Ukuhlolwa kwe-STD kuhilela ukubheka izifo ezithathelwana ngocansi (STDs), manje ezibizwa nge-STIs (izifo ezithathelwana ngocansi). Phakathi kweshumi nambili izifo ezithathelwana ngocansi ezikhona, ezinye zibangela izimpawu, ezinye azikwenzi. Ngakho-ke ukubaluleka kokuzihlola ukuze ubelaphe futhi ugweme, kwezinye, izinkinga ezinkulu.

Ukuhlolwa kwe-STD kuhilela ukuhlolelwa ama-STD ahlukene (izifo ezithathelwana ngocansi), manje okuthiwa ama-STI (izifo ezithathelwana ngocansi). Lena iqoqo lezimo ezibangelwa amagciwane, amabhaktheriya noma izimuncagazi ezingasakazwa ngesikhathi sokuya ocansini, ngokungena noma kwabanye, ngaphandle.

Kunezinhlobo ezahlukene ze-STI:

• ukutheleleka nge-HIV noma igciwane le-AIDS;
• i-hepatitis B;
• ugcunsula ("pox");
• i-chlamydia, ebangelwa igciwane I-Chlamydia trachomatis;
• i-lymphogranulomatosis venereal (LGV) ebangelwa izinhlobo ezithile ze I-Chlamydia thrachomatis ikakhulukazi enolaka;
• i-herpes yesitho sangasese;
• ukutheleleka kwe-papillomavirus (HPV);
• i-gonorrhea (evame ukubizwa ngokuthi “i-hot piss”) ebangelwa amagciwane athathelwanayo kakhulu, Neisseria gonorrhoeae i-gonocoque;
• i-vaginitis I-Trichomonas vaginalis (noma i-trichonomase);
• ukutheleleka kwe-mycoplasma, okubangelwa amagciwane ahlukene: I-Mycoplasma genitalium (MG), I-Mycoplasma, I-Mycoplasma urealyticum ;
• ezinye izifo zemvubelo ye-vulvovaginal zingadluliselwa ngesikhathi socansi, kodwa futhi kungenzeka ukuthi ube nokutheleleka kwe-yeast ngaphandle kokuya ocansini.

Amakhondomu avikela kuma-STI amaningi, kodwa hhayi wonke. Ukuxhumana okulula kwesikhumba kuya kwesikhumba kunganele ukudlulisa i-chlamydia, isibonelo.

Ngakho-ke ukuhlolelwa izifo ezithathelwana ngocansi kubaluleke kakhulu. Ngokuvamile ukuthula, kungaba umthombo wezinkinga ezihlukahlukene: 

• jikelele nezinye izindawo zesifo: ukulimala kwamehlo, ubuchopho, izinzwa, inhliziyo ye-syphilis; i-cirrhosis noma umdlavuza wesibindi we-hepatitis B; ukuziphendukela kwengculazi ku-HIV;
• ingozi yokuqhubekela phambili esilonda esiyingozi noma somdlavuza kuma-HPV athile;
• ukubandakanyeka kwe-tubal, ovarian noma i-pelvic okungaholela ekungeneni kwe-tubal (okulandela i-salpingitis) noma ukukhulelwa kwe-ectopic (i-chlamydia, i-gonococcus);
• ukudluliswa kwengane-umama ngokubandakanyeka komntwana osanda kuzalwa (i-chlamydia, i-gonococcus, i-HPV, i-hepatitis, i-HIV).

Okokugcina, kufanele kuqashelwe ukuthi zonke izifo ezithathelwana ngocansi zenza buthaka ulwelwesi lwamafinyila futhi zandise kakhulu ingozi yokungenwa igciwane lengculazi.

Ukuhlolwa komtholampilo kungase kubhekisele kwezinye izifo ezithathelwana ngocansi, kodwa ukuxilongwa kudinga ukuhlolwa kwaselabhorethri: i-serology ngokuhlolwa kwegazi noma isampula ye-bacteriological kuye nge-STI.

