淋病与艾滋病毒高血清流行率：纽约市卫生部性传播疾病诊所，1990 - 1997年

High HIV seroprevalence associated with gonorrhea: New York City Department of Health, sexually transmitted disease clinics, 1990-1997.

作者信息

Torian L V, Makki H A, Menzies I B, Murrill C S, Benson D A, Schween F W, Weisfuse I B

机构信息

Office of AIDS Research and HIV Serosurveys, The New York City Department of Health, New York 10013, USA.

出版信息

AIDS. 2000 Jan 28;14(2):189-95. doi: 10.1097/00002030-200001280-00015.

DOI:10.1097/00002030-200001280-00015

PMID:10708290

Abstract

OBJECTIVE

To measure trends in HIV seroprevalence associated with gonorrhea in patients presenting to New York City Department of Health sexually transmitted disease (STD) clinics, 1990-1997 (n = 94 577).

METHOD

Unlinked HIV-1 serosurvey using remnant serum originally drawn for routine serologic tests for syphilis (STS). Demographic, risk factor, clinical and laboratory data were abstracted from clinic charts. No other data sources were used. Patients were not interviewed.

RESULTS

During 1990-1997 HIV seroprevalence declined from 9 to 6% (P for trend < 0.01) in the STD clinic sample. Gonorrhea incidence city-wide declined from 481 per 100 000 to 194 per 100 000. HIV seroprevalence in patients with a diagnosis of gonorrhea (n = 11 914) remained stable at 10-11% during the period, whereas HIV seroprevalence associated with all other STDs combined declined from 8 to 5% (P for trend < 0.01). Seroprevalence in women with gonorrhea (n = 2243) declined from 8 to 4% (P for trend < 0.001), whereas seroprevalence in men with gonorrhea was stable at 11-12%. Seroprevalence in men aged less than 25 years and diagnosed with gonorrhea declined from 5 to 3% (P for trend = 0.02). In contrast, in men aged 25 years and older and diagnosed with gonorrhea, seroprevalence remained at 14-16% throughout the period 1990-1997. Among men with gonorrhea, seroprevalence was associated with same gender or bisexual contact [odds ratio (OR), 9.2; 95% confidence interval (CI), 8.1-10.4], age > 25 years (OR, 5.1; 95% CI, 4.6-5.7), and white race/ethnicity (OR, 1.3; 95% CI, 1.2-1.4).

CONCLUSIONS

In this 9-year serosurvey the association between HIV and gonorrhea remained strong during a period when HIV seroprevalence and gonorrhea incidence declined. The data suggest that a gonorrhea diagnosis is an important risk marker in this era of 'safe sex' and that behavior patterns of patients with gonorrhea warrant further study.

摘要

目的

测定1990 - 1997年（n = 94577）前往纽约市卫生部门性传播疾病（STD）诊所就诊的患者中，与淋病相关的HIV血清阳性率趋势。

方法

使用最初为梅毒常规血清学检测（STS）抽取的剩余血清进行非关联HIV-1血清学调查。从诊所病历中提取人口统计学、危险因素、临床和实验室数据。未使用其他数据源。未对患者进行访谈。

结果

在1990 - 1997年期间，STD诊所样本中的HIV血清阳性率从9%降至6%（趋势P值<0.01）。全市淋病发病率从每10万人481例降至每10万人194例。在此期间，诊断为淋病的患者（n = 11914）中的HIV血清阳性率保持在10% - 11%稳定，而与所有其他STD合并相关的HIV血清阳性率从8%降至5%（趋势P值<0.01）。患淋病的女性（n = 2243）中的血清阳性率从8%降至4%（趋势P值<0.001），而患淋病的男性中的血清阳性率稳定在11% - 12%。诊断为淋病的25岁以下男性中的血清阳性率从5%降至3%（趋势P值 = 0.02）。相比之下，在1990 - 1997年整个期间，诊断为淋病的25岁及以上男性中的血清阳性率保持在14% - 16%。在患淋病的男性中，血清阳性率与同性或双性接触相关[比值比（OR），9.2；95%置信区间（CI），8.1 - 10.4]、年龄>25岁（OR，5.1；95%CI，4.6 - 5.7）以及白人种族/族裔相关（OR，1.3；95%CI，1.2 - 1.4）。