nrtpypaHfSf;fhd mbg;gil VMHb

kUj;Jt gapw;rp ifNaL

(njhlhr
; r
; pahd n`rI
; tp ftdpgG; -
VMHtp njugp kwW; k; jLjj
; y;)

,e;jpag; gapw;rpf;fhd tiuT> [{d; 2007

cyf Rfhjhu mikg;gpd; ,e;jpa mYtyfj;jhy;
Mjupf;fg;gl;lJ

1
mj;jpahak; 1: VMHb cldhd njhlh;r;rpahd (Chronic)n`r;Itp
ftdpg;gpw;fhd KfTiu
n`r;Itpahy; ghjpf;fg;gl;l egHfspd; KOikahd guhkhpg;gpy; kUj;Jtkidapy; mspf;fg;gLk;
kUj;Jt guhkhpg;G kw;Wk; FLk;gj;jpdH> ez;gHfs;> r%f Rfhjhug; gzpahsHfs;> gpw r%fk;
rhHe;j guhkhpg;ghsHfs;> ghuk;ghpa kUj;JtHfs; kw;Wk; jd;dhHt njhz;L epWtdq;fs;>
FBOf;fs; Nghd;w r%f ey epWtdq;fs; Mfpait ,ize;J Nehahspf;F tPl;by; mspf;Fk;
guhkhpg;Gk; mlq;Fk;. “njhlh;r;rpahd n`r;Itp guhkhpg;G” topfhl;L ifNal;bd; H8 Kjy; H9
tiuapyhd gf;fq;fspy; $wg;gl;Ls;s thpirahd kUj;Jtg; guhkhpg;G Fwpj;j tp\aq;fs;
r%f guhkhpg;G kw;Wk; rpfpr;irf;fhd MjuT mfpatw;iw ikakhf nfhz;L cs;sJ.
,g;ghlj;jpl;lkhdJ kUj;Jt guhkhpg;gpy; ftdk; nrYj;JfpwJ. ,J KOikahd guhkhpg;gpd;
xU Kf;fpakhd mq;fNk MFk;. ,ijNa KOikahd guhkhpg;ghf fUjf;$lhJ. IMAI
ART cjtp ghlj;jpl;lkhdJ NehahspfSf;fhd fy;tp> kNdhhPjpapyhd MjuT> njhlHe;J
kUe;J cl;nfhs;tjw;fhd jahhpg;G kw;Wk; kUj;Jtf; FOtpw;Fs; cjtp Mfpatw;wpw;Nfw;g
PLHA, eH]pq; cjtpahsHfs;> nrtpypaHfs; kw;Wk; MNyhrfHfis jahH nra;fpwJ. IMAI
jfty; njhlHG rhjdq;fs; kf;fis rpfpr;irf;F jahHgLj;jTk;> r%fj;jpy; mspf;fg;gLk; gpw
gapw;rpfSf;Fk; cjtpfukhf ,Uf;Fk;.

njhlh;r;rpahd n`r;Itp guhkhpg;G topfhl;L khl;a+y;> gh]pl;bt; n`r;Itp Nrhjid kw;Wk;

Nehahsp rpfpr;irf;F xg;Gf;nfhs;Sjy; Mfpatw;NwhL Jtq;FfpwJ. rpy Nehahspfs;
n`r;Itp gh]pl;bt; vd;W Nrhjidapy; fz;lwpag;gl;L rpwpJ fhy ,ilntspf;Fg; gpwNf
rpfpr;irf;fhf kUj;Jtkidf;F tUfpd;wdH.

jPtpu(Acute) kw;Wk; njhlh;r;rpahd n`r;Itpahy; ghjpf;fg;gl;lth;fSf;fhd guhkhpg;G

kw;Wk; Neha;jLg;G

Rfhjhu ikaq;fs; kw;Wk; khtl;l GwNehahspfs; kUj;Jtkidfspy; PLHA - tpw;F

mspf;fg;gLk; KOikahd guhkhpg;ig Nkk;gLj;j rpwg;ghd> rupahd kw;Wk; njhlh;r;rpahd
guhkupg;G kw;Wk; jLg;G Mfpa ,uz;L trjpfisAk;> tPL kw;Wk; r%fj;ij mbg;gilahff;
nfhz;l guhkupg;gpw;fhd ,izg;GfisAk; mj;jifa Rfhjhuikaq;fs; nfhz;bUf;f
Ntz;baJ Kf;fpakhFk;.

ePq;fs; cq;fSila kUj;Jtkid my;yJ cly; eyikaj;jpy; jw;NghJ toq;Fk; guhkupg;G

Fwpj;J epidj;Jg; ghUq;fs;. mJ kpfTk; rupahdjh my;yJ njhlh;r;rpahdkhdjh? ehk;
toq;Fk; ngUk;ghyhd guhkupg;Gfs; rupahdjhNt cs;sd. rpwpatHfs; kw;Wk; ngupatHfSf;F
toq;Fk; nghJthd cly; eyg; guhkupg;Gfis Nkyhz;ik nra;tJk; rupahd guhkupg;gpy;
cs;slq;Fk;. ,tw;Ws; nghJthd fpUkp njhw;Wfs;> Njhy;> euk;Gfs; uPjpapyhd gpur;ridfs;
kw;Wk; kdey gpur;ridfSk; cs;slq;Fk;. n`r;Itp njhw;W mjpfkhf Vw;gLk; ekJ
ehl;by;> n`r;Itp njhw;wpdhy; Neha; vjpHg;G jpwd; Fiwghl;bd; mbg;gilapy; Vw;gl
tha;g;Gs;s ,j;jifa rupahd tha;g;Gs;s njhlh;r;rpahd njhw;Wfs; mjpfupj;J tUfpd;wd.
n`r;Itp njhw;W njhlh;r;rpahd tpahjpfis Vw;gLj;JfpwJ. Mdhy; ehk; jhf;fpa tpahjpfs;
Fwpj;Nj mjpf ftiy nfhs;fpNwhk;. Mdhy; ehk; rupahd rpfpr;iria khj;jpuNk toq;fp
tUfpNwhk;. ehk; ,d;Dk; rpwg;ghd njhlh;r;rpahd guhkupg;G toq;Ftjpy;iy.

Vnddpy;> ngUk;ghyhd cly;ey mikg;Gfs; rupahd gpur;ridfis jPHg;gjw;fhfTk; kw;Wk;

mtru cly;eyj; Njitfs; kw;Wk; Nrhjidfs; nra;jy;> FwpaPLfs; kw;Wk; jPHTfs;
Njitg;gLgitfspd; mbg;gilapNyNa mitfs; tbtikf;fg;gLfpd;wd. rupahd
gpur;ridfSf;fhd guhkupg;G vd;gJ njhlh;r;rpahd gpur;ridf;fhf guhkupg;gpypUe;J
NtWgl;ljhFk;.

n`r;Itp cl;gl njhlh;r;rpahd epiyfis rpwg;ghf Nkyhz;ik nra;tjhw;fhf> cly; eyg;

guhkupg;ghdJ NtWgl;l topKiwfspd; topahf ntspg;gLj;jg;gl Ntz;Lk;. rupahd guhkupg;G
vd;gJ kpfTk; Kf;fpakhFk; (njhlh;r;rpahd guhkupg;G epiyfspYk; rupahd guhkupg;G
Njitg;gLfpwJ)> Mdhy; guhkupg;G vd;gJ ePz;l fhyfl;lj;jpw;F cly;eyg; gpur;ridfis
rkhspf;Fk; jpwd;’ nfhz;ljhf ,Uj;jy; Ntz;Lk;.

2
njhlh;r;rpahd guhkupg;gpd; nghJthd nfhs;iffSf;fhd mwpKfk;
rpwg;ghd njhlh;r;rpahd guhkupg;G vd;gJ> Nehahsp mtuJ njhlh;r;rpahd epiy Fwpj;J
mwpe;Jk; kw;Wk; Gupe;Jk; itj;jpUg;gNjhL> mij Nkyhz;ik nra;tjw;fhd jpwidAk;
ngw;wpUg;gNj MFk;. n`r;Itp njhw;Wfs; kw;Wk; va;l;]; epiyf;Fr;nry;Yk; epiyfis
Nehahsp Racly; guhkhpg;G (mtHfsJ epiyia mth;fNs ftdpj;Jf; nfhs;Sjy;)
nra;tjw;fhd jpwid toq;Ftjw;fhf> mjpfg;gbahd fw;wYk; kw;Wk; MjuTk; Njitg;gLk;.
kUj;Jt FO kw;Wk; tPl;bYs;s kw;wtHfs; kw;Wk; r%fj;jpYs;stHfs; MfpNahH cjtp
Gupe;jhYk;> gpur;ridia ;fNs ftdpj;Jf; nfhs;Stjw;Fk; kw;Wk; mtHfsJ
ek;gpf;iff;Ffe;jtHfSld; mtuJ epiyapid gfpHe;Jnfhs;sTk; kw;Wk; $Ljy; cjtpfis
ngwTk; kw;Wk; njhw;wpid jLf;fTk>; n`r;Itp njhw;Wld; tho;tjw;Fk; kw;Wk;
g;Nuh/gpyhf;rp]; Fwpj;J Gupe;J nfhs;Tk; kw;Wk; mij cgNahfpf;fj; njupaTk; VMHb kw;Wk;
gpw rpfpr;irfs; Fwpj;J mwpe;J nfhs;sTk; Nehahsp njupe;J itj;jpUg;gJ Kf;fpakhFk;.
,jw;F mjpfg;gbahd fw;wYk; kw;Wk; MjuTk; Njitgl;lhYk; NehahspfSf;fhd KbTfs;
kpfTk; Kf;fpakhFk;.

gpd;tUk; Kiwfs;> n`r;Itp / va;l;]; cl;gl gy tpahjpfs; my;yJ ,lHghl;L epiyfis

Nkyhz;ik Guptjw;F gad;gLj;jg;glyhk;. ,g;gapw;rp KOtJk; ehk; mJ Fwpj;J rpwpJ
rpwpjhf mwpe;J nfhs;syhk;. (,f;ifNal;bd; gy mj;jpahaq;fspy; mitfs; Njhd;Wk;.
rpwg;ghd njhlh;r;rpahd guhkupg;gpd; nghJthd nfhs;iffSf;fhd mwpKfk;
mj;jpahak; gy ey;y tptuizfs; kw;Wk; cjhuzq;fisf; nfhz;L 5 A - f;fs;
Fwpj;J ePq;fs; fw;f cq;fSf;F cjTk;):

1. cq;fSila Nehahspapd; rpfpr;irf;fhf mtUld; xU $l;Lj;jpl;lj;ij Vw;gLj;jpf;

nfhs;sTk;
2. cq;fSila Nehahspapd; ftiyfs; kw;Wk; fUj;Jf;fis $He;J ftdpj;J
nray;glTk;
3. 5Vf;fis cgNahfpf;fTk; — ASSESS (kjpg;gply;), ADVISE (MNyhrid), AGREE
(xj;Jf;nfhs;Sjy;), ASSIST (cjtp Gupjy;), ARRANGE (Vw;ghL nra;jy;)
4. NehahspfSf;F mth;fs; jq;fis Kiwahf guhkhpj;Jf; nfhs;s cjtp GhpaTk;
5. njhlh; ftdpg;Gfis xUq;fikf;fTk;
6. cq;fSila cly;ey ikaj;jpy;> “epGzj;Jt Nehahspfs;:> rf fy;tpahsh;fs;
kw;Wk; MjuthsHfisAk; NrHj;Jf;nfhs;Tk;;.
7. r%fj;jpy; ,Uf;Fk; tsq;fisAk; MjuTfisAk; n`r;Itp njhw;whsh;fSld;
,izf;fTk;
8. vOj;Jj; jfty; - gjpNtLfs;> rpfpr;ir jpl;lk; kw;Wk; rpfpr;ir ml;ilfs; -
Mtzg;gLj;jy;> fz;fhzpj;jy; kw;Wk; epidTWj;jy; Mfpaitfis
cgNahfg;gLj;jTk;.
9. kUj;Jt FOthf gzpahw;wTk;.
10. njhlHr;rpahd guhkupg;ig cWjpg;gLj;jTk;

,JNghd;w guhkupg;ig Nehahspfs; ngw;why; mtHfsJ cly;epiy

rpwg;ghf Kd;Ndw;wkilfpwJ vd;W Ma;T KbTfspy; njupate;Js;sJ.

gpd;tUk; gpupTfspy; ,f;nfhs;iffs; tpthpf;fg;gLk;.

