandana namanye

Ngonxibelelwano lwe-anal-genital, umngcipheko wokudluliselwa kwentsholongwane yokugonyelwa komntu (i-HIV / AIDS) ukonyuswa kakhulu, okuthi kukwenziwe kukuqina okungaphelelanga kwe-mucosa eyi-rectal (I-Baggaley 2010; I-Belec 1995; I-Levy 1993) Xa i-HIV / AIDS yafunyanwa okokuqala e-United States, kwi-1981, yona yayibizwa ngokuba yi-gay-immune immune deffurity (GRID) ngamafanasini³kuba abantu abathandana abathandanayo babala ngaphezulu kwe-90% yazo zonke iimeko ezisandula ukufumana.I-Altman 1982) NgokweZiko leSizwe loLawulo lweSifo loThintelo lweSizwe (i-NCHP) yonyaka we-2015, amadoda abelana ngesondo namadoda enza i-67% yalo lonke usulelo olutsha lwe-HIV e-USA kunye ne-82% yalo lonke usulelo olutsha lwe-HIV kubafana nakumadoda. ngaphezulu kweminyaka ye-13 (I-CDC 2015) Ukuxhaphaka kwe-AIDS phakathi kweli qela labantu ngamaxesha e-50 ngamaxesha exesha kwamanye amaqela (iBagby 2009). Umngcipheko wosulelo lwe-HIV ngokudibana okungakhuselekanga kwezokwabelana ngesondo ngamaxesha e-17,25 aphezulu kunokwabelana ngesondo okungakhuselekanga (Patel 2014).

Kwi-2007, i-NCHP ipapashe ingxelo ebonelela ngezibalo malunga nokusweleka kunye nomngcipheko wokufa (I-CDC 2007) Phakathi kwenani elipheleleyo lokusweleka ngenxa kaGawulayo, umngcipheko obakhokelela kwisifo uGawulayo (umzekelo, utofelo-gazi, ubufanasini, iziyobisi, njl. Njl.) Wabalwa. Ngokwengxelo ye2007, ukunxibelelana ngesini kuphela kwendlela yokosulelwa yi-HIV kwi-59,2% yabo bonke ukubulawa sisifo sikagawulayo.I-CDC 2007, iphe. 19), nakwi-2015 inani lifikelele kwi-66,8% (I-CDC 2015, iphe. 18). Idatha eboniswe kwiNkomfa yeSizwe ye-NCHP kwi-2010 ibonise ukuba imvamisa yokuchongwa kwe-HIV okusha phakathi kwamadoda athandana namanye ingaphezulu kwamaxesha e-44 ngaphezulu kwalawo amanye amadoda (I-CDC 2010; Cine Press Khupha i-xnumx) Ngokwengxelo ye-NCHP yonyaka we-2010, amadoda abathandana abatshatileyo ababalelwa i-63% yazo zonke iimeko ezitsha zosulelo lwe-HIV ezirekhodiweyo (I-CDC 2012) kunye ne-67% - yazo zonke iimeko ze-HIV zonyaka u-2015 (UNelson xnumx) E-Australia, amadoda ezitabane enza i-80% yamatyala amatsha e-HIV kunyaka we-2017 (Iziko leKirby 2017).

Kuyathakazelisa ukuba, ngokwe-NCHPZ efanayo ngeminyaka ye-2010-2016, inani losuleleko phakathi kwabantu abathandana nabantu abatshatileyo liyancipha minyaka le (kwi-2015, malunga ne3 000 ngonyaka), ngelixa phakathi koongqingili kuhlala kungaguqukiyo-malunga ne26 000 ngonyaka (I-CDC 2016) Ngenxa yokuba e-United States amafanasini enza i-2.3% yabemi kuphela (UWard et al. I-Xnumx), Usulelo lwe-HIV phakathi kwabo lwenzeka malunga namaxesha e-375 rhoqo kunaphakathi kwabantu abathandanayo. Okwangoku, yi-9% yosulelo e-United States eyenzeka ngokudibana kwabantu abangatshatanga, ngelixa amafanasini, ngaphandle kwamanani amancinci, anoxanduva lwe-67% lwalo lonke usulelo lwe-HIV, kunye ne-83% phakathi kwamadoda.

Umfanekiso ofanayo ubonwa nakwamanye amazwe.

Ngapha koko, ngenxa yezehlo eziphezulu ze-AIDS phakathi kwabantu abathandana abathandanayo, banqatshelwe ukunikela ngezitho negazi, nkqu nakumazwe apho ubufanasini bukhutshelwa kubomi boluntu (umzekelo, i-USA, iJamani okanye iNetherlands).I-FDA 2017).

Kwakhona, isifo sikagawulayo kunye nokuphazamiseka komzimba okunxulumene nakho kungomnye unobangela wokukhula kwesundu lesikhumba esibuhlungu esibizwa ngokuba yiKaposi's sarcoma: e-USA, iKaposi's sarcoma enxulunyaniswa noGawulayo ibonwa ikakhulu phakathi kwamadoda abelana ngesondo namadoda (Kumar 2016; PDQ 2015).

