Farley Thomas A, Cohen Deborah A, Wu Shin-Yi, Besch Ceryl Lynn
Department of Community Health Sciences, Tulane University, School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA 70112, USA.
J Acquir Immune Defic Syndr. 2003 Aug 15;33(5):642-8. doi: 10.1097/00126334-200308150-00014.
Because bacterial sexually transmitted diseases (STDs) facilitate HIV transmission, screening for and treatment of STDs among HIV-infected persons should prevent HIV spread to partners. Before screening programs for gonorrhea and Chlamydia infection should be widely established in HIV clinics, it is useful to know the prevalence of these infections. This study analyzed the results of a urine-based screening program for gonorrhea and Chlamydia in a New Orleans HIV clinic and compared the positivity rates to the prevalence in the local community. Among persons screened in the HIV clinic, 1.7% (46/2629) had gonorrhea and 2.1% (56/2629) had Chlamydia infection. Among persons aged 18-29 years, the test positivity for gonorrhea was similar in the HIV clinic to that of persons in sociodemographically similar community samples (3.1 versus 2.4%, adjusted odds ratio 1.6, P = 0.11) and the test positivity for Chlamydia infection was lower (5.4% versus 10.5%, adjusted odds ratio 0.6, P < 0.01). Based on a previously published mathematical model, it was estimated that treatment of all 46 gonorrhea and 56 Chlamydia infections in the HIV clinic may have averted 9 HIV infections among sex partners and saved far more in future medical costs than the cost of the screening. Routine screening for gonorrhea and Chlamydia infection should be considered in HIV clinics.
由于细菌性性传播疾病（STD）会促进HIV传播，因此对HIV感染者进行STD筛查和治疗应可防止HIV传播给性伴侣。在HIV诊所广泛开展淋病和衣原体感染筛查项目之前，了解这些感染的流行情况很有必要。本研究分析了新奥尔良一家HIV诊所基于尿液的淋病和衣原体筛查项目的结果，并将阳性率与当地社区的患病率进行了比较。在HIV诊所接受筛查的人群中，1.7%（46/2629）患有淋病，2.1%（56/2629）患有衣原体感染。在18至29岁的人群中，HIV诊所淋病检测阳性率与社会人口统计学特征相似的社区样本中的人群相似（3.1%对2.4%，调整优势比为1.6，P = 0.11），而衣原体感染检测阳性率较低（5.4%对10.5%，调整优势比为0.6，P < 0.01）。根据之前发表的数学模型估计，对HIV诊所中所有46例淋病和56例衣原体感染进行治疗，可能避免性伴侣中9例HIV感染，并且未来节省的医疗费用远远超过筛查成本。HIV诊所应考虑对淋病和衣原体感染进行常规筛查。