3
5Af;fs; —ASSESS (kjpg;gply;), ADVISE (MNyhrid), AGREE
(xj;Jf;nfhs;Sjy;), ASSIST (cjtp Gupjy;), ARRANGE (Vw;ghL nra;jy;)
5Af;fs; vd;gJ midj;J NehahspfSf;F MNyhrid jUk;nghOJ cgNahfg;gLj;jg;gLk;
gbfspd; njhFg;ghFk;. ,e;j 5Vf;fis Nkw;nfhs;Sk; Rjhjhug; gzpahsuhfs; / VMHb
cjtpahsHfspd; Nehahspfs; kw;wtHfis tpl rpwg;ghf ,Ug;gjhf njupa tUfpwJ.

kjpg;gply;: mtHfsJ cly;epiy> FLk;gk; kw;Wk; #o;epiy Fwpj;J Nfl;fg;gLk;

Nfs;tpfs;.

MNyhrid: Neha;> MNuhf;fpakhd tho;f;if kw;Wk; jLg;G Fwpj;J toq;fg;gl;l

jfty;fs;

Vw;Wf;nfhs;Sjy; : VMHb cjtpahsH kw;Wk; NehahspapilNa Vw;gLk;

xg;ge;jq;fs;

cjtp Gupjy;: gpur;ridfis rkhspg;gJ vg;gb vd;gJ Fwpj;J fye;jhNyhridfs;

Vw;ghL nra;jy; : kw;nwhU re;jpg;G Neuj;ij Vw;ghL nra;jy;> Nkw;gb gupe;Jiu nra;jy;>
MZiwfs; toq;Fjy; kw;Wk; gjpT nra;jy; Nghd;w VMHb
cjtpahsHfshy; Nkw;nfhs;sg;gLk; gzpfs;.

,e;j 5Vf;fs; VMHb cjtpahsH Nkw;nfhs;Sk; mNj fl;likg;ig nfhz;bUf;fpwJ

kjpg;gply;: “,d;W ePq;fs; vJ Fwpj;J $w tpUk;GfpwPHfs;”

re;jpg;gpw;F Nehahsp te;jpUg;gjd; fhuzj;ij fz;Lgpbf;fTk; mtHfsJ
cly; eyk; kw;Wk; ftiyfs; Fwpj;J Nfl;fTk; Nehahspf;F ,Uf;Fk;
tptuk;> mtuJ ek;gpf;if my;yJ gof;f tof;fq;fs; Fwpj;J
gupNrhjpf;fTk;.

MNyhrid: “vd;dplk;....Fwpj;j rpy jfty;fs; cs;sd. Nfl;f tpUk;GfpwPHfsh?”

jPHT Nghd;W ,y;yhky;> mtHfSia Neha;> mtHfs; vLf;Fk; Mgj;J
eltbf;iffs;> rpfpr;irapd; gyd;fs;> MNuhf;fpa tho;f;if
Nghd;witfs; Fwpj;j rupahd jfty;fis toq;fTk;.

xj;Jf;nfhs;Sjy;: “ehk; MNyhrpj;jtw;wpy; vtw;iw ePq;fs; NjHe;njLf;fpwPHfs;”

xt;nthU NjHtpd; rhjf> ghjf mk;rq;fis tpsf;fp Nehahspf;F
Ntz;baJ vd;dntd;W NjHe;njLf;f cjtp GupaTk;. xt;nthU
NjHtpYk; Nfl;fg;gl;litfspypUe;J xd;iw NjHe;njLf;f mtHfSf;F
cjtTk;. KbT Nehahspapd; fl;Lg;ghl;by; jhd; ,Uf;f Ntz;Lk;

cjtp Gupjy;: “,e;j jpl;lj;ij ePq;fs; gpd;gw;wpdhy; ve;j gpur;ridfs; Vw;glyhk;”

vOj;J jfty;fs; my;yJ filgpbj;jy; njhlHghd rhjdq;fshd gpy;
ngl;bfs; my;yJ ehs;fhl;bia toq;Fjy;. mtHfsJ jpl;lj;ij
nray;gLk;NghJ Vw;gLk; rpy gpur;ridfs; Fwpj;J Nehahsp fz;Lgpbf;f
cjTk;. Njitahd MjuT my;yJ FO $l;lf; fy;tpj;njhlH Nghd;w
MjuTfSf;F gupe;Jiu nra;aTk;.

Vw;ghL nra;jy; “ehd; cq;fsJ cly;eyk; Fwpj;J mwpe;Jnfhs;s cq;fis

(tha;g;gpUe;jhy; Njjpfis Fwpg;gplTk;) md;W re;jpf;f tpUk;GfpNwd;
gpd;tUk; re;jpg;Gfs;> FO Mjutpw;F ,izg;ig Vw;gLj;jpj;jUjy;.
re;jpg;Gfis vOj;J tbtpy; jUjy;. tUifapd; NghJ vd;d Vw;gl;lJ
vd;w gjpT.

4
mj;jpahak; 4: n`r;Itp / va;l;]; kw;Wk; re;jh;g;gthj njhw;Wfspd; KfTiu

n`r;Itp ek;Kila cly;eyj;ij vt;thW jhf;FfpwJ?

1. rpb4 nry;fs; nts;is

,uj;j mDf;fs;
Nghd;wjhFk;. rpb4 ekJ
clypd; ez;gdhFk;.

cly;
rpb4

2. ,Uky; Nghd;w
gpur;ridfs; ekJ
clypid jhf;f
Kaw;rpf;Fk;
NghJ> rpb4 jdJ
ez;gdhd
cliy
mjpypUe;J
Nghupl;L fhf;fpwJ. rpb4
cly;
,Uky;
l;

3.tapw;Wg;Nghf;F Nghd;w
gpur;ridfs; ekJ
clypid jhf;f
Kaw;rpf;Fk; NghJk;>
rpb4 cliy
mjpypUe;J fhf;fpwJ
rpb4
CD4 cly;
tapw;Wg;Nghf;F

5
4. ,g;nghOJ> n`r;Itp
Eioe;J rpb4 – I
jhf;FfpwJ

rpb4 cly;
n`r;Itp

5. jd;dhy; clypid
n`Itpf;F vjpuhfg;
Nghuhb fhf;f KbahJ
vd;gij rpb4
njhptpf;fpwJ

n`r;Itp
rpb4 cly;

6. tpiutpy;> rpb4
n`r;Itpf;F vjpuhd
mjd; rf;jpia
,of;fpwJ.
cly;
n`r;Itp

rpb4

6
7. rpb4 Nghuhl;lj;jpy;
,we;J tpLfpwJ.
cly; ghJfhg;gpd;wp
,Uf;fpwJ.

cly;

rpb4

8. ,g;nghOJ> cly;
ghJfhg;gpd;wp jdpahf
,Uf;fpwJ. ,Uky; kw;Wk;
tapw;Wg;Nghf;F Nghd;w
tpahjpfs; jw;NghJ
Rygkhf clypid jhf;fj;
njhlq;FfpwJ.
,Uky;l cly;

tapw;Wg;Nghf;F

9. ,Wjpapy; cly; kpfTk;

typikaw;W NghfpwJ.
midj;J tpahjpfSk;
jw;NghJ kpfTk;
Rygkhf clypid
jhf;FfpwJ.
,Uky;

tapw;Wg;Nghf;F cly;

7
 HIV / AIDS tsHr;rpailjy;

cz;ik: rpb4 nry;fs;

n`r;Itp

Muk;gk;: rpy tUlq;fSf;F gy tUlq;fSf;F 10 tUlq;fSf;F

mwpFwpfs; gpd;G: gpd;G: gpd;G:
VJkpy;iy Fiwe;j Kf;fpakhf vil Nt];l;bq;
vil mstpyhd vil ,og;G> j;u\;> bgp> rpd;l;Nuhk;>
,og;Gk; ,og;G fha;r;ry; f;uhdpf; n`Hg;];
,y;iy tha;g;Gz;fs;> rpk;g;nsf;];
mhpg;Gfs;> Njhy; my;rNu\d;];>
tpahjpfs; vf;l;uhgy;kdhp bgp

5 Kjy; 10 tUlq;fs;

8
ehk; rpy Nehahspfis ghHf;fyhk;. gapw;rp KOtJk; mtHfis gpd;njhlUNthk;

R\;kh xU 22 taJ ngz;kzp

mtUila n`r;Itp epiyia $wpajd; fhuzkhf

mtuJ fztH mtiu tpl;Lr; nrd;W tpl;lhH.
,g;nghOJ mtH jdpahf trpj;J tUfpwhH

njhlHr;rpahd eLf;fhJ njhw;wpidf; nfhz;Ls;s mtH

rpwpJ viliaAk; ,oe;J tpl;lhH. mjpf vil my;y.
mtUf;F NtW ve;j kUj;Jt FwpaPLfNsh ,y;iy.
R\;kh jw;NghJ ve;j kUj;Jt epiyapy;
cs;shH________

kdp\; xU 27 taJ Mz;. ,jw;F Kd;> mtH tPjpapy;

tPl;L cgNahf rhjdq;fs; rpytw;iw tpw;W te;jhH.
Mdhy; jw;NghJ mtuJ cly;epiy kpfTk; Nkhrkile;J
,Ug;gjdhy;> mtuhy; gzpGupa Kbatpy;iy.
mtuJ cly;epiy jw;NghJ kpfTk; Nkhrkhf
,Ug;gjdhy;> mjpfg;gbahd Neuk; mtH gLf;ifapNyNa
,Uf;f Ntz;bAs;sJ. mtH kpfTk; xy;ypahf
,Ug;gNjhL> gy khjq;fshf mtUf;F njhlHe;J [{uKk;
cs;sJ. va;l;]; ,Ug;gjdhy;> mtH ePz;l ehl;fshf
tUj;jj;jpy; cs;shH. Mdhy;> rpfpr;ir
vLj;Jf;nfhs;tjw;fhd ijupak; mtUf;F ,y;iy. ,ytr
VMHb Fwpj;J Nfs;tpg;gl;l gpwF> ,Wjpapy; mtH
gupNrhjid nra;J nfhz;lhH. mjpy; mtUf;F n`r;Itp
gh]pl;bt; cs;snjd;W mwpag;gl;Ls;sJ.
kdp\; jw;NghJ ve;j kUj;Jt epiyapy;
cs;shH?______

9
FkhH xU njhopyjpgH. mtUf;F 40 taJ MfpwJ.
mtUf;F xU mofhd tPLk; kw;Wk; nrhFR fhH xd;Wk;
cs;sJ. mtH jw;NghJ Kk;igapy; trpf;fpwhH. mtH
kidtpia ,oe;jtH. mtuJ kidtp ,uz;L
tUlq;fSf;F Kd; ,we;J tpl;lhH. ehd;F tajpYk;
kw;Wk; MW tajpYk; mtUf;F ey;y cly;
epiyapYs;s ,uz;L Foe;ijfs; cs;sd. mtH xU
,sk; ngz;iz Gjpjhf jpUkzk; nra;Jnfhz;lhH.

rkPgj;jpy; mtUila vil 75 – ypUe;J 73 – Mf

Fiwe;jJ. NkYk; mtuJ if kw;Wk; fhy;fspy; mupf;Fk;
Gs;spfs; cs;sd.
ePq;fs; FkhUf;F vij rpghupR nra;tPHfs;?