Intsholongwane kaGawulayo / uGawulayo ayisiyiyo kuphela isifo esidluliselwa ngeentlobano zesini esixhaphakileyo kubantu abathandana abathandanayo. Ngokweengxelo ezahlukeneyo, amadoda athandana nabantu abathandanayo abasemngciphekweni akhula ngomngcipheko kwezi STD zilandelayo: syphilis (Iidolophu 2017), inyamakazi (I-Fairley 2017b), chlamydia kunye ne-venemal lymphogranulomatosis (I-Saxon xnumx; Annan 2009) intsholongwane (hepatitis)I-CDC 2015; I-Lim xnumx,, cryptosporidiosis (Isihogo xnumx), Intsholongwane ka-Epstein-Barr (Hsu xnumx; UVan Baarle 2000; UNaher 1995), shigellosisUDanila xnumx; Thorpe ngaphakathi I-Holmes xnumx, iphe. 549), isalmonellosis kunye typhoid (Umthengisi 2003; Bhaka xnumx), papillomavirus (Patel 2017) Apha ngezantsi siza kuqaphela ngokweenkcukacha ezinye zee-STD ezidwelisiweyo.

Syphilis

Abanye ababhali babiza i-syphilis entsha (emva kwe-HIV) ubhubhane phakathi kwabathandana (I-Spornraft-Ragaller 2014) Umzekelo, ngokweKing County yaseWashington State eMelika kunyaka we-1999, i-85% yezehlo zesifo seengcongconi kwabikwa phakathi kwamadoda athandana namanye (I-CDC 1999) Kwinqanaba likazwelonke eMelika, imeko ye-syphilis yamabanga aphantsi kunye nasesekondari phakathi kwamadoda athandana namabhinqa ingaphezulu kwe-46 ngaphezulu kobungqingili (I-CDC 2010) Kubekho ukwanda kweziganeko zesirphilis phakathi kwamadoda athandana namanye kwisithuba eshumini leminyaka (USodolophu 2017; I-Abara xnumx, iphe. 9).

Ingono

Kukho ukwanda kwesifo se-gonorrhea phakathi kwamadoda athandana nawo (I-Fairley 2017b) Isimo se-gonorrhea phakathi kwamadoda abelana ngesondo namadoda siphindaphindwe kalishumi kunesifo se-gonorrhea kwiintlobano zesini phakathi kwabantu abathandanayo, nkqu nakumazwe aneenkqubo zempilo eziphuculweyo (I-Fairley 2017a) Kumadoda athandana nabantu abathandana nabo, usuleleko lwe-gonorrhea luchaphazela ikakhulu i-pharynx kunye ne-rectum, kwaye usuleleko luqhubeka kunye neempawu ezingabonakaliyo, okanye ngokubanzi asymptomatically (I-Barbee 2014).

B. Umngcipheko womonakalo kwi-anal sphincter

Ngokophononongo olukhulu lwaseMelika, ukuziqhelanisa rhoqo nokunxibelelana ngokwesini kukhokelela ekungasebenzi kakuhle kwe-anal sphincter kunye ne-fecal incinuence - encopresis (UMarkland xnumx).

Uhlalutyo lubandakanya idatha evela kubantu abayi-4 abaneminyaka engama-170-20 iminyaka (69 yabasetyhini kunye ne-2 yamadoda) ... Emva kohlengahlengiso oluninzi lwezinye izinto ezinxulunyaniswa nokungasebenzi kakuhle komnwe, unxibelelwano lwangaphambi kwesini lwangasemva lwalusisiqalo sokungaziphathi kakuhle kwamadoda (inqanaba lokuxhaphaka: 070 , 2, nge-100% yexesha lokuzithemba: 2,8-95) kunye nabasetyhini (ukwanda: 1,6, nge-5,0% yokuphumla kokuzithemba: 1,5-95) ... Iziphetho: iziphumo zifumene inkxaso yenkcazo Ukudibana kwamalungu esini yinto ekhokelela ekungahambini kakuhle kwabantu abadala, ngakumbi emadodeni (UMarkland xnumx).

Ukupheliswa kwentsimbi ye-fecal kubhekisele kukukhutshelwa ngaphandle kwezibilini zamathumbu (ulwelo, ulwelo, igesi) kunye nokungakwazi ukulibaziseka de kufike indlu yangasese (I-Paquette xnumx) Ukungahambi kakuhle kwe-Fecal kuthwala umngcipheko weengxaki zesekondari, kungakhokelela ekukhubazekeni kunye neengxaki ezinzulu zabantu kwizigulana, kwaye unyango lwayo ngumsebenzi onzima kakhulu (USaldana Ruiz 2017) Iziphumo zokulalana kwezomzimba, "ngokuvuma kunye kukrwada kakhulu", kunokuba kukulimala kakhulu kwamathumbu okufuna ungenelelo olungxamisekileyo (I-Altomare 2017, iphe. 372). Ukudibana kwe-anal-genital kwiimeko ezininzi kukhokelela kwintlungu enkulu (I-Rosser 1998; Damon 2005; Iihagu xnumx; IHirshfield xnumx)