• Ukuhlolwa kwe-HIV kwenziwa ngokuhlolelwa igazi, okungenani izinyanga ezi-3 ngemva kocansi oluyingozi, uma kufanele. Kusetshenziswa ukuhlolwa kwe-ELISA okuhlanganisiwe. Iqukethe ukusesha amasosha omzimba akhiqizwa phambi kwe-HIV, kanye nokusesha izinhlayiyana zegciwane, i-p24 antigen, etholakala ngaphambi kwesikhathi kunamasosha omzimba. Uma lokhu kuhlola ku-positive, ukuhlolwa kwesibili okubizwa nge-Western-Blot kufanele kwenziwe ukuthola ukuthi ingabe igciwane likhona ngempela yini. Yilokhu kuhlola kokuqinisekisa kuphela okungasho ukuthi umuntu une-HIV ngempela yini. Qaphela ukuthi namuhla kukhona orientation self-test ukudayiswa ngaphandle kadokotela in Pharmacy. Yenziwa ngethonsi elincane legazi. Umphumela kufanele uqinisekiswe ngokuhlolwa kwesibili kwaselabhorethri;
• i-gonococcal gonorrhea itholwa kusetshenziswa isampula emnyango wesitho sangasese sowesifazane kwabesifazane, ekugcineni kwepipi kwabesilisa. I-urinalysis ingase yanele;
• ukuxilongwa kwe-chlamydia kusekelwe ku-swab yendawo ekungeneni kwesitho sangasese sowesifazane kwabesifazane, futhi emadodeni, isampula yomchamo noma i-swab emnyango we-urethra;
• ukuhlolwa kwe-hepatitis B kudinga ukuhlolwa kwegazi ukwenza i-serology;
• ukuxilongwa kwe-herpes kwenziwa ukuhlolwa komtholampilo kwezilonda ezijwayelekile; ukuze kuqinisekiswe ukuxilongwa, amasampula eseli avela ezilonda angakhuliswa elabhorethri;
• i-papillomaviruses (HPV) ingatholwa ekuhlolweni komtholampilo (phambi kwe-condylomata) noma ngesikhathi sokuhlolwa. Esimeni se-smear engavamile (uhlobo lwe-ASC-US "lokungajwayelekile kweseli eli-squamous ukubaluleka okungaziwa"), ukuhlolwa kwe-HPV kungase kunqunywe. Uma i-positive, i-colposcopy (ukuhlolwa komlomo wesibeletho kusetshenziswa ingilazi enkulu yokukhulisa) kutuswa ngesampula ye-biopsy uma kutholakala ukungavamile;
• I-Trichomonas vaginitis itholakala kalula lapho kuhlolwa izifo zabesifazane lapho kubhekene nezimpawu ezihlukahlukene ezisikiselayo (ukuzwa ukusha kwe-vulvar, ukulunywa, ubuhlungu ngesikhathi sokuya ocansini) kanye nokubonakala kokuphuma koketshezi esithweni sangasese (okuningi, okunukayo, okuluhlaza okotshani kanye namagwebu). Uma ungabaza, isampula yesitho sangasese sowesifazane singathathwa;
• ukuxilongwa kwe-lymphogranulomatosis venereal kudinga isampula kusuka ezilonda;
• ukutheleleka kwe-mycoplasma kungatholwa kusetshenziswa i-swab yendawo.

Lezi zivivinyo ezihlukahlukene zezinto eziphilayo zinganqunywa ukwelashwa noma udokotela onguchwepheshe (i-gynecologist, i-urologist). Kufanele kuqashelwe ukuthi kukhona nezindawo ezizinikele, i-CeGIDD (Isikhungo Solwazi Lwamahhala, Ukuhlolwa Nokuxilongwa) esigunyazwe ukwenza ukuhlolwa kwesifo sokusha kwesibindi kohlobo B no-C kanye nezifo zocansi. Izikhungo Zokuhlela Umama Nezingane (PMI), Izikhungo Zokuhlela Umndeni Nezemfundo (CPEF) kanye Nezikhungo Zokuhlela Umndeni noma Zokuhlela nazo zinganikeza ukuhlolwa kwamahhala.