kUj;JtHfs; mtiu n`r;Itp gupNrhjid nra;J

nfhs;SkhW Nfl;Lf;nfhz;ldH. gupNrhjidapy; mtuJ
n`r;Itp epiy gh]pl;bt; vd;W mwpag;gl;Ls;sJ.

kUj;JtH Fkhiu ,J Fwpj;J mtuJ Gjpa kidtpaplk;

NgRkhWk; kw;Wk; mtUld; clYwT nfhs;Sk; NghJ
MZiw mzpAkhWk; $WfpwhH. mtuJ Kjy; kidtp
,we;jJ vg;gb vd;gJ Fwpj;Jk; kw;Wk; mtuJ Gjpa
kidtpAk; kw;Wk; Foe;ijfSk; MNuhf;fpakhf
,Ug;gpDk; mtHfis kUj;Jt gupNrhjidf;F
cl;gLj;JtJ Fwpj;J Fkhuplk; Nfs;tpfs; Nfl;lhH.
FkhH jw;NghJ ve;j kUj;Jt epiyapy;
cs;shH.________

10
mj;jpahak; 5: n`r;Itp kw;Wk; Md;bnul;Nuhituy; kUe;Jfs;

kdpj clypy; VMHb vt;thW Ntiy nra;fpwJ?

 n`r;Itp itu];
 rpb4 nry;fs;

11
mj;jpahak; 7: kjpg;gply;

khHgpd; xU gf;fj;jpy; fhaj;Jld; R\;kh

MNyhridf;F tUfpwhH. mJ kpfTk;
typAilajhf ,Uf;fpwJ. ,J ,uz;L
ehl;fSf;F Kd; Njhd;wpaJ.

mNj Neuj;jpy;> vjpHfhyj;jpy; gps;is

ngw;Wf;nfhs;s Ntz;L;k; Mdhy;> jw;NghJ
,y;iy vd;W epidj;J> Gjpa Mz; xUtiu
re;jpf;fpwhH.. mtH tha;top fw;gj;jLg;G
Kiwapid gpd;gw;WfpwhH.

cly;ey ikaj;jpYs;s nrtpypauhy; kdp\;

Ma;Tf;Fl;gLj;jg;gLfpwhH.
mtH kWgbAk; mtuJ njhlh;r;rpahd vilFiwjy; kw;Wk;
njhlHr;rpahd [{uk; Fwpj;J njuptpf;fpwhH. NkYk; mtH fle;j
3 thuq;fshf njhlHr;rpahd ,UkiyAk; nfz;Ls;shH. fle;j
thuk; gupNrhjidf;fhf nrtpypaH %d;W Kiw ckpo; ePiu
Nrhjidfis Ma;tfj;jpw;F mDg;gpdhH.

mtUf;F iffs; kw;Wk; fhy;fspy; rpy mupf;Fk; Gs;spfSk;

kw;Wk; thapd; Xuj;jpy; rpW Gz;fSk; cs;sd. mtH
nrtpypauplk; tha;g;G ,Ug;gpd; VMHb ,d;W fl;lhak;
vLj;Jf;nfhs;s Ntz;Lk; vd;W $WfpwhH. ,y;iynadpy; mtH
,we;J tpLthH vd;Wk; $WfpwhH.

FkhH ,d;Dk; mjpf vilapid ,oe;J tpl;lhH. mtuJ

MNuhf;fpa vilahd 75 fpNyh jw;NghJ 66 fpNyhthf
Fiwe;J tpl;lJ. iffs; kw;Wk; fhy;fspYs;s mupf;Fk;
Gs;spfisj; jtpu mtUf;F NtW VJk; FwpaPLfNsh my;yJ
mwpFwpfNsh Vw;gltpy;iy. mtH ,UKtjpy;iy. mtH
njhlHe;J gzpGupfpwhH. mtH mUfpYs;s VMHb ikaj;jpw;Fr;
nrd;W rpb4 gupNrhjid Nkw;nfhz;lhH. mjd; KbT 150
cells/mm³ MFk;.

12
gapw;rp 7-1
ek;Kila %d;W NehahspfSk; rpfpr;irf;fhf ,d;Dk; kUj;Jtkidapy;jhd; cs;sdH.
mtHfsJ fijia kWgbAk; gbj;J gpd;tUk; Nfs;tpfSf;F tpilaspf;fTk;.

R\;khtpw;F:

fle;j tUifapd; NghJ mtH ve;j kUj;Jt epiyapypUe;jhH (mj;jpahak; 2 nry;yTk;)?

_________

,e;j tUifapd; NghJ mtH ve;j kUj;Jt epiyapy; ,Uf;fpwhH? _______

kpfTk; typapid Vw;gLj;Jk; fhaq;fSf;fhd rpy rpfpr;irfs; R\;khtpw;F Njit

gLfpd;wJ.

ePq;fNsh my;yJ kUj;JtNuh mtUf;F vd;d jUtPHfs;?

___________________________

mtuJ Gjpa ,izia nghUj;j tiuapy; vd;d Nfs;tpfs; my;yJ MNyhridfs;

Njitg;gLfpd;wJ?

kdP\pw;F> kUj;JtH bgp ckpo; ePH

gjpNtl;bid Nrhjpf;fpwhH. fle;j thuk;
mDg;gg;gl;l mj;jid ckpo;ePH
gupNrhjidfSk; nefbt; MFk;.
[{uj;jpw;fhd fhuzj;ij fz;lwpa mtH
kNyupah ,uj;jg; gupNrhjidAk;
Nkw;nfhz;lhH. Mdhy; mJTk; nefbt;.

mtH ,jw;F Nky; vd;d nra;a Ntz;Lk;.

vd;d nra;a Ntz;Lk; vd;W FkhH nrtpypauplk; MNyhrid NfhUfpwhH.

ePq;fs; FkhUf;F vg;gb MNyhrid $WtPHfs;?

vd;d nra;a Ntz;Lk; vd;gjw;fhd tpilAila gFjp ve;j mj;jpahaj;jpy; cs;sJ?

13
mj;jpahak; 9: g;Nuh/gpyhf;rp];

epNkhdpahTld; R\;kh fle;j thuk;

kUj;Jtkidapy; mDkjpf;fg;gl;lhH. mtH
jw;NghJ eykhf ,Ue;jhYk; kPz;Lk; [{uk;
tUk; vd ftiyf;nfhz;Ls;shH. nrtpypaH
R\;kh cld; fhd;l;upkhf;]hN[hy;
g;Nuh/gpyhf;rp]; Fwpj;J NgRfpwhH. nrtpypaH
R\;khtplk; ry;/ghNlhf;]pd; - gpupnkjhkpd;
(/gd;rplhH) my;yJ fhd;l;upkhf;]hN[hy;
xt;thik Fwpj;J Nfl;fpwhH. Mdhy;
R\;khtpw;F ,uz;bYk; vg;nghOJk; myH[p
vw;gltpy;iy vd;W njupa tUfpwJ.

xt;nthU ehSk; ,uz;L khj;jpiufs;

vLj;Jf;nfhs;s Ntz;Lk; vd;W nrtpypaH
R\;khtplk; $WfpwhH. NkYk; mtH mJ
njhlh;r;rpahd EiuaPuy; njhw;Wfs;>
Fwpg;gpl;l rpy tif njhlh;r;rpahd
tapw;Wg;Nghf;Ffs; kw;Wk; clypd; xU
gf;fj;jpy; rf;jpapd;wp ,Ug;gJ my;yJ
gf;fthjj;ij Vw;gLj;Jk; xU Fwpg;gpl;l
%is ghjpg;G Mfpaitfs; Vw;gLtjw;fhd
tha;g;Gfis mJ Fiwf;Fk; vd;W $WfpwhH.

fhd;l;upkhf;]hN[hy; g;Nuh/gpyhf;rp]; ,y;yhj kUj;Jtkid xd;wpw;F kdp\; nry;fpwhH –

Njitahd nghUl;fis mtHfs; nfhz;bUf;ftpy;iy.

FkhH 3 – Mk; epiyapy; ,Ug;gNjhL> [{uk; Vw;gLtJ Fwpj;J mjpf ftiy

nfhz;Ls;shH.

g;Nuh/gpyhf;rp]; FkhUf;Fj; Njitah?

FkhH kUj;Jtuplk; gy Nfs;tpfisf; Nfl;fpwhH. “g;Nuh/gpyhf;rp];]pw;fhd

fhl;upkhf;]hN[hypd; Nlh]; vd;d?” kw;Wk; “fhl;upkhf;]hN[hy; g;Nuh/gpyhf;rp]; vd;d
nra;Ak;?”

ePq;fs; vd;d gjpyspf;f Ntz;Lk;?

14
gapw;rp: fhd;l;upkhf;]hN[hy; bupy;

1. OIs vd;why; vd;d?

2. g;Nuh/gpyhf;rp]; vd;why; vd;d?

3. CTX g;Nuh/gpyhf;rp]; - d; gyd;fs; vd;d?

4. CTX g;Nuh/gpyhf;rp]; ahH vLj;Jf;nfhs;sNtz;Lk;?

5. CTX g;Nuh/gpyhf;rp]; vt;thW vLj;Jf;nfhs;sg;glNtz;Lk;?

6. CTX g;Nuh/gpyhf;rp]; vt;tsT fhyk; vLj;Jf;nfhs;sg;glNtz;Lk;?

7. CTX - d; gf;f tpisTfs; vd;d?

15
mj;jpahak; 10: gof;fg;gLjy; jahH nra;jy;

mbf;fb nts;is Gs;spfs; R\;khtpd; thapy;

Vw;gl Muk;gpf;fpwJ.

R\;khtpd; thapy; Vw;gLk; ,e;j nts;is

Gs;spfSf;F ePq;fNsh my;yJ kUj;JtNuh
vj;jifa rpfpr;iria toq;FtPHfs;. rpfpr;ir
Fwpj;J vq;F mwptPHfs;? R\;kh jw;NghJ ve;j
epiyapYs;shH?

xt;nthU KiwAk; kUj;JtH nts;is Gs;spfSf;F

ep];lhbd; nfhz;L rpfpr;iraspj;jhH. Mdhy;
R\;khtpw;F mJ kPz;Lk; kPz;Lk; vw;gLfpwJ.

nrtpypaH VMHb Fwpj;J R\;khTld;

fye;jhNyhrpf;f Muk;gpf;fpwhH.

VMHb Fwpj;J Kjy; jahH nra;jypy; ePq;fs; vij

Fwpj;J fye;jhNyhrpg;gPH?

xU khjk; fopj;J> kdp\; kUj;JtkidapypUe;J

tPL jpUk;gfpwhH. mtH ,d;Dk; NrhHthf kw;Wk;
xy;ypahfNt ,Ue;jhYk; Kd;ig tpl rpwg;ghfTk;
kw;Wk; vil $bAk; cs;shH. mtuJ kPs;ghHit
fbjk; mtUf;F guTk; jd;ikAila bgp ,Ug;gjhf
njuptpf;fg;gl;Ls;sJ. bgp rpfpr;ir kw;Wk;
fhd;l;upkhf;]hN[hy; g;Nuh/gpyhd;rp];> cly;
mupg;gpw;fhf> f;NshHngdpuhikd;Dk;
vLj;Jf;nfhs;fpwH.

nrtpypaH VMHb Fwpj;J kdP\{ld;

fye;jhNyhrpf;f Muk;gpf;fpwhH.

VMHb Fwpj;J Kjy; jahH nra;jypy; ePq;fs; vij

Fwpj;J fye;jhNyhrpg;gPH?

16
(VMHb jahH nra;jy; gapw;rpf;fhf nrtpypaH
Fkhiu mioj;Js;shH (mtuJ rpb4 vz;zpf;if
150> mtH kUj;Jt epiy 3 – y; ,Uf;fpwhH))

VMHb Fwpj;J FkhH Vw;fdNt mwpe;Js;sij mtH

kjpg;gpLfpwhH. FkhUila rpy ez;gHfs; VMHbapy;
,Ug;gjhy; mtUf;F VmHb Fwpj;J nfhQ;rk;
njupAk;.