B. Imingcipheko enxulunyaniswa nokuphendula komzimba kwisidoda

Ii-antibodies ze-Antisperm (ASA) -amayeza okubulala iintsholongwane aveliswa ngumzimba womntu ngokuchasene nesidoda se-antigen (I-Krause 2017, iphe. 109). Ukwenziwa kwe-ASA sesinye sezizathu zokwehla kwesibeleko okanye ukuzala kwe-autoimmune: I-ASA ichaphazela ukusebenza kwe-spermatozoa, ukuphazamisa iinkqubo zokuchumisa (ukutshintsha ikhosi ye-acrosomal reaction), ukumiliselwa kunye nokukhula kombungu (Ukubuyisela i-2013) Izifundo kwiimodeli ezahlukeneyo zezilwanyana zibonakalise ubudlelwane phakathi kwe-ASA kunye nokuvela kwesibeleko (I-Krause 2017, iphe. 164) UCui et al. Emva kokwenza uhlalutyo lwe-meta ulwalamano phakathi kwe-ASA kunye nokuzala kwabesilisa, igubungela iimeko ze-1167 zokungazinzanga kwamadoda, safumanisa ukuba kwi-238 iimeko (20,4%) emadodeni angenamadoda, i-ASA (Cui xnumx), kwaye i-restrepo kunye ne-Cardona-Maya zibonisa kwisigxeko-ncomo sabo ukuba i-ASA ingunobangela wokungachumi kwi-10 - 30% isibini esitsala nzima (Ukubuyisela i-2013) Ngokuka-Fijak et al, esi salathisi sinokuphakama ngakumbi, kuba kwi-31% yeemeko oonobangela bokungachumi bahlala bengachazwanga, kwaye i-ASA inokudlala indima kula matyala angachazwanga (I-Fijak xnumx, 2018) Iziphumo zokuthintela ukukhulelwa kwe-ASA zisaphononongwa ngexesha lokuphuhliswa koko kubizwa isitofu sokugonya isifo sokuthintela isifoI-Krause 2017, iphe. 251), kunye nokunciphisa nokulawula inani lezilwanyana zasendle (I-Krause 2017, iphe. 268).

Inani lababhali libonisa ukuba i-sperm kwi-rectum ngexesha lokudibana kwe-anal genital ngunobangela wokusekwa kwe-ASA kwisini zombini (I-Rao 2014UTom. I-1, iphe. 311; Lu 2008; I-Bronson xnumx) U-Wolff et al. Wafumanisa ukuba imvamisa yokufunyanwa kwe-ASA kumadoda athandana nabantu abatshatileyo ifikelela kwi-28,6% (I-Wolff xnumx) Uphononongo olwenziwe nguWitkin kunye noogxa bakhe baveza unxibelelwano phakathi kobukho be-antigen yesidoda kunye nokujikeleza kweeseli zomzimba kwi-plasma egazi kumadoda athandana nabantu abatshatileyo.I-Witkin 1983a) Kuphononongo olwenziwe ngu-Mulhall kunye noogxa bakhe, ukubonwa rhoqo kwe-ACA kumadoda angabinakho ukukhusela ukwamkela unxibelelwano lobuchwephesha kwiinyanga ezi-6 zokugqibela yayiyi-17%, kunye ne-0% emadodeni angakhange aqhelise unxibelelwano olunjalo (I-Mulhall 1990) Nangona kunjalo, uphononongo olwenziwe nguSands et al. Aluzange luveze ubudlelwane phakathi konxibelelwano olufanasini kunye nee-ASA titers kumadoda (Iisanti xnumx) Nangona kunjalo, iingcali ezikhokelayo kwicandelo lokungazinzi komzimba zikholelwa ukuba, ngaphandle kwenani elaneleyo lezifundo zesiphelo esingathandabuzekiyo, ukubakho kokudalwa kwe-ASA kumaqabane okwamkela kwamadoda kwi-genital-anal contact kuphezulu kakhulu (I-Krause 2017, iphe. 142).

I-ASA inokwakheka emzimbeni xa isithintelo segazi-testicular siphulwe (igazi linxibelelana neeseli ze-semigenic) ngenxa yezifo ezidluliselwa ngesondo (jonga apha ngasentla: igonorrhea, njl.njl.).Jiang xnumx; Ukubuyisela i-2013; UFrancavilla xnumx, iphe. 2899).

Into enomdla kukuba i-spermatozoa edibene ne-ASA inokubangela ukwakhiwa kwe-ASA kubafazi (I-Krause 2017, iphe. 166). Le nyaniso yeyomdla okhethekileyo kwisayensi nakwiklinikhi, kuthathelwa ingqalelo idatha evela kwi-45,6% ukuya kwi-73% yamadoda athandana namanye abelana ngesondo nabasetyhini (Tao xnumx; I-Larmarange xnumx) I-Fethers kunye nababhali bebandla bacacisa idatha efanayo kwizifundo zabo zokuziphatha ngokwesini kubafazi abathandana abathandanayo: kubo, amathuba okuba neentlobano zesini nomntu ongatshatanga naye yayiphindaphindwe ngaphezulu kunabafazi abathandanayo.I-Fethers xnumx, iphepha 347 - 348).