Ukuhlolwa kwe-STD kunganqunywa ngezimpawu ezilandelayo:

• ukukhishwa kwesitho sangasese sowesifazane okungajwayelekile ngombala, iphunga, ubuningi;
• ukucasuka endaweni eseduze;
• ukuphazamiseka kokuchama: ubunzima bokuchama, ukuchama okubuhlungu, isifiso esivamile sokuchama;
• ubuhlungu ngesikhathi sokuya ocansini;
• ukubonakala kwama-warts amancane (HPV), i-chancre (isici esibuhlungu esingenabuhlungu esincane se-syphilis), i-blister (i-herpes yobulili) ezithweni zangasese;
• ubuhlungu be-pelvic;
• i-metrorrhagia;
• ukukhathala, isicanucanu, i-jaundice;
• ukushisa kanye / noma ukuphuma okuphuzi epipini (bennoragia);
• ukukhishwa kwesitho sangasese njengeconsi lasekuseni noma ukukhanya, okucwebezelayo (i-chlamydiae).

Ukuhlolwa kungabuye kucelwe isiguli noma kunqunywe udokotela ngemuva kocansi oluyingozi (ucansi olungavikelekile, ubudlelwano nomuntu onokwethembeka okungabazekayo, njll.).

Njengoba amanye ama-STD ehlala ethulile, ukuhlolwa kwe-STD kungenziwa njalo njengengxenye yokulandelela izifo zabesifazane. Njengengxenye yokuvimbela umdlavuza womdlavuza womlomo wesibeletho ngokuhlolelwa i-HPV, i-High Authority of Health (HAS) incoma ukuthi kuhlolwe njalo ngemva kweminyaka emi-3 kusukela eminyakeni engama-25 kuye kwengama-65 ngemva kokuhlolwa okujwayelekile okubili okulandelanayo okwenziwa unyaka owodwa ngokuhlukana. Ngombono kaSepthemba 2018, i-HAS iphinde income ukuhlolwa okuhlelekile kwezifo ze-chlamydia kwabesifazane abaya ocansini abaneminyaka engu-15 kuya kwengama-25, kanye nokuhlolwa okuhlosiwe ezimweni ezithile: abalingani abaningi (okungenani abalingani ababili ngonyaka) , ushintsho lwakamuva lozakwethu, umuntu. noma abalingani abatholakala benesinye i-STI, umlando we-STIs, amadoda abalala namadoda (MSM), abantu abadayisa ngomzimba noma ngemva kokudlwengulwa.

Okokugcina, esimweni sokuqapha ukukhulelwa, okunye ukuhlolwa kuyimpoqo (ugcunsula, i-hepatitis B), okunye kunconywa kakhulu (i-HIV).

Uma kunemiphumela emihle, ukwelashwa kuncike ekuthelelekeni:

• igciwane lesandulela ngculaza alikwazi ukuqedwa, kodwa inhlanganisela yokwelapha (ukwelashwa kathathu) impilo yonke ingavimba ukukhula kwalo;
• i-trichomonas vaginitis, i-gonorrhea, izifo ze-mycoplasma ziphathwa kalula nangempumelelo nge-antibiotic therapy, ngezinye izikhathi ngendlela "yokwelashwa okusheshayo";
• i-lymphogranulomatosis venereal idinga inkambo yamaviki ama-3 yama-antibiotics;
• i-syphilis idinga ukwelashwa ngama-antibiotics (umjovo noma ngomlomo);
• Ukutheleleka nge-HPV kuphathwa ngendlela ehlukile kuye ngokuthi kudale izilonda noma cha, kanye nobukhulu bezilonda. Abaphathi basukela ekuqaphelweni okulula kuya ekuhlanganisweni uma kwenzeka izilonda zebanga eliphezulu, okuhlanganisa nokwelashwa kwendawo kwama-warts noma ukwelashwa kwezilonda nge-laser;
• igciwane le-herpes lobulili alikwazi ukuqedwa. Ukwelashwa kwenza kube nokwenzeka ukulwa nobuhlungu nokunciphisa ubude nokuqina kwe-herpes uma kwenzeka ukuhlaselwa;
• ezimweni eziningi, isifo sokusha kwesibindi kohlobo B sixazulula ngokuzenzakalelayo, kodwa kwezinye izimo singadlulela ekubeni yisifo esingamahlalakhona.

Uzakwethu kufanele futhi elashwe ukuze agweme isenzakalo sokuphinde angcoliswe.

Okokugcina, kufanele kuqashelwe ukuthi akuvamile ukuthola izifo zocansi eziningana ezihlobene ngesikhathi sokuhlolwa.