,Ug;gpDk;> mtuJ ez;gHfs; topahf mtH ngw;w

rpy jfty;fs; rup ,y;yhjjhFk;. nrtpypaH
mj;jifa jtwhd vz;zq;fs; Fwpj;J
tpsf;fkspg;gNjhL> $Ljyhf rpy jfty;fisAk;
FkhUf;F mtH toq;FfpwhH.

FkhH rpfpr;ir ngw tpUk;GtijAk; kw;Wk; mjw;fhf

mtH tho;tpy; gof;fg;gLj;Jtjw;fhd jahH nra;Ak;
eltbf;iffspy; <LgLtijAk; cWjp nra;J
nfhs;fpwhH. xNu Neuj;jpy; mtH midj;J
jfty;fisAk; toq;fptpltpy;iy. Mdhy;>
kw;WnkhU tUiff;fhf Njjpfis mtH
jpl;lkpl;Lf;nfhz;lhH.

17
gapw;rp: nghJthd Nfs;tpfs;
Nehahsp gpd;tUk; Nfs;tpfis Nfl;lhy; cq;fsJ gjpy; vd;d?

"xU ehisf;F ,uz;L khj;jpiufis Fwpg;gpl;l Neuj;jpy; tho;ehs; KOtJk; vLj;Jf;nfhs;s

Ntz;Lk; vd;gij vt;thW ehd; epidtpy; epWj;jpf;nfhs;s KbAk;? "
_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________
“tpahjp rupahfhj gl;rj;jpy; ,g;gbg;gl;l rpf;fy; tha;e;j rpfpr;iria ehd; Vd;
vLj;Jf;nfhs;s Ntz;Lk;?”

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________
"rpy ehl;fs; ehd; kUe;Jfs; vLj;Jf;nfhs;shky; ntspNa nrd;W tpl;lhy; vd;d MFk;?”

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________
“vd;Dila kidtp n`r;Itp gh]pl;bt;. mtHfs; VMHbapy; ,y;iy. ehd; vg;gb mij
vLj;Jf;nfhs;s KbAk;?”
_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________
“ePq;fs; $Wk; gf;f tpisTfs; vd;id ftiyg;gl itf;fpd;wd. vd;id Nkhrkhf czu
itf;Fk; mj;jifa kUe;Jfis ehd; vg;gb vLj;Jf;nfhs;tJ?”
_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

18
“ehd; VMHb vLj;Jf;nfhs;tij gpwH ghHj;Jtpl;lhy; ehd; vd;d nra;a Ntz;Lk;?”

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________
“ehd; kUj;Jtkidf;F te;J kUe;Jfs; thq;Ftij gpwH ghHj;Jtpl;lhy; ehd; vd;d nra;a
Ntz;Lk;?”

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________
“,q;fpyhe;J ehl;by; VMHb ,t;tsT rpf;fy; tha;e;jjhf ,y;iy vd;W ehd;
Nfs;tpg;gl;bUf;fpNwd;. mtHfs; thuj;jpw;F xU khj;jpiu jUfpwhHfs;. ePq;fs; Vd; xU
ehisf;F ,uz;L khj;jpiufs; jUfpwPHfs;?"

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________
“ehd; n`r;Itp gh]pl;bt; vd;W xUtuplkhtJ nrhy;y Ntz;Lk; vd;W $WfpwPHfs;. gpwuplk;
$WtJ Fwpj;j vz;zj;ij ehd; khw;wptpl;Nld;. vdf;F Mjutspf;f ahUk; Ntz;lhk;
vd;id ehNd ghHj;Jf;nfhs;Ntd;.”

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________
“vd;Dila rpfpr;ir Mjuthsuhd kidtpf;F %d;W Foe;ijfs; ,Ug;gjhYk; mjpYk; xd;W
cly; eyk; ,d;wp ,Ug;gjhYk; cq;fis te;J ghHf;f mtUf;F Neukpy;iy”
_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

19
mj;jpahak; 11: ehd;F Kjy; epiy VMHtp jpl;l Kiwfs;

n`r;Itp / va;l;];> VMHb kw;Wk; njhle;J rpfpr;ir ngWjy; Fwpj;J

Ngrg;gl;l gy re;jpg;GfSf;F R\;kh tUif Gupe;Js;shH. mtH
vg;nghOJk; re;jpg;gpw;F Neuk; jtwhJ tUif GuptNjhL> mtuJ
fhz;l;upkhf;]hN[hiyAk; rupahf vLj;Jf;nfhs;fpwhH. mtUf;F xU
rpfpr;ir MjuthsUk; (xU mz;il tPl;lhH) cs;shH. VMHb
vLj;Jf;nfhs;s mtH jahH vd;W nrtpypaH / MNyhrfHfs; kw;Wk;
R\;kh MfpNahH vz;Zfpd;wdH.

nrtpypaH / MNyhrfHfs; kdP\{ld; gy jahupg;G re;jpg;Gfis

Nkw;nfhz;ldH. epiyahfTk; kw;Wk; jahuhFk; tiu VMHbAld;
kdPi\ fhj;jpUf;f itg;gJ vd;gJ kpfTk; fbdkhd xd;whf
,Ue;jhYk; nrtpypaH / MNyhrfHfs; mij rkhspj;Jtpl;ldH.

mtuJ cly; vil mjpfupj;Js;sJ. [{uk; kw;Wk; ,Uky; Kw;wpYk;

ePq;fptpl;lJ. bgp – d; Kjy; ,uz;L khj rpfpr;iria mtH Kbj;J
tpl;lhH. iffspy; ,Uf;Fk; mupg;G Vw;gLj;Jk; jOk;Gfs; kw;Wk;
jhilapy; Vw;gl;Ls;s gs;sk; Mfpaitfs; ,d;Dk; kiwatpy;iy.

kdPi\ kjpg;gpl;l VMHb kUj;Jt mYtyH bgp rpfpr;ir kw;Wk;

VMHbf; rpfpr;irfSld; Jiz rpfpr;iriaAk; Muk;gpf;f
Ntz;Lnkd;W KbT nra;Js;shH. me;j kUj;Jt mYtyH AZT-3TC-
EFV – I gupe;Jiu nra;Js;shH.

Fkhupd; Fiwe;j msT VmHb – d; fhuzkhf> FkhH VMHb

vLj;Jf;nfhs;tjw;fhd jFjp ngw;Ws;shH vd;W KbT
nra;ag;gl;Ls;sJ. FkhH 7 Njitg;ghLfis g+Hj;jp nra;fpwhH.

kUj;Jt mYtyH d4T-3TC-NVP– I gupe;Jiu nra;Js;shH. NkYk;

mtH %d;W kUe;Jfis cila Kjy; khj;jpiuia fhiyapYk;
kw;Wk; khiyapy; xU jdp khj;jpiuiaAk; Kjy; ,uz;L
thuq;fSf;F kl;Lk; Nghlr; nrhd;dhH.

jfty;fs; FkhUf;Fg; Gupe;jij cWjp nra;J nfhs;s mtH Fkhiu

$wpaij jpUk;gf; $WkhW Nfl;lhH.
jw;NghJ VmHbapy; ,Ug;gjhy;> fhl;upkhf;]hN[hy; g;Nuh/gpyhf;]p];
vLj;Jf; nfhs;s Ntz;Lkh vd;W FkhH Nfl;lhH.

ePq;fs; Fkhuplk; vd;d $WtPHfs;?

200 nry;fs; / mm³ - f;Fk; mjpfkhf rpb4 vz;zpf;if mjpfupf;Fk;

tiu Fiwe;j gl;rk; MW khjq;fSf;F fhl;upkhf;]hN[hiy njhlu
Ntz;Lnkd;W kUj;JtH mwpTWj;jpdhH.

20
21
 VMHb n`r;Itpia Fzg;gLj;jhJ : VMHbapypUe;jhYk; ghJfhg;ghd
clYwT kpfTk; Kf;fpakhFk;
n`r;Itpia ngWjy; kw;Wk; gug;Gjiy jLf;Fk; xNu ghJfhg;ghd top clYwtpy;
<Lglhky; ,Ug;gJjhd;.

ePq;fs; Foe;ij ngw;Wf;nfhs;s tpUk;gpdhy;> n`r;Itpia Foe;ijf;F guTk; tha;g;ig

Fiwf;f> fHg;gkhtjw;F Kd; Rfhjhug; gzpahsUld; NgrTk;
cq;fisAk; kw;wtiuAk; ghJfhg;gij
njhlUq;fs;. ePq;fs; clYwT nfhs;Sk;
xt;nthU KiwAk; jtwhky; MZiwia
mzpaTk;. cq;fsJ ,izahsp Fwpj;J
vg;nghOJk; tpopg;ghf ,Uq;fs;.

ghJfhg;ghd clYwT cq;fis

kw;WnkhU n`r;Itp njhw;wpypUe;J fhf;fpwJ.
kw;nwhU tifapyhd n`r;Itpapdhy; ePq;fs;
kWgbAk; ghjpf;fg;gl;lhy; cq;fSila
vjpHg;G rf;jp kpfTk; FiwAk;.
FLk;gf; fl;Lg;ghL
cq;fSf;F Foe;ij ngw;Wf;nfhs;s
tpUg;gkpy;iy vd;why; FLk;gf;fl;Lg;ghL
Fwpj;J Rfhjhug; gzpahsuplk; NgrTk;

gpd;tUk; VjhtnjhU epiyapy; gpwf;Fk; Foe;ijf;F n`r;Itp Neha; guTk;

fHg;gk; gpurtk; ghy;Gfl;Ljy;

kw;witfis fhl;bYk; rpy VMHb kUe;Jfs; fHg;gj;jpd; NghJ cgNahfg;gLj;jg;gl

ghJfhg;ghdjhFk;
gpvk;brpb – I cgNahfg;gLj;jTk;
rpy VMHb kUe;Jfs; fHg;gj;jpd; NghJ cgNahfg;gLj;jg;gl ghJfhg;ghdjhFk;.
cq;fSila Rfhjhug; gzpahsuplk; ve;j tifahd VMHb kUe;Jfs; cgNahfg;gLj;jg;gl
Ntz;Lk; vd;W Nfl;fTk;. ePq;fs; fHg;gkhf ,Ue;jhNyh my;yJ gps;is ngw;Wf;nfhs;s
tpUk;gpdhNyh ,g;nghONj mtuplk; mJ Fwpj;J NgrTk;

22
23
 VMHb n`r;Itpia Fzg;gLj;jhJ : VMHbapypUe;jhYk; ghJfhg;ghd
clYwT kpfTk; Kf;fpakhFk;
n`r;Itpia ngWjy; kw;Wk; gug;Gjiy jLf;Fk; xNu ghJfhg;ghd top clYwtpy;
<Lglhky; ,Ug;gJjhd;.
ePq;fs; Foe;ij ngw;Wf;nfhs;s tpUk;gpdhy;> n`r;Itpia Foe;ijf;F guTk; tha;g;ig
Fiwf;f> fHg;gkhtjw;F Kd; Rfhjhug; gzpahsUld; NgrTk;
cq;fisAk; kw;wtiuAk; ghJf;fhg;gij
njhlUq;fs;. ePq;fs; clYwT nfhs;Sk;
xt;nthU KiwAk; jtwhky; MZiwia
mzpaTk;. cq;fsJ ,izahsp Fwpj;J
vg;nghOJk; tpopg;ghf ,Uq;fs;.