Malunga nemiphumela yexesha elide ye-ASA kwingxaki yokungachumi, uKirilenko et al ubhale:

"... Kwiminyaka yakutshanje, kucacile ukuba ukungabikho komgangatho wesidala kungunobangela wokungabikho kokukhulelwa, kodwa nokukhubazeka komungu, kunye nokuzalwa komntwana kunye nomhlaza ebantwaneni. Kwizizathu ezininzi ezikhoyo ezicetyiswayo zomsebenzi wokungasebenzi kakuhle kwesidoda, ukonakaliswa kweDNA yenyukelo yeyona nto ifundwayo kunye nokwamkelwa njengeyona nto ichaphazela umgangatho wombungu, ukukhula kwayo kunye nokufakwa. Uhlalutyo lwe-Meta ngendima yokwahlulwa kweDNA lubonise ukuba umngcipheko wokukhupha isisu ngokungazenzisiyo kunye nokukhula kwesifo sokukhula kwesibeleko ukonyuka ukuya kumathuba amane ngokunyuka kwesidanga se-DNA (i-15-30% yesiqhelo, kuxhomekeka kwiindlela ezisetyenzisiweyo), nasemva kwendlela yokuchumisa in vitro kunye nesitofu se-intracytoplasmic sperm. Indlela ehamba phambili ye-pathogenetic yomonakalo onjalo uthathwa njengongaphezulu kokuveliswa kwe-oksijini esebenzayo-i-ozone, hydrogen peroxide, nitric oxide, ekhokelela kwi-spermatozoa OS. Esona sizathu siqhelekileyo soxinzelelo lwe-oxidative kwinkqubo yokuzala kwamadoda sisifo esosulelayo nesosulelayo kunye ne-ASA kumgaqo we-urogenital wamadoda ... "(I-Kirilenko 2017).

Ewe kunjalo, uphononongo lokuvavanya ubudlelwane kunye nabantu ababelana ngesondo kunye nabantu njengezinto ezinobungozi bokungafezeki kwabasetyhini luya kuwucacisa lo mbandela.

Ukongeza kwiingxaki zokuzala, ukulawulwa kwesidoda kungenzeka ukuba kungunobangela wokuphazamiseka. Uqwalaselo olunomdla lwenziwa nguWitkin et al. Iveki yonke ukutsalwa kwelebhu yomvundla ngesidoda somvundla kwiiveki ze-15 kukhokelele ekubonakaleni kwee-antibodies kwii-GM1 gangliosides. Izinto ezifanayo ezichasene ne-antibodies zifunyenwe kwizigulana ezinobungqingili be-AIDS (Iwitkin 1983b), nangona kunjalo, kule meko, uphando olongezelelweyo luyafuneka kuso nasiphi na isigqibo esingathandekiyo.

Abantu abathandana nabantu abathandanayo bane-autoimmune thrombocytopenic purpura, kubandakanya iifom ezibi (Bender xnumx; IGoldsweig 1986; Morris xnumx) U-Morris kunye noogxa bakhe bacebisa ukuba ukuxhatshazwa kwe-hematologic kwakubangelwa ziimpendulo ze-immune spermogenic immune system (Morris xnumx).

Umngcipheko onxulunyaniswa nolunye uhlobo lwe-eroticism

Ukuhlaziya nokungena ngesandla⁴ -Uqheliselo lonxibelelwano ngokwesondo ngokufakwa kwesandla kwi-rectum (I-Holland xnumx, iphe. 34). Ngokutsho kuvavanyo lwamazwe aphesheya kwe-Europe, phakathi kwabantu abathandana abathandanayo ababa neentlobano zesini kunye namaqabane angengawo rhoqo kunyaka ophelileyo, i-17,1% yafunda ukungena kwi-anal-Manual in the indima esebenzayo, kunye ne-10,5% kwindima yokwamkela (I-EMIS 2010, iphe. 116). Ngokutsho kophando phakathi kwamadoda athandana namanye, i-7% yabaphenduli eLos Angeles, e-USA ukuziqhelanisa ngenqindi (I-NTS 1998) kunye ne-8% yabaphenduli eSydney, e-Australia (I-Richters xnumx).

Ukungena kolwazi lokuhlaziya (kokubini ngokunyanzelwa kunye nemvume) kukhokelela kwinani lomonakalo obonakalayo kunye nokusebenza kwendlela yokugaya (ICapeletti 2016) Kwisifundo esenziwe phakathi kwamadoda abelana ngesondo namadoda, i-14% yaqhelanisa ngenqindi. Ngapha koko, ikhonkco phakathi kokungqisha kunye ne-HIV kunye nee-STDs zichongiwe (Ilayisi xnumx) Uphononongo olwenziwe phakathi kwamadoda athandana nabantu ababhinqileyo abosulelwe yi-HIV lukwabonisa ukuba amanqatha yenye yezinto zomngcipheko kusulelo lwe-HIV (I-Callander 2016).

Ukudibana ngomlomo okanye irimming⁵ -Isiqhelo sokunxibelelana ngokwesondo nokukhuthaza i-anus ngolwimi kunye nemilebe. Ngokutsho kuvavanyo lwamazwe aphesheya kwe-Europe, phakathi kwabantu abathandana abathandanayo ababa neentlobano zesini namaqabane angengawo rhoqo kunyaka ophelileyo, i-64,6% yaqhelana nonxibelelwano ngomlomo kunye ne-76,0% kwindima eyamkelayo.I-EMIS 2010, iphe. 116).

