Reynolds M W, Peipert J F, Collins B
Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore 21201-1596, USA.
Obstet Gynecol Surv. 2000 Jan;55(1):51-7. doi: 10.1097/00006254-200001000-00023.
The objective of this study was to investigate the epidemiologic aspects of sexually transmitted diseases (STDs) in victims of sexual assault and to discuss the methodological issues in determining risk of STD acquisition. We performed a comprehensive review of the medical literature to determine the prevalence of STDs in victims of sexual assault. A MEDLINE search and a search of bibliographies of published manuscripts was performed to discover relevant articles published in the English language. Studies were included in our review if they provided estimates of the prevalence of infection with Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, Trichomonas vaginalis, or human papillomavirus (HPV). The main outcome measure was prevalence rates of STDs in victims of sexual assault. It is difficult to determine the rate of newly acquired STDs from sexual assault. In the populations studied the prevalence of STDs can be summarized as follows: N. gonorrhoeae 0.0 to 26.3 percent; C. trachomatis 3.9 to 17 percent; T. pallidum 0.0 to 5.6 percent; T. vaginalis 0.0 to 19.0 percent; and HPV 0.6 to 2.3 percent. We conclude that prevalence estimates vary widely depending on the population studied and known risk factors for STDs. Given the limited follow-up rates in this population, preventive treatment for STDs in addition to emergency contraception should be offered in most instances.
Obstetricians & Gynecologists, Family Physicians.
After completion of this article, the reader will be able to estimate the prevalence of STD transmission from an act of sexual assault, to describe the various types of STDs that a sexual assault victim is at risk for, and to explain the role of preventive therapy in this setting.
本研究的目的是调查性侵犯受害者中性传播疾病（STD）的流行病学情况，并讨论确定感染STD风险的方法学问题。我们对医学文献进行了全面回顾，以确定性侵犯受害者中STD的患病率。通过检索MEDLINE以及已发表手稿的参考文献，查找以英文发表的相关文章。如果研究提供了淋病奈瑟菌、沙眼衣原体、梅毒螺旋体、阴道毛滴虫或人乳头瘤病毒（HPV）感染患病率的估计值，则纳入我们的综述。主要结局指标是性侵犯受害者中STD的患病率。很难确定因性侵犯而新感染STD的发生率。在所研究的人群中，STD的患病率可总结如下：淋病奈瑟菌为0.0%至26.3%；沙眼衣原体为3.9%至17%；梅毒螺旋体为0.0%至5.6%；阴道毛滴虫为0.0%至19.0%；HPV为0.6%至2.3%。我们得出结论，患病率估计值因所研究的人群和已知的STD风险因素而有很大差异。鉴于该人群的随访率有限，在大多数情况下，除紧急避孕外，还应提供STD预防性治疗。
妇产科医生、家庭医生。
阅读本文后，读者将能够估计性侵犯行为导致的STD传播患病率，描述性侵犯受害者面临风险的各类STD，并解释预防性治疗在这种情况下的作用。