ghJfhg;ghd clYwT cq;fis

kw;WnkhU n`r;Itp njhw;wpypUe;J fhf;fpwJ.
kw;nwhU tifapyhd n`r;Itpapdhy; ePq;fs;
kWgbAk; ghjpf;fg;gl;lhy; cq;fSila
vjpHg;G rf;jp kpfTk; FiwAk;.
FLk;gf; fl;Lg;ghL
cq;fSf;F Foe;ij ngw;Wf;nfhs;s
tpUg;gkpy;iy vd;why; FLk;gf;fl;Lg;ghL
Fwpj;J Rfhjhug; gzpahsuplk; NgrTk;

gpd;tUk; VjhtnjhU epiyapy; gpwf;Fk; Foe;ijf;F n`r;Itp Neha; guTk;

fHg;gk; gpurtk; ghy;Gfl;Ljy;

kw;witfis fhl;bYk; rpy VMHb kUe;Jfs; fHg;gj;jpd; NghJ cgNahfg;gLj;jg;gl

ghJfhg;ghdjhFk;
gpvk;brpb – I cgNahfg;gLj;jTk;
rpy VMHb kUe;Jfs; fHg;gj;jpd; NghJ cgNahfg;gLj;jg;gl ghJfhg;ghdjhFk;.
cq;fSila Rfhjhug; gzpahsuplk; ve;j tifahd VMHb kUe;Jfs; cgNahfg;gLj;jg;gl
Ntz;Lk; vd;W Nfl;fTk;. ePq;fs; fHg;gkhf ,Ue;jhNyh my;yJ gps;is ngw;Wf;nfhs;s
tpUk;gpdhNyh ,g;nghONj mtuplk; mJ Fwpj;J NgrTk;

24
25
 VMHb n`r;Itpia Fzg;gLj;jhJ : VMHbapypUe;jhYk; ghJfhg;ghd
clYwT kpfTk; Kf;fpakhFk;
n`r;Itpia ngWjy; kw;Wk; gug;Gjiy jLf;Fk; xNu ghJfhg;ghd top clYwtpy;
<Lglhky; ,Ug;gJjhd;.
ePq;fs; Foe;ij ngw;Wf;nfhs;s tpUk;gpdhy;> n`r;Itpia Foe;ijf;F guTk; tha;g;ig
Fiwf;f> fHg;gkhtjw;F Kd; Rfhjhug; gzpahsUld; NgrTk;
cq;fis kw;wtiuAk; ghJf;fhg;gij
njhlUq;fs;. ePq;fs; clYwT
nfhs;Sk; xt;nthU KiwAk; jtwhky;
MZiwia mzpaTk;. cq;fsJ
,izahsp Fwpj;J vg;nghOJk;
tpopg;ghf ,Uq;fs;.

ghJfhg;ghd clYwT cq;fis

kw;WnkhU n`r;Itp njhw;wpypUe;J fhf;fpwJ.
kw;nwhU tifapyhd n`r;Itpapdhy; ePq;fs;
kWgbAk; ghjpf;fg;gl;lhy; cq;fSila
vjpHg;G rf;jp kpfTk; FiwAk;.
FLk;gf; fl;Lg;ghL
cq;fSf;F Foe;ij ngw;Wf;nfhs;s
tpUg;gkpy;iy vd;why; FLk;gf;fl;Lg;ghL
Fwpj;J Rfhjhug; gzpahsuplk; NgrTk;

gpd;tUk; VjhtnjhU epiyapy; gpwf;Fk; Foe;ijf;F n`r;Itp Neha; guTk;

fHg;gk; gpurtk; ghy;Gfl;Ljy;

kw;witfis fhl;bYk; rpy VMHb kUe;Jfs; fHg;gj;jpd; NghJ cgNahfg;gLj;jg;gl

ghJfhg;ghdjhFk;
gpvk;brpb – I cgNahfg;gLj;jTk;
rpy VMHb kUe;Jfs; fHg;gj;jpd; NghJ cgNahfg;gLj;jg;gl ghJfhg;ghdjhFk;.
cq;fSila Rfhjhug; gzpahsuplk; ve;j tifahd VMHb kUe;Jfs;
cgNahfg;gLj;jg;gl Ntz;Lk; vd;W Nfl;fTk;. ePq;fs; fHg;gkhf ,Ue;jhNyh my;yJ
gps;is ngw;Wf;nfhs;s tpUk;gpdhNyh ,g;nghONj mtuplk; mJ Fwpj;J NgrTk;

26
27
 VMHb n`r;Itpia Fzg;gLj;jhJ : VMHbapypUe;jhYk; ghJfhg;ghd
clYwT kpfTk; Kf;fpakhFk;
n`r;Itpia ngWjy; kw;Wk; gug;Gjiy jLf;Fk; xNu ghJfhg;ghd top clYwtpy;
<Lglhky; ,Ug;gJjhd;.
ePq;fs; Foe;ij ngw;Wf;nfhs;s tpUk;gpdhy;> n`r;Itpia Foe;ijf;F guTk; tha;g;ig
Fiwf;f> fHg;gkhtjw;F Kd; Rfhjhug; gzpahsUld; NgrTk;
cq;fis kw;wtiuAk; ghJf;fhg;gij
njhlUq;fs;. ePq;fs; clYwT
nfhs;Sk; xt;nthU KiwAk; jtwhky;
MZiwia mzpaTk;. cq;fsJ
,izahsp Fwpj;J vg;nghOJk;
tpopg;ghf ,Uq;fs;.

ghJfhg;ghd clYwT cq;fis

kw;WnkhU n`r;Itp njhw;wpypUe;J fhf;fpwJ.
kw;nwhU tifapyhd n`r;Itpapdhy; ePq;fs;
kWgbAk; ghjpf;fg;gl;lhy; cq;fSila
vjpHg;G rf;jp kpfTk; FiwAk;.
FLk;gf; fl;Lg;ghL
cq;fSf;F Foe;ij ngw;Wf;nfhs;s
tpUg;gkpy;iy vd;why; FLk;gf;fl;Lg;ghL
Fwpj;J Rfhjhug; gzpahsuplk; NgrTk;

gpd;tUk; VjhtnjhU epiyapy; gpwf;Fk; Foe;ijf;F n`r;Itp Neha; guTk;

fHg;gk; gpurtk; ghy;Gfl;Ljy;

kw;witfis fhl;bYk; rpy VMHb kUe;Jfs; fHg;gj;jpd; NghJ cgNahfg;gLj;jg;gl

ghJfhg;ghdjhFk;
gpvk;brpb – I cgNahfg;gLj;jTk;
rpy VMHb kUe;Jfs; fHg;gj;jpd; NghJ cgNahfg;gLj;jg;gl ghJfhg;ghdjhFk;.
cq;fSila Rfhjhug; gzpahsuplk; ve;j tifahd VMHb kUe;Jfs;
cgNahfg;gLj;jg;gl Ntz;Lk; vd;W Nfl;fTk;. ePq;fs; fHg;gkhf ,Ue;jhNyh my;yJ
gps;is ngw;Wf;nfhs;s tpUk;gpdhNyh ,g;nghONj mtuplk; mJ Fwpj;J NgrTk;

28
mj;jpahak; 12: ehd;F Kjy; epiy VMHtp kUe;Jfspd; gf;ftpisTfs; kw;Wk; jpl;lj;jpy;
,Uf;Fk; NehahspfSf;F Vw;gLk;; gpw Gjpa mwpFwpfSf;F rpfpr;iraspj;jy;

gf;f tpisTfs; - xU mwpKfk;

ngUk;ghyhd kUe;Jfis cgNahfpg;gjhy; VNjDk; xU tpjj;jpy; gf;f tpisTfs; Vw;gLk;.

,Ug;gpDk; ngUk;ghyhd Nf];fspy; ,J kpfTk; fLik FiwthfNt cs;sJ. kUe;Jfis
vLj;Jf;nfhs;Sk; vy;yh egHfSf;Fk;> xNu khjphpahd gf;f tpisTfs;> xNu mstpw;F
Vw;gLtjpy;iy. VMHtp kUe;Jfis vLj;Jf;nfhs;Sk; Nehahspfspy;> Ie;J rjtPjj;jpw;Fk;
Fiwthd egHfSf;Nf njhlh;r;rpahdkhd kUj;Jt gf;f tpisTfs; Vw;gLfpd;wd.
ngUk;ghyhdtHfSf;F> Fwpg;ghf rpfpr;irapd; Jtf;ffhyj;jpy;> fLikaw;w> mjpf
njhy;iyfs; juhj gf;f tpisTfNs Vw;gLk;.

cq;fSila Nehahsp Kjd;Kjyhf VMHb rpfpr;iriaj; Jtf;Fk;NghJ> gf;f tpisTfs;

Vw;gLk; Mgj;J Fwpj;Nj mjpfk; ftiyf;nfhz;bUg;gH. vdNt> kpfTk; Nkhrkhd gf;f
tpisTfs; Fwpj;J Nehahspfsplk; vr;rhpf;if nra;tJk;> mtw;iw vjpHnfhs;sNtz;ba
Kiwfs; Fwpj;J mtHfSf;F njhptpg;gJk; kpfTk; mtrpakhFk;. ,t;thW Nehahspfs;
vjpHnfhs;sf;$ba tp\aq;fs; Fwpj;J Kd;Ng njhptpg;gJ> mtHfSf;F kpfTk; cjtpfukhf
,Uf;Fk;. NkYk; gpw gf;f tpisTfs; kw;Wk; mtHfSf;F> ftiyfs; Fwpj;Jk; MNyhrid
mspf;fNtz;baJk; kpfTk; mtrpakhFk;.

mjpfsT gf;f tpisTfs; Vw;gLk; Nehahspfs;> jhq;fs; kUe;J vLj;Jf;nfhs;tij

epWj;jptpLfpd;wdH. Vnddpy; gf;f tpisTfshy; mtHfs; Cf;fk; ,of;fpd;wdH.
Nehahspfs; rhpahf kUe;Jfis vLj;Jf;nfhs;shtpl;lhy;> rpfpr;ir Njhy;tpailAk;.

vdNt> kf;fs; gf;f tpisTfs; Fwpj;J $wpdhy;> mij njhlh;r;rpahdkhf vLj;Jf;nfhz;L>

Njitahd MNyhridfis $wTk;. ,y;iynad;why; mtHfs; kUe;Jfs; vLj;Jf;nfhs;tij
kwf;fj; Jtq;fptpLthHfs;.

gf;f tpisTfspd; %d;W tiffs;:

Kjy; tif : NehahspfSf;F njhe;jutspf;Fk;> mNj rkaj;jpy; Mgj;jpy;yhj gf;f

tpisTfs;

(a) rpy gf;f tpisTfs; kpfTk; nghJthditahFk;. ,Ug;gpDk; ,jdhy; Nehahspapd;

cly;eyDf;F Mgj;J VJk; fpilahJ. mitfs; kpfTk; nghJthditfshf ,Ug;gjhy;>
,e;j gf;f tpisTfs; Fwpj;J NehahspfSf;F njhptpg;gJk;> mitfs; Vw;gl;lhy; vd;d
nra;aNtz;Lk; vd;gJ Fwpj;J vspjhd mwpTiufs; toq;FtJk; mtrpakhFk;.

 ,t;tifapy; Fkl;ly;> jiytyp> fpWfpWg;G> Ngjp> fisg;ghf czHjy; kw;Wk; jir

typ Nghd;wit mlq;Fk;.
 nghJthf ,e;j gf;f tpisTfs; rpfpr;ir Jtq;Fk;NghJ Vw;gLfpwJ. ,uz;L Kjy;
ehd;F thuq;fspy; ,itfs; mjpfhpf;fpd;wd.
 Nehahsp gf;f tpisTfs; Fwpj;Njh> mtw;iw vt;thW vjpHnfhs;s Ntz;Lk; vd;gJ
Fwpj;Njh mwpe;Jnfhs;shtpl;lhy;> rhpahd Kiwapy; kUe;Jfis
vLj;Jf;nfhs;skhl;lhHfs;. vdNt n`r;Itp ghjpg;G ePbj;J> rpfpr;ir ntw;wpfukhf
mikahJ.
 ,/ghitud;]; kUe;Jfs; %ykhf rpy Fwpg;gpl;l gf;f tpisTfs; mbf;fb Vw;gLk;.
,e;j gf;f tpisTfs; rpy thuq;fSf;Fg; gpwF mfd;W tpLk; vd;W Nehahspf;F
cWjpahf njhptpf;fNtz;Lk;. cjhuzk; : ,/ghitud;]; kUe;jhy; tpj;jpahrkhd
fdTfSk;> nfhLq;fdTfSk; Njhd;WtJld;> kdepiy khw;wq;fs;> fpWfpWg;G> mbf;fb
ftdk; ,oj;jy; Nghd;w gf;ftpisTfs; rpfpr;ir Jtq;fp Kjy; ,uz;L thu fhyj;jpw;F
fhzg;gLk;.