Kuphononongo olwenziwe phakathi kwabesilisa ababelana ngesondo kunye nabantu besilisa, i-rimming yayisenziwa yi-85%, kwaye ubudlelwane babonakaliswa kwakhona phakathi kwe-rimming kunye nee-STD (Ilayisi xnumx) Kuphononongo olwenziwe ngu-Keystone kunye noogxa bakhe (1980), iipatalitis zamathumbu zabonwa kwi-67,5% yamadoda athandana nabantu abatshatileyo, kunye ne-16% yamadoda angamadoda angatshatanga, kubandakanya amathumbu amoebiasis (27% kunye 1%, ngokulandelelana) kunye ne-giardiasis (13% kunye 3%, ngokulandelelana)Isitshixo 1980) Into enomdla kukuba, i-17% yabantu abathandana nabalingani kule sampulu ye-anilingus, kodwa babengenazithobi zamathumbu (Isitshixo 1980) Uqwalaselo olunjalo lucacisa ukuba iiparadise zamathumbu phakathi kwabantu abathandana abatshatileyo azidibaniswa kuphela nokuziqhelanisa ne-anal eroticism, kodwa kunye nenyaniso yokuba zisebenza njengendawo yokugcina izilwanyana zamathumbu emathumbu, eqinisekiswa ngophando olungaphezulu kolulodwaEzeh 2016) Ukunxibelelana ngomlomo nako ukunxulunyaniswa nokuxhaphaka okukhulu kosulelo lwe-garyorrheal ye-pharynx kumadoda abelana ngesondo namadoda (Chow xnumx, 2016; I-Templeton xnumx).

Abafazi ababhinqileyo

Iziphumo zempilo yokuziphatha kwabantu besini esahlukileyo kwabasetyhini zichazwe kwaye zafundelwa ubuncinci kunakumadoda - oku ngokuyinxenye kungenxa yokuba ubhubhane we-HIV phakathi kwamadoda athandana namanye atsala umdla wengonyama kunyango. Kwakhona, ubunzima bokufunda umngcipheko wezempilo phakathi kwabafazi abathandana nabantu besini esinye kungenxa yokuba uninzi lwabantu ababelana ngesondo nabasetyhini baye baba neentlobano zesini kunye namadoda, ukuya kuthi ga kwi-30% baqhubeka nezenzo zesini esinye (UMarrazzo xnumx; I-Solarz 1999; I-O'Hanlan 1996; Isikhumba 1996; UFerris xnumx; I-Einhorn xnumx; UJohnson 1987) Umzekelo, kuphando kwiklinikhi ye-STD yase-Australia, yi-7% yabasetyhini abathandana nabantu besini esinye kuphela abathi abakaze babe neentlobano zesini phakathi kwabantu besini esinye (I-Fethers xnumx, iphe. 348). Olu phononongo lukwavavanye nenani eliyi-avareji lamaqabane angamadoda ngexesha lokudla kwabo ubomi: ababhinqileyo amafanasini babephindwe kabini kunamabhinqa angafaniyo (I-Fethers xnumx, iphe. 347). Umngcipheko wokuba neentlobano zesini namadoda angaphezu kwe-50 wawuphindaphindwe kumaxesha e-4,5 kubantu abathandana abathandanayo kunabesini esahlukileyo, kwaye amathuba okuba neentlobano zesini nendoda enesifo uGawulayo okanye iziyobisi lixesha le-3 liphezulu (I-Fethers xnumx, iphepha 347 - 348).

Ukongeza kwii-STDs, kukho umngcipheko wokuba usulelo losuleleko lwamathumbu kunye nokwenzakala phakathi kwabantu ababhinqileyo. Ngokutsho kovavanyo lwabasetyhini abathandana abathandana nabesini esinye e-Michigan, ukubandakanyeka kwabasetyhini besini esifanayo kubandakanya: ukuvuselela umlomo wesibeleko ngexesha lokuya esikhathini kwiqabane elamkelayo-i-38,1% yezehlo, ukuvuselela ngomlomo - i-16,9%, ukungena ngaphakathi kwe-anal (ngesandla okanye izinto) ukopha okanye umvandedwa - I-2,4%, inaliti yomchamo okanye izilwanyana emlonyeni okanye kwilungu lobufazi - 1,7% (I-Bybee xnumx) Kuphononongo olwenziwe e-Italian Turin, i-95,1% yabasetyhini abalala nabasetyhini yabonisa ukuba babelana ngesondo ngexesha lokuya esikhathini (URaiteri 1994, iphe. 202), kunye ne-46,1% ukuziqhelanisa nokunxibelelanisa ngesondo (URaiteri 1994, iphe. 202). Kolunye uphononongo, i-7% yabasetyhini abathandana nabantu besini esinye babonisa ukuba babeziqhelanisa nokukhuthaza ukuxubusha ngomlomo kwezi veki zimbini zidlulileyo (URussel 1995) Ngokutsho kolunye uphononongo, i-17% ukuziqhelanisa nokungena kwamalungu esibeleko - ukufakelwa kwesandla kwilungu lobufazi okanye ubuchwephesha belungu lobufazi, i-29% - ukuvuselela umlomo kunye nokufakwa kwe-3%I-Bailey 2003, iphe. 148). Kwisifundo esenziwe nguSchick kunye noogxa bakhe, ukulwela amanqina kwilungu lobufazi kwinyanga ephelileyo kwenziwe ngo-14,5% wamabhinqa abelana ngesondo nabasetyhini (ISchick xnumx, iphe. 409).

Ngokwezifundo, abantu ababhinqileyo, xa kuthelekiswa nabasetyhini abathandana abesilisa abangatshatanga, ukunyuka kwamanqanaba ebacterial vaginosis (I-Bailey 2004; McCaffrey 1999; Isikhumba 1996; I-Berger 1995; Edward xnumx), Amaxesha e-2,5 aphezulu kunawabafazi abathandanayoU-Evans 2007).

Iingozi ezinxulunyaniswa nokuphazamiseka kwengqondo okuqhubekayo

Kwi-2017, iqela labaphandi abavela kwiYunivesithi yaseSeattle bapapashe uhlalutyo lwedatha evela kuPhando lweSizwe lweNzululwazi ngezeMpilo (2013 - 2014)UFredriksen-Goldsen 2017). Uhlalutyo lubandakanya i-33 yamadoda nabasetyhini abaneminyaka eyi-346 nangaphezulu, apho i-50% ingamadoda angamafanasini kwaye i-1,34% ngamadoda angamafanasini (UFredriksen-Goldsen 2017, iphe. 1335). Ababhali bafumanise ukuba abantu abathandana besini esinye xa kuthelekiswa nabaphenduli abatshatileyo baneempawu ezininzi zokuphila ubomi obungenampilo, bahlupheka kuluhlu olupheleleyo lwezifo ezahlukeneyo, kubandakanya ukuphazamiseka komzimba, ukuphazamiseka rheumatic, ukubetha, ukuphazamiseka kwengqondo, njl. Njl.UFredriksen-Goldsen 2017).

Kuhlalutyo lwe-meta olunikezelwe kuphononongo lombuzo wokuba ingaba kukho ubudlelwane phakathi kobufanasini kunye nonyango lwengqondo phakathi kwabantu abancinci kunye nabantu abadala, abapapashwe kwijenali yoLondolozo lweeNdalo eziGcweleyo kwi-Intanethi, kule datha ilandelayo yafunyanwa:

Izikhombisi zengozi yokunyuka kokuzibulala zihambelana kakhulu nomtsalane wobungqingili (I-Herrell 1999, iphe. 873). Akunakulindeleka ukuba umngcipheko omkhulu wokuziphatha ngokuzibulala kumadoda athandana namanye ungabakho ngenxa yokusebenzisa gwenxa iziyobisi okanye ezinye izifo zengqondo (I-Herrell 1999, iphe. 867).

Iziphumo ziqinisekisa ubungqina bokuba abantu abathandana abathandanayo kunye nabantu abathandanayo abasemngciphekweni basengozini eyandileyo yeengxaki zempilo yengqondo, ngakumbi ekuziphatheni ukuzibulala kunye nokunye ukuphazamiseka (UFergusson 1999, iphe. 876).

Ngokusekwe kwisampulu yabaphenduli, uGilman kunye noogxa bakhe (2001) babale isifo ngokuxhaphakileyo kwiinyanga ze-12 ("i-12 iinyanga”) kunye nomngcipheko wobomi ("umngcipheko wobomi") kumaqela abathandanayo abathandanayo.UGilman xnumx).

Thelekisa iimpawu eziphambili zengxaki yokuphazamiseka kwengqondo phakathi kwabafazi ababhinqileyo nobungqingili (UGilman xnumx).

I-Psychopathology	Indawo yangaphambili: abaphenduli abathandanayo / abathandanayo	Umngcipheko wexesha lobomi: Abantu abathandana nabantu abathandanayo okanye abesilisa
Isigulo esibuhlungu emva koxinzelelo	21% / 6%	2,7
Ingxaki yokuxhalaba	40% / 22,4%	1,8
Isifo sokudakumba	34,5% / 12,9%	1,9
Izifo ezichaphazelekayo	35,1% / 13,9%	2,0
Iziyobisi	19,5% / 7,2%	2,4

Isifundo esenziwe nguJorm kunye noogxa bakhe (i-2002) safumana idatha efanayo kwisifo esibonakalayo phakathi kwabantu abathandana nabantu abathandanayo abaphendule nge-pathologies enje ngexhala lokuxhalaba, uxinzelelo, utyekelo lokuzibulala kunye nokuphazamiseka okubambekayo (Jorm xnumx).

Izifundo ezahlukeneyo zivelise amanqanaba aphezulu okuphazamiseka kwengqondo phakathi kwabantu abathandanayo (Kumkani xnumx; Bradford xnumx; Intsika 1988).

Uxinzelelo kunye noxinzelelo lwexhala

URon Stoll, umphandi ophambili we-AIDS yaseMelika iminyaka emininzi, uthi "kukho iingxaki ezinzulu ngokwengqondo phakathi kwabantu abathandana nabo" (Yiyeke xnumx). Umbutho waseMelika "iGay & Lesbian Medical Association" kwizinto zayo ibonisa ukuba amadoda athandana namanye amadoda asengozini yokufumana uxinzelelo kunye noxinzelelo (Silenzio 2010), eqinisekisiweyo kwinani lezifundo (I-Cochran xnumx; Kumkani xnumx, 2008; Meyer 2003; Jorm xnumx; UGilman xnumx; Sandfort xnumx; UFergusson 1999; IHershberger 1995; I-Berg 2008; I-Bostwick xnumx) Kuphononongo eNetherlands, phakathi kwamadoda athandana nabantu abangatshatanga, iimeko zokuphazamiseka koxinzelelo unyaka wonke zazinamaxesha e-2,94 ephakamileyo kunaphakathi kwamadoda abathandanayo, kwaye imeko yexinzelelo lokuxhalaba yayinamaxesha e-2,61 aphezulu (Sandfort xnumx) Abanye abaphandi bacebisa ukuba amadoda athandana nabantu ababhinqileyo enza phantse isiqingatha seimeko zokuphazamiseka kwengqondo - 42 - 49% (Isilumkiso xnumx).