29
Mgj;jpy;yhj gf;f tpisTfspd; vz;zpf;if kpfTk; mjpfkhFk;. ,it midj;ijAk;
Fwpj;J Nehahspaplk; $wpdhy;> mtHfs; Cf;fkpog;gJld;> Fog;gKk; miltH. xt;nthU
kUe;jpdhYk; (kw;Wk; xt;nthU kUe;J vLj;Jf;nfhs;Sk; Kiwf;Fk;) Vw;gLk; kpfTk;
nghJthd gf;f tpisTfs; Fwpj;J ehk; mwpe;Jnfhs;tJld;> mtw;iw vjpHnfhs;tjw;fhf
Nehahspia jahH nra;tJk; kpfTk; mtrpakhFk;. NkYk; Nehahspfs; jq;fSf;F Vw;gLk;
gf;f tpisTfs; Fwpj;J $Wk;NghJ mspf;fNtz;ba kUj;Jt MNyhridfs; Fwpj;J
mwpe;nfhs;sNtz;baJk; mtrpakhFk;. Vnddpy; ,e;j mwpFwpfs; njhlHe;J fhzg;glyhk;
my;yJ njhlh;r;rpahdkhfyhk;.

rpy rkaq;fspy; ,e;j nghJthd gf;f tpisTfs; ePz;l fhyj;jpw;F njhlHe;J

fhzg;gl;lhNyh my;yJ njhlh;r;rpahd vjpHtpisTfs; Vw;gl;lhNyh mitfs; kpfTk;
njhlh;r;rpahdkilayhk; vdNt Nehahspaplk; ,e;j gf;f tpisTfis tPl;bNyNa
rhpnra;Jnfhs;tJ Fwpj;J Njitahd mwpTiufs; toq;FtJk;> mwpFwpfs; njhlHe;J
fhzg;gl;lhNyh> njhlh;r;rpahdkile;jhNyh mjw;fhd rpfpr;ir vLj;Jf;nfhs;tJ Fwpj;Jk;
Nehahspf;F njhptpf;f Ntz;baJ mtrpakhFk;.

(b) nghJthf mjpfk; Vw;glhj kw;Wk; njhlh;r;rpahdkw;w gf;f tpisTfs;

,e;j gf;f tpisTfs; Fwpj;J Nehahspfsplk; vr;rhpf;if nra;aNtz;ba mtrpakpy;iy.

,Ug;gpDk;> mtw;iw vt;thW vjpHnfhs;sNtz;Lk; vd;gJ Fwpj;J ePq;fs; njhpe;J
itj;jpUf;fNtz;Lk;. ,e;j gf;f tpisTfspy; AZT kUe;jhy; efq;fs; ePy epwkhjy; kw;Wk;
rpy kUe;Jfshy; Vw;gLk; nghJthd gf;f tpisTfSk; kw;Wk; gpw kUe;Jfshy; mjpfk;
Vw;glhj> Mdhy; rpy rkaq;fspy; Vw;glf;$ba gf;f tpisTfSk; mlq;Fk;.

,uz;lhtJ tif : njhlh;r;rpahdkhd ghjpg;Gfis Vw;gLj;jf;$ba gf;f tpisTfs;

,jw;F mtru MNyhrid Njitg;gLfpwJ. ,e;j njhlh;r;rpahdkhd gf;f tpisTfs;

Fwpj;J Nehahspfsplk; Kd;Ng vr;rhpf;if nra;aNtz;baJ mtrpakhFk;. ,tw;w py; rpy
tpisTfs; Vw;gl;l Nehahspfs; Njitahd rpfpr;iria vLj;Jf;nfhs;sNtz;Lk;. ,e;j gf;f
tpisTfs;> Nehahspapd; jfty; ml;ilapy; xU l;uk; %ykhf Fwpg;gplg;gl;bUf;Fk;.

cjhuzq;fs;:

 ntspwpa Kfk; (AZT My; Vw;gLk; uj;jNrhif)

 fy;yPuy; ghjpf;fg;gLtjhy; fz;fs; kQ;rs; epwkhjy; (NVP my;yJ EFV kUe;jhy;
n`ghll;b]; Vw;glyhk;)
 fLikahd tapw;W typ
 jbg;Gfs; NVP my;yJ EFV - My; Vw;gLk;> Gjpa jbg;Gfs; Fiwthf ,Ue;jhYk;>
mitfs; Mgj;ij Vw;gLj;jyhk;. vdNt> ,ad;w msT tpiutpy; Nehahspia>
kUj;Jthplk; fhz;gpf;fNtz;baJ mtrpakhFk;.
 d4T (nghpnguy; epa+Nuhgjp) kUe;jhy; iffspNyh> ghjq;fspNyh vhpr;ry;> kuj;Jg;Nghjy;>
FWFWg;ghd czHT Nghd;wit Vw;glyhk;. ,itfs; Vw;gLk;NghJ cldbahf
kUj;Jthplk; nry;yNtz;ba mtrpakpy;iy. ,Ug;gpDk; mLj;j Kiw nry;Yk;NghJ
,itfs; Fwpj;J $w Ntz;Lk;.

%d;whk; tif : rpfpr;irapd; gpw;gFjpapy; Njhd;Wk; gf;f tpisTfs;

,t;tif gf;f tpisTfs; Nehahspfs; VMHtp kUe;Jfis gy khjq;fs; my;yJ gy
Mz;Lfs; vLj;Jf;nfhz;l gpwF Vw;gLk;.

,jpy; kpfTk; nghJthff; fhzg;gLk; gf;f tpisT> cly; nfhOg;ghdJ xOq;fw;w Kiwapy;
cly; KOtJk; gutpf;fhzg;gLk;. tapW> khHgfq;fs;> Njhs;fs;> fOj;J (rpy rkq;fspy;
NjhYf;F fPo; nfhOg;Gf; fl;bfs; cUthfyhk;) Nghd;w ghfq;fspy; nfhOg;G mjpfkhfyhk;.
if> fhy;fs;> Gl;lq;fs; kw;Wk; Kfk; Nghd;wtw;wpy; nfhOg;G ,og;G Vw;glyhk;
(ypNghb];l;Nuhgp).

30
gf;f tpisTfis vjpHnfhs;tjw;fhd rpwe;j topKiwfs;:
 Nehahsp kUe;Jfis vLj;Jf;nfhs;sj; Jtq;Ftjw;F Kd;Ng nghJthf Vw;glf;$ba gf;f tpisTfs;
Fwpj;J $wptplNtz;Lk;
 rpwpa gf;f tpisTfis vt;thW vjpHnfhs;tJ vd;gJ Fwpj;j mwpTiufs; $wNtz;Lk;. nu[pnkDf;fhf
Nehahsp jfty; ml;iliag; gad;gLj;jTk;
 njhlh;r;rpahdkhd ghjpg;Gfis Vw;gLj;Jk; gf;f tpisTfs; Fwpj;J Nehahspfis vr;rhpj;J> mitfs;
Vw;gl;lhy; cldbahf> mjw;Fhpa rpfpr;iria ngw;Wf;nfhs;SkhW mwpTWj;jTk;
 gf;f tpisTfis cldbahf ftdpj;J> NeubahfNth my;yJ njhiyNgrp %ykhfNth f;spdpf;if
njhlHGnfhs;sTk;.
 Nehahsp gf;f tpisTfs; Fwpj;J ,ay;ghf VJk; $whtpl;lhYk;> mitfs; Fwpj;J fye;JiuahlTk;.
 Nehahspfis gPH – v[{Nfl;lHfsplk; mDg;gTk;
 gf;f tpisTfs; fhuzkhf> kUj;Jthplk; fye;jhNyhrpf;fhky; ARV kUe;Jfis vLj;Jf;nfhs;tij
epWj;jNtz;lhk;.

kpfTk; nghJthd gf;f kpfTk; njhlh;r;rpahdkhd rpfpr;irapd;

tpisTfs; : ,it Fwpj;J ghjpg;ig Vw;gLj;jf;$ba gf;f gpw;gFjpapy; Vw;gLk;
Nehahspfsplk; vr;rhpj;J> tpisTfs;: Nehahspfis gf;f tpisTfs;:
vjpHnfhs;s Ntz;ba vr;rhpf;if nra;J cldbahf Nehahspaplk;
Kiwfs; Fwpj;Jk; $wTk;. rpfpr;ir ngWkhW fye;jhNyhrpf;fTk;
NkYk; Nehahspfs; mwpTWj;jTk;
rpfpr;irf;F tUk;NghJ
mtw;iw vjpHnfhs;s jahuhf
,Uf;fTk;.
AZT Fkl;ly; cldbahf rpfpr;ir
[pNlht;bd; Ngjp vLj;Jf;nfhs;sNtz;bait:
(ZDV vd;Wk; jiytyp uj;jNrhif = Kfk; ntspWjy;>
miof;fg;gLk;) fisg;G %r;Rj;jpzwy;> jirtyp

d4T Fkl;ly; cldbahf rpfpr;ir nfhOg;G guty;

];lht;bd; Ngjp vLj;Jf;nfhs;sNtz;bait khw;wq;fs;: iffs;>
ghd;fphpahl;b]; / yhf;bf; fhy;fs;> Gl;lq;fs;>
mrpNlhrp]; = fLk; tapw;Wtyp> fd;dq;fs; Nghd;wit
fisg;G> %r;Rj;jpzwy;> nkypjhfpd;wd.
njhlHe;J Fkl;ly; kw;Wk; khHgfq;fs;> ,Lg;G>
the;jp Vw;gLjy; fOj;jpd; gpd;gf;fk;
Nghd;wtw;wpy;
tpiutpy; MNyhridfshy; nfhOg;G NrHfpwJ
ngwNtz;bait : fhy;fs;
my;yJ iffspy; FWFWg;G>
kuj;Jg;Nghjy; my;yJ typ
Vw;gLjy;
3TC Fkl;ly;
Nykpt;bd; Ngjp
NVP Fkl;ly; cldbahf rpfpr;ir
netpuh/gpd; Ngjp Njitg;gLgit :
Nyrhd Njhy; jbg;G fz;fs; kQ;rs; epwkhjy;
kpa+Nfhrhty; Vw;gLk; Njhy;
jbg;G kw;Wk;
vf;];/NghypNa\d; fha;r;ry;
EFV Fkl;ly; cldbahf rpfpr;ir
,/ghtpud;]; Ngjp Njitg;gLgit :
tpj;jpahrkhd fdTfs; irNfh]py; my;yJ Fog;gk;
J}f;fk; ghjpg;G Njhy; jbg;G
kwjp
jiytyp
fpWfpWg;G

31
Kf;fpa nra;jp:

midj;J tif rpfpr;irfSf;Fk;> jdpj;jdpahf xt;nthU kUe;ijAk; vLj;Jf;nfhs;Sk;

Kiwfs; gw;wpf; $whky;> KOikahf midj;jpw;Fk; NrHe;jhw;Nghy; Nehahspfsplk;
$wNtz;Lk;. Nehahspfs; xU kUe;ij cl;nfhs;tij kl;Lk; epWj;jNth my;yJ
Fiwthd msT cl;nfhs;tNjh $lhJ. xU Fwpg;gpl;l kUe;jpdhy; Vw;gLk; gf;ftpisT
njhlh;r;rpahdkhf ,Ue;J> Nehahsp mij epWj;j Ntz;Lk; my;yJ rpfpr;iria
khw;wNtz;Lk; vd;W fUjpdhy;> ,ad;w msT tpiuthf mtH kUj;Jt ikaj;ij
mZfTk;. xd;W my;yJ ,uz;L kUe;Jfis kl;Lk; epWj;jf; $lhJ. VMHb
ikaj;jpw;F nry;yTk;.