Ukuzibulala

Abantu bobabini isini esinotyekelo lobufanasini bamele iqela elisengozini ephezulu yokuzibulala (IVoroshilin 2012, iphe. 40). Isifundo esenziwe nguHerrell kunye noogxa bakhe (1999) safumanisa ukuba ukutsala kwabantu abathandana besini esifanayo kulungelelaniswe kakhulu nezalathiso ezahlukileyo zokuqhaqeka: kumadoda athandana nabantu abangatshatanga, umngcipheko wokuzibulala wawuphindaphindwe amaxesha e-4,1, umngcipheko wokuzibulala wawuphindaphindwe amaxesha e-6,5 (I-Herrell 1999) Emva kohlengahlengiso lweenkcukacha-manani lokuvavanya iimpembelelo zezinto ezinje ngokusetyenziswa kweziyobisi kunye neempawu ezixinzelelweyo, zonke iziphumo zokuzibulala zazisabalulekile. Uphononongo olwenziwe kubantu abancinci abazichaza njengamafanasini luveze inani eliphakamileyo lokuzama ukuzibulala kunye nokuzama ukuzibulala phakathi kwabo (Mathy xnumx) kunokuba phakathi kwabantu abatsha abathandanayo. Kunyaka we-2008, iziphumo zohlalutyo lwe-meta zathi zapapashwa, ngexesha apho kwagqitywa ngaphezulu kwe13 yamawaka apapashiweyo kwesi sihloko, njengesiphumo apho izifundo ezizezona zichanekileyo zichongiweyo zaza zafundwa ngu25 (Kumkani xnumx) Kwafunyaniswa ukuba xa kuthelekiswa nenani labantu ngokubanzi abanotyekelo lobufanasini, kukho ukwanda okungaphezulu kokuphindwe kabini kumngcipheko wokuziphatha ngokuzibulala; umngcipheko wokudakumba noxinzelelo, isiselo esinxilisayo kunye nokuxhomekeka kwiziyobisi kwakusihlandlo esinye nesiqingatha ngaphezulu (Kumkani xnumx) Ngokukodwa, ukwahlukana kwamaqela emngcipheko ngokwesini kuveze ukuba, xa kuthelekiswa nexabiso eliphakathi, phakathi kwamadoda athandana nabantu abathandanayo, umngcipheko wokuzibulala wawuphindaphindwe amaxesha e-4,28; phakathi kwabasetyhini abathandanayo, umngcipheko wokuxhomekeka kotywala wawunamaxesha e-4 ngaphezulu, kwaye iziyobisi kwakunguxesha le-3,5 ngaphezulu (Kumkani xnumx) Kwisifundo esikhulu saseMelika, kwafumaniseka ukuba umngcipheko wokuziphatha ngokuzibulala, ukudakumba nokudakumba (ukuzenzakalisa) kubantu abancinci abanotyekelo lobufanasini udlula kwiingozi ezifanayo phakathi kolutsha olufananayo, ngaphandle kohlanga lwabaphenduli (ILytle 2014) Umngcipheko wokuphazamiseka kwengqondo kunye nokuziphatha ngokuzibulala phakathi kwabantu abathandana nabo kuyaqatshelwa kwizifundo e-Australia (Swannell xnumx; I-Skerrett 2015), eNgilane (Chakraborty xnumx), e-New Zealand (Skegg 2003), eSweden (Björkenstam 2016) Abacebisi be-LGBT + ngamanye amaxesha bathi uphawu lolo lucalulo. Nangona kunjalo, siphawula ukuba ezi zifundo zingasentla beziqhutywa kumazwe apho abantu abanotyekelo lobufanasini banandipha inkxaso kunye nokukhusela izixhobo zikarhulumente.

Iziyobisi

Ngokwezifundo ezahlukeneyo, inqanaba leziyobisi phakathi kwabantu abathandana ababhinqileyo liphezulu kunabantu ngokubanzi, kunye nokuthelekisa nabantu abathandanayo abathandanayo.IPadilla 2010; IHalkitis 2009; I-Cochran xnumx; Kumkani xnumx, 2008; Meyer 2003; Jorm xnumx; UGilman xnumx; Sandfort xnumx; Yiyeke xnumx; UFergusson 1999; IHershberger 1995), ngokweengxelo ezithile, amaxesha e-2 -3 aphakamileyo kunaphakathi kwamadoda abathandana abathandanayo (I-Cochran xnumx; URyan xnumx; Isikhumba 1994; Luhlaza xnumx). Ngokwentlangano yaseMelika iGay & Lesbian Medical Association, amadoda angamafanasini asengozini yokuba ngamakhoboka eziyobisi (Silenzio 2010) NgokukaGrant noogxa bakhe, abesilisa abathandana nabantu besini esinye banokubandezeleka ngenxa yokuphazamiseka okunganyanzelekanga kunye nokusetyenziswa kweziyobisi kunamadoda angatshatanga.Isibonelelo xnumx) Kwabafazi abathandana abathandanayo, umngcipheko wokusetyenziswa kweziyobisi apha enyakeni wawuphakathi kwamaxesha e-4,05 ngaphezulu kunabasetyhini abathandanayo.Sandfort xnumx).

Utywala

Umbutho waseMelika "iGay & Lesbian Medical Association" ibonisa ukuba phakathi kwabantu abathandana besini esinye kukho inqanaba elonyukayo lotywala (Silenzio 2010) Amadoda athandana nabantu abatshatileyo baneziganeko eziphezulu zokunxila xa kuthelekiswa nobungqingili (I-Irwin 2006; Iphaphama xnumx; Yiyeke xnumx) Kwiminyaka edlulileyo, izifundo zibonise inqanaba eliphezulu kakhulu lotywala phakathi kwabafazi abathandana nabayeni xa kuthelekiswa nabasetyhini abathandanayo abathandanayo (Cassidy in McElmurry 1997; Eliason xnumx; Idrabble 2005; Isikhumba 1996, 1994; Yeha ngaphakathi UDan xnumx; I-O'Hanlan 1995; I-Rosser 1993; NGLTF 1993; Cabaj ngaphakathi I-Lowinson xnumx, ICabaj 1996; Iholo 1993; Finnegan ngaphakathi I-engs 1990; Iglaus xnumx).

Izifo ze-oncological

Kukho ubungqina obuqatha bokuba ukwanda komhlaza kuphakamileyo phakathi kwabantu “be-LGBT +” (uBoehmer kunye neRonit 2015). Uphononongo olwenziwe nguZaritsky kunye noDibble bavavanya isampulu yamabhanti ama-370 amabhinqa angatshatanga noodade abathandanayo, kwafumaniseka ukuba abantu ababhinqileyo banomngcipheko omkhulu wokukhula nomhlaza wesibeleko xa kuthelekiswa noodade wabo - ababhali bacebisa ukuba oku kungenxa yokuba ukungabikho komntwana kunye nokukhuluphala phakathi kwabasetyhini abathandanayo ababhinqileyoIZaritsky 2010) I-anal carcinoma ngumhlaza wecctum ohambelana neparillomavirus (I-Breese xnumxngokuchasene nemvelaphi yentsholongwane kaGawulayo.Hleyhel xnumx) Ukuhamba rhoqo kwe-anal carcinoma kumadoda aqhelisela ukunxibelelana nge-genital ephezulu kakhulu kunobunkunkqele bayo kubantu ngokubanzi (Siegenbeek van Heukelom 2017; I-Chin-hong xnumx, 2005; I-Tseng 2003; I-Willett xnumx) Kwisifundo esikhulu esenziwe nguDaling kunye noogxa bakhe emngciphekweni wokuhlakulela umdlavuza we-anal phakathi kwamadoda, ukugubungela ixesha ukusuka kwi-1978 ukuya kwi-1985, ukuziqhelanisa naluphi na ubudlelwane besini esifanayo kwandise umngcipheko ngamaxesha e-50, kunye nokuziqhelanisa nokunxibelelana ngokuthe ngqo nangokwesini kwanda ngamaxesha e-33 (Ukutsala xnumx) Uhlalutyo olucwangcisiweyo kunye nohlalutyo lwe-meta nguMachalek et al. Ukufumanisa ukuba imeko yomhlaza womchamo phakathi kwabantu abathandana abosulelwe yi-HIV yayiyimeko ze-45,9 kubantu abangama-100 000, phakathi kwabantu abathandana nabangenazifo-kwi-5,1 kwi-100 ye-000 yabantu (IMachalek xnumx), kubemi ngokubanzi-ukusuka kwi-1 ukuya kwi-2 kubemi be-100 000 (I-Grulich xnumx).

Ulwazi olongezelelekileyo

Ulwazi olongezelelekileyo kunye neenkcukacha zingafumaneka kule mithombo ilandelayo:

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Amanqaku

Ukufakwa kwe-penile ye-1 kwiqabane elisebenzayo kwi-rectum yeqabane elamkelayo

I-2 IsiNgesi: "isifo samathumbu esisesiswini"

I-3 Okwangoku, phantsi koxinzelelo lwemibutho yoluntu ye-LGBT + intshukumo, iinkcazo ezinjengokungafezeki komntu onobungqingili kunye nesifo esifana nesakho. Iinzame ezinkulu zokususa igama elithi "ukungaqiniseki kobufanasini" ekusebenziseni kwenziwa ngugqirha webhayoloji kunye nomzabalazi uBruce Weller, umsunguli we-National Gay Task Force (Chuck 2003, iphe. 168).

I-4 isuka kwisiNgesi Inqindi ngenqindi

I-5 isuka kwisiNgesi "Molweni" - emqolo

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Iziko le-Laser Proctology "ATLANTiK" ukubonelela Unyango lwe-gay bowel syndrome (isifo samathumbu esisesiswini):

I-Lesbianism: oonobangela kunye nemiphumo

UJan Goland kunyango lobufanasini (udliwanondlebe wevidiyo ekhethekileyo)