32
R\;kh VMHbia gupe;Jiu nra;ag;gl;lthW
cl;nfhs;SfpwhH. mtUf;F rpwpa mstpyhd
Fkl;ly; Vw;gl;lJ. Mdhy;> nrtpypaH /
MyhrfHfs; mJ Fwpj;J mwpTWj;jpapUe;jdH.
nrtpypaH / MNyhrfHfs; mij tof;fkhd xd;W
kw;Wk; rpy thuq;fspy; mJ rupahfptpLk; vd;W
$wpdH. R\;khtpw;F ,J Vw;fdNt
mwpTWj;jg;gl;bUe;jjhy;> mtH mJ Fwpj;J
mjpfstpy; ftiyg;gltpy;iy. mtUf;F
gpbj;jkhd czit mbf;fb rpwpJ rpwpjhf
rhg;gpl;L rpfpr;iria njhlHe;J
vLj;Jf;nfhs;fpwhH.

kdP\; VMHbia gupe;Jiu nra;ag;gl;lthW

cl;nfhs;SfpwhH. mtUf;F nfl;l fdTfs;
Vw;gLfpd;wd> Mdhy; nrtpypaH / MyhrfHfs;
mJ Fwpj;J mwpTWj;jpapUe;jdH. NkYk;
nrtpypaH / MyhrfHfs; mij tof;fkhd xd;W
kw;Wk; rpy thuq;fspy; mJ rupahfptpLk; vd;W
$wpdH. kdP\pw;F ,J Vw;fdNt
mwpTWj;jg;gl;bUe;jjhy;> mtH mJ Fwpj;J
mjpfstpy; ftiyg;gltpy;iy. cwq;Ftjw;F
Kd; kfpo;r;rpfukhf gzpfis Nkw;nfhs;s mtH
Kay;fpwhH. rpy thuq;fSf;Fg; gpd; nrtpypaH /
MyhrfHfs; $wpathW nfl;l fdTfs; tUtJ
epd;Wtpl;lJ.

VMHb Muk;gpj;j %d;W thuq;fs; fopj;J>

FkhUf;F ,Lg;GG; gFjpapy; xU Nyrhd jOk;G
Vw;gl;lJ. mJ mupg;gpidAk; Vw;gLj;JfpwJ.
Mdhy; mtUf;F [{uk; Vw;gltpy;iy.

ePq;fs; vd;d nra;tPHfs;? ,jw;fhd fhuzk;

vd;dthf ,Uf;Fk;?

kUj;JtH mtUf;F f;NshH/gPdpuhikd; toq;fp

VMHbia njhlHe;J Nkw;nfhz;lhH. jOk;G
,d;Dk; Nkhrkile;jhNyh my;yJ [{uk;
Vw;gl;lhNyh clNd te;J ghHf;FkhW vr;rupj;jhH.
rpy ehl;fspy; jOk;G kiwe;Jtpl;lJ.

NkYk; nrtpypaH / MNyhrfHfs; kUe;jpd; gpw

gf;f tpisTfs; Fwpj;Jk; Fkhiu vr;rupj;jdH.
Mdhy; ,J tiu mtH mJ Nghd;w gf;f
tpisTfshy; ghjpf;fg;gltpy;iy.

ePq;fs; Fkhuplk; Fwpg;gpl Ntz;ba gf;f

tpisTfs; vd;d?

33
mj;jpahak; 13: VMHb Muk;g MjuT gpwF fz;fhzpg;G kw;Wk; njhlHe;j VMHb
rpfpr;irf;fhd MjuT

R\;kh Rfhjhuikaj;jpw;F njhlHe;J tUif Gupe;jhH. njhlHe;J VMHb cl;nfhs;StJ

Fwpj;J nrtpypaHfs; / MNyhrfHfs; mtuplk; Nfl;lwpe;jdH. R\;kh mtuJ kUe;Jfis
vg;nghOJk; kwe;jjpy;iy. mtuJ ,izAk; mtUld; kUe;J cl;nfhs;SfpwhH. ,UtUk;
mtutH kUe;J Fwpj;J epidTWj;jpf; nfhs;fpd;wdH.

kdP\; Rfhjhuikaj;jpw;F njhlHe;J tUif

Gupe;jhH. njhlHe;J VMHb cl;nfhs;StJ
Fwpj;J nrtpypaHfs; / MNyhrfHfs; mtuplk;
Nfl;lwpe;jdH. kdP\; mtuJ kUe;Jfis
vg;nghOJk; kwe;jjpy;iy

FkhH kpfTk; gugug;ghd njhopyjpgH. mtuJ

njhopy;epkpj;jkhf mtH mjpfstpy; gazq;fs;
Nkw;nfhs;s Ntz;baJ tUk;. rpy Neuq;fs;
mtuJ kdjpy; gy vz;zq;fs; ,Ug;gjdhy;
mtH kd mOj;jj;jpw;F MshfpwhH.

ehshf ehshf> mtH khj;jpiufs;

cl;nfhs;tijAk; kwe;J tpLfpwhH. Fwpg;ghf
mtH gazq;fs; Nkw;nfhs;Sk;NghJ. my;yJ
mtH Kf;fpa $l;lq;fspy; ,Uf;Fk; NghJ.
ePq;fs; FkhUf;F cjt vd;d nra;tPHfs;?
ePq;fs; Fkhuplk; vd;d $WtPHfs;?

34
mj;jpahak; 14: rpfpr;irapid jLg;Gld; xUq;fpizj;jy;

ePq;fs; vz;zpg;ghHf;f xU fij …

g;upah kw;Wk; uNk\pd; fij uNk\; xU tUlj;jpw;F Kd;G

• uNk\; nrd;idapy; fil
- fij 2000 tUlj;jpy; njhlq;FfpwJ xd;iw itj;jpUf;fpwhH
- nrd;id efupy; trpf;Fk; mofhd • fle;j tUlk; tpahghu
ngz; g;upah tp\akhf gazk;
Nkw;nfhz;bUe;jhH.
- jw;NghJ jdJ gbg;ig Kbj;jpUf;Fk;
g;upah> uNki\ jpUkzk; nra;J • me;j gazj;jpd; NghJ
nfhs;s ,Uf;fpwhH xU ghupy; gy gPHfis
Fbj;j uNk\; xU
- g;upahtpd; FLk;gj;jhUf;F uNki\ ,dpikahd ngz; -
kpfTk; gpbj;jpUf;fpwJ. xUtiu mq;F re;jpj;jhH.
• mtUld; xU ,uit
uNk\; fopj;jhH.

uNk\;
• uNk\{f;F md;W
,uT> jhd;
n`r;Itpahy;
ghjpf;fg;gl;lJ
njupahJ.

1. uNk\; n`r;Itpahy; vg;gb ghjpf;fg;gl;lhH?

2. ghJfhg;ghd clYwT vd;why; vd;d?

3. n`r;Itp gutpa topfs; vd;d?

35
 khHr; 2000 Vg;uy; 2000
• g;upah kw;Wk; uNk\pw;F
jpUkzk; eilngWfpwJ. • g;upah xU ehs;
• mNefk; Ngiu mioj;J RftPdkhf czHfpwhs;
mw;Gjkhd czTld; • ngupjhf VJkpy;iy.
$ba mUikahd njhz;il fufug;Gld;
tpUe;J elj;jg;gl;lJ. $ba /g;Sthy;
• g;upah kw;Wk; uNk\; ghjpf;fg;gl;bUe;jhy;
Mfpa ,UtUk; jw;NghJ • rpy ehl;fSf;F gpwF
xd;whf tho;ifapYk; cly;; epiy rupaile;J
kw;Wk; thzpgj;jpYk; mtuJ gzpapy;; kPz;Lk;
<LgLthHfs; <Lgl;lhH.

g;upah ghjpf;fg;gl;Ltpl;lhH
• g;upahtpw;Fk;
njupahJ
uNk\pw;Fk;
njupahJ. Mdhy;
jw;NghJ uNk\;
g;upahtpw;F
itui]
gug;gptpl;L tpl;lhH

4. g;upahtpw;F n`r;Itp vg;gb te;jJ?

5. n`r;Itp ghjpg;gpypUe;J jg;gpf;f g;upah vd;d

gz;zpapUf;fyhk;?

6. mtsJ Neha; vd;d?

36
 2001 KbT 2003 – y; kN`\; gpwe;jhd;
• g;hpah fHg;gkhf
,Uf;fpwhs; • FLk;gk; kpfTk;
re;Njh\khf czHe;jJ.
• mtSf;F kpfTk; njhopYk; ed;whf
kfpo;r;rp. ele;jNjhL g;upah
kN`\; vd;w kw;nwhU
• mf;FLk;gj;jpd; Kjy; Foe;ijia
Foe;ijahf Mz; <d;nwLj;jhs;.
Foe;ij gpwe;jJ. • kN`\pw;F jha;
• uhN[\; n`r;Itpahy; topahf n`r;Itp
ghjpf;fg;gltpy;iy gutpapUe;jJ. ,g;nghOJ
mtDk; n`r;Itpahy;
ghjpf;fg;gl;Ls;shd;

7) jhapypUe;J Foe;ijf;F n`r;Itp guTk; topfs;

vd;ndd;d?

8) vy;yh Nf];fspYk; jha; Foe;ijf;F n`r;Itpia

gug;Gthuh?

9) Foe;ij ngWk; fhyj;jpypUf;Fk; n`r;Itp gh]pl;bt;

ngz;fSf;fhd MNyhrid vd;d?

10) fHg;gkhf ,Uf;Fk; n`r;Itp gh]pl;bt; ngz;fSf;fhd

MNyhrid vd;d?

11) ,ul;il ghJfhg;G vd;why; vd;dntd;W cq;fSf;Fj;

njupAkh?

37
mj;jpahak; 15: epiyahd Kd;ndr;rupf;iffs;> njhw;W fl;Lg;ghL kw;Wk;
ghjpg;gpw;Fg; gpe;ija g;Nuh/gpyhf;rp];

cyfshtpa Kd;ndr;rupf;iffs; my;yJ epiyahd Kd;ndr;rupf;iffs; ahit?

n`r;Itp my;yJ n`gilb]; gp kw;Wk; rp Nghd;w uj;jj;jpypUe;J cw;gj;jpahFk;

NgNjhn[d;fspd; ghjpg;gpypUe;J cly;eyg; gzpahsHfis ghJfhg;gjw;fhf tbtikf;fg;gl;l
topKiwfspd; njhFg;Ng cyfshtpa Kd;ndr;rupf;iffs; vdg;gLk;.

mbg;gil tpjpfs;
 midjJ ; NehahspfSk; / egHfSk; ghjpgg ; pid gugG ; k; jdi ; k cilatHfs;
 Nehawpjy; / Kdf ; zpff
; gg
; ll; njhwW ; epiyfis vgn ; ghOJk; fUjj ; py; nfhss; f; $lhJ
 midjJ ; cly; jputq;fSk; kwW ; k; jpRff
; Sk; ghjpgi ; g Vwg; LjJ
; tNj MFk.;
 midjJ ; ]n
; lHiy]; nraa ; gg
; lhj CrpfSk; / $H KidfSk; ghjpgi ; g Vwg; LjJ
; tNj
MFk;
 vej
; nthU nrayK ; iwia Mukg ; pfF
; k; KdG ; k; ,lHghli ; l milahsk; fhzTk;

cly; jputq;fs; kw;Wk; cyfshtpa Kd;ndr;rupf;iffs;

gapw;rp 15.1: gpd;gw;wg;glNtz;ba kw;Wk; gpd;gw;wNtz;lhj cly; jputq;fSf;fhd nghJthd

Kd;ndr;rupf;iffs;

nghJthd Kd;ndr;rupf;iffs; nghJthd Kd;ndr;rupf;iffs;

gpd;gw;wg;glNtz;bait gpd;gw;wg;gl Ntz;lhjit

njhw;Ws;s cly; jputq;fs; my;yJ njhw;Ww;w cly; jputq;fs; my;yJ

Rug;Gfs; Rug;Gfs;

VjhtJ njhw;Wfisf; nfhz;bUf;Fk;

cly; jputq;fs; my;yJ Rug;Gfs;

38
epiyahd Kd;ndr;rupf;iffspd; gbepiyfs;

epiyahd Kd;ndr;rupf;iffspd; gbepiyfs;

ghJfhg;G rhjdq;fis gad;gLj;Jjy;

jd;id fhj;Jf;nfhs;Sjy;
tpgj;Jfis jtpHj;jy;
njhw;Wfis jLf;Fk; njhopy;El;gq;fs; kw;Wk; ];nlHiyNr]dpd; xOq;fhd
cgNahfk;;
fopTfis mfw;Wjy;

nray;Kiw rk;ge;jg;gl;l ,lHghLfspd; tiffs;

nray;Kiwapd; ghJfhg;G Njitg;gLtJ

tiffs;

Fiwthd ifAiwfs; cjtpfukhf ,Ug;gpDk; mJ

Mgj;J kpfTk; Kf;fpakpy;iy
gpurtj;jpd; NghJ ifAiwfs; kw;Wk; Kf%b
mzpa Ntz;Lk;
eLj;ju Mgj;J ifAiwfs; kw;Wk; jz;zPHGfh ciwfs;
Njitg;glyhk;.
mjpf Mgj;J ifAiwfs;> jz;zPHGfh ciwfs; kw;Wk;
ghJfhg;G fz;zhbfs; kpfTk; Kf;fpak;.

Fwpg;gplj;jf;f fopTfid mfw;Wk; Kiwfs;

fopTfs; cjhuzq;fs; mfw;Wk; Kiwfs;

jputk;  ,uj;jk;  Rj;jkhd rhf;fil my;yJ
 rpWePH foptiwf; Fopapy; /gs\; nra;jy;
 kyk;
jpd;kg;nghUs;  vupf;fTk; my;yJ ftdkhf
 eide;j gQ;Rfs;
Gijf;fTk;
 rhdpl;lup NgLfs; /
ehg;fpd;fs;  Kbe;jhy; rhk;gyhf;fTk;
 gpsnrz;lh  kpUfq;fs; my;yJ Foe;ijfSf;F
vspjhff; fpl;Lk; tifapy;
 mWit khjpup jpwe;jntspapy; itg;gij
jpRf;fs; jtpHf;fTk;.
 kPz;Lk; Njhz;lg;gl tha;g;Gs;s
,lq;fspYk; kw;Wk; ePH
$Hikahd Mjhuq;fis khRg;gLj;j tha;g;Gs;s
cgfuzq;fs;  Crpfs; ,lq;fspYk; Gijg;gij jtpHf;fTk;.
 ];fhy;ngy;fs;
 gpNsLfs;  Xl;il tpohj fd;nlapdHfspy;
epug;gp mfw;wTk;. FWfhd
Kidapid cila ghl;by;fs;
,jw;F Vw;wjhFk;.
 urhadq;fs; nfhz;l njhw;W
Vw;gLj;jhjjhfTk; my;yJ Ml;Nlhf;Nyt;
my;yJ mfw;Wtjw;F Kd; rhk;gyhf;Fjy;

39
ghjpg;gpw;Fg; gpe;ija g;Nuh/gpyhf;rp]; (PEP)

PEP - d; gbepiyfs;

 Mgj;J fhy rpfpr;ir

 cldb ftdpg;G
 gjpT kw;Wk; mwpf;if jhf;fy;
 Mgj;J kjpg;gply;
 Nrhjid kw;Wk; MNyhrid
 PEP rpfpr;ir
 njhlh; ftdpg;G

gzp njhlHghd ghjpg;Gfs; kw;Wk; jpl;l Kiwfspd; tifapid tifg;gLj;Jjy;

Fiwe;j msT  rpy Jspfs; uj;jk; / cly; jputk; / gpw mbg;gil

njhw;Nww;gLj;Jk; jpwDs;s tp\aq;fs; (OPIM) kUj;Jt
Kiw
 Fiwthd Neuk;
rpwpJ  jpd;k Crp (mjDs; xl;il ,y;yhjJ)
njhlh;r;rpahdk;  Nkw;gug;G rpuha;g;G
mjpf msT  gy Jspfs; uj;jk; / cly; jputk; / gpw etPd
njhw;Nww;gLj;Jk; jpwDs;s tp\aq;fs; (OPIM) kUj;Jt
Kiw
 mjpf Neuk;

mjpf  ngupa Xl;ilAs;s Crpfs;

njhlh;r;rpahdk;  Mokhd Xl;il
 Nehahspfspd; FUjpf;Foha; / FUjpehsj;jpy;
gad;gLj;jg;gl;l ghHitapy; gLk; uj;jk; my;yJ
Crpfs;

PEP vg;nghOJ Muk;gpf;fg;gl Ntz;Lk;?

Kf;fpa egH my;yJ Mjhu egupd; Ma;tf KbTfs; tUk; tiu PEP Muk;gpg;gjpy; jhkjk;
Vw;gLj;j Ntz;lhk;.
vdpDk;> ,e;j Nf]py; KbTfs; nefbt; vd;why; rk;ge;jg;gl;l cly; eyg; gzpahsH PEP –
I epWj;jpf; nfhs;syhk;.
Kbe;j msT tpiuthf> 1-24 kzp Neuq;fSf;Fs; PEP Muk;gpf;fg;gl Ntz;Lk; kw;Wk;. 1-2
kzp Neuj;jpy; Muk;gpg;gJ kpfTk; ey;yjhFk;. ghjpg;gpw;F 72 kzp Neuj;jpw;F gpd;G
rpfpr;iria Muk;gpf;fg;gLtJ rpghupR nra;ag;gLtjpy;iy

40
mj;jpahak; 16: VMHbapYs;s fHg;gkhd kw;Wk; rkPgj;jpy; Foe;ij ngw;wtHfSf;fhd
rpwg;gk;rq;fs;

R\;kh ,g;nghOJ fHg;gkhf cs;shH. mtH

jw;NghJ kpfTk; kfpo;r;rpahf cs;shH. ,e;j
epiyapy; VMHb Foe;ijia ghjpf;Fkh kw;Wk;
VMHb vLj;Jf;nfhs;tij jtpHg;gjh my;yJ
njhlUtjh vd;gij mwpa tpUk;GfpwhH.

ePq;fs; vd;d epidf;fpwPHfs;?

41
mj;jpahak; 18: VMHb nray;gLfpwjh?

R\;kh mtuJ rpfpr;iria vy;yh Neuq;fspYk;

rupahf vLj;Jf;nfhs;fpwhH. mtuJ cly; vil $b
tUfpwJ ,Wjpahf mtuJ thapy; Vw;gl;l
nts;isf; Gs;spfs; rpwpjp rpwpjhf Fiwe;J tpl;lJ.

mtuJ Kfk; khwptpl;lJ xd;Nw mtiu kpfTk;

ftiyf;Fs;shf;fpAs;sJ. mtuJ cly; vil
ed;whf ,Ug;gpDk; mtuJ jhilapy; gs;sk;
Vw;gLfpwJ. mij Vw;Wf;nfhs;Tk; kw;Wk; mJ
Fwpj;J nrtpypauplk; fye;jhNyhrpf;fTk; mtH
kpfTk; rpukg;gLfpwhH.

,jd; fhuzk; vd;dthf ,Uf;f KbAk;? ePq;fs;

,e;epiyapy; vd;d nra;tPHfs;?

R\;khtpd; n`r;gp – I Nrhjpj;jg; gpwF> jpl;l

Kiwia AZT-3TC-NVP – f;F khw;wp nrtpypaH
MNyhridiaf; NfhUthH

R\;kh cz;ikapNyNa re;Njh\khf cs;shH.

mtuJ Foe;ij gpwe;J 18 khjq;fs; taJilajhf
,Ue;j NghJ ,UtUk; kUj;Jtkidf;F nrd;W
Nkw;nfhz;l n`r;Itp gupNrhjid KbTfs;
nefbt; vd;W njupa te;jJ.

42
 nrtpypaH $wpagb
kUe;Jfis kwf;fhkYk;
kw;Wk; njhlHe;Jk; cl;nfhs;s
mtH ,d;Dk; mjpfkhf
gofptpl;lhH.

kdp\; mtuJ rpfpr;irfis vy;yh

Neuq;fspYk; jtwhJ vLj;Jf;nfhs;fpwhH.
mtuJ cly; vil mjpfupf;fpwJ kw;Wk;
,Wjpahf mtH mupg;G rpwpJ rpwpjhff;
Fiwe;Jtpl;lJ.

kdp\pw;F mOj;j czHT Vw;gl;lhy;

mtUf;F MjuT njuptpf;f xU ez;gH
cs;shH. mtH eykhf czHfpwhH.

midj;J re;jpg;GfSf;F
jtwhky; FkhH tUif
GupNthL> kUe;J
cl;nfhs;tjw;Fk; mtH
jtWtNj ,y;iy.

43
 khj;jpiufis xOq;fhf vLj;Jf;nfhs;shj
NeHTfis FkhH ,d;dKk; nfhz;Ls;shH. xU
KiwiaAk; jtw tplf;$lhJ vd;W nrtpypaH
$Wtij mtH mjpfkhf $Wtjhf
vLj;Jf;nfhz;lhH. njhlHe;J khj;jpiu
vLj;Jf;nfhs;shj mNu Neuj;jpy; ey;y cly;
epiyapypUf;Fk;> gy ez;gHfis mtUf;Fj;
njupAk;. rpy Ntisfspy; thuf;filrpfspy; FkhH
mjpf mstpyhd gPH Fbg;gij tpUk;GthH.

Kjy; tUlk; Fkhupd; cly; epiy ed;whfNt

cs;sJ. mtUf;F cly; vil $baNjhL iffs;
kw;Wk; fhy;fspy; vt;tpj Gs;spfSk; Vw;gltpy;iy.

,uz;lhtJ tUlKk; mtH eykhfNt cs;shH.

%d;whk; Mz;bd; Kbtpy; mtH gy thuq;fSf;F

njhlHe;J ,Uk Muk;gpj;jhH. mtH cly;
viliaAk; ,oe;jhH. Nrhjidfspd; Kbtpy; mtH
bgpahy; ghjpf;fg;gl;bUf;fpwhH vd;W njupa
te;Js;sJ. VMHb – I rupahf vLj;Jf;
nfhs;shjjd; fhuzkhfj;jhd; mtUf;F ,e;j epiy
Vw;gl;Ls;sJ vd;W mtHfs; $wpdH.

Fkhhpd; iffs; kw;Wk; fhy;fspy; re;jh;g;gthj

Neha;fSf;fhd mwpFwpfSk; kw;Wk; jOk;Gfs;
Vw;gl Muk;gpj;Js;sJ. mtH njhlHe;J VMHb – I
vLj;Jf;nfhs;shjjhy; mtuplk; VMHb
nray;Gupatpy;iy vd;Wk; nrtpypaH mtuplk;
njhptpj;Jtpl;lhH. ,uz;lhk; - epiy njugp – I
vLj;Jf;nfhs;tjw;fhf nrtpypaH mtUf;F NtW xU
kUj;Jtiu gupe;Jiu nra;jhH.

jw;NghJ FkhH mjpf tpiy nfhz;l ,uz;lhk;

epiy njugpf;fhf mjpf gzk; nrytopj;J
tUfpwhH. NkYk; mjpf khj;jpiufs; cz;z
Ntz;bapUg;gjd; fhuzkhf mjpf gf;f
tpisTfisAk; re;jpj;J tUfpwhH.

,e;epiyapd; fhuzkhf mtH re;Njh\j;ij

,oe;Js;sNshL> mtUf;F NtW ve;j tha;g;Gk;
,y;iy vd;gijAk; kw;Wk; nrtpypaH $wpaJ rupNa
vd;Wk; czHe;Js;shH.

44