Tai E, Sanchez T, Lansky A, Mahle K, Heffelfinger J, Workowski K
Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3717, USA.
Sex Transm Infect. 2008 Nov;84(6):478-82. doi: 10.1136/sti.2008.030973.
The Centers for Disease Control and Prevention provides guidance on sexually transmitted disease (STD) testing specifically for men who have sex with men (MSM) in STD treatment guidelines to address increasing rates of gonorrhoea and syphilis among MSM in the USA. The guidelines recommend at least annual syphilis, gonorrhoea and chlamydia testing for sexually active MSM. The implementation of these guidelines was evaluated.
Data from the 2003-5 MSM cycle of the National HIV Behavioural Surveillance System were used. The proportion of sexually active HIV-negative MSM reporting syphilis and gonorrhoea testing during the previous year was determined and multivariate logistic regression was used to identify factors associated with testing.
Of 10 030 MSM, 39% and 36% reported having been tested for syphilis and gonorrhoea in the previous year, respectively. Four factors were associated with syphilis and gonorrhoea testing, respectively: age 18-24 years versus > or =45 years (odds ratio (OR) 2.2, 95% CI 1.8 to 2.5; OR 2.7, 95% CI 2.3 to 3.2), black versus white race (OR 1.3, 95% CI 1.1 to 1.4; OR 1.4, 95% CI 1.2 to 1.6), private insurance versus no insurance (OR 1.3, 95% CI 1.1 to 1.4; OR 1.3, 95% CI 1.1 to 1.4) and disclosing male-male sex to a healthcare provider (OR 2.2, 95% CI 2.0 to 2.5; OR 2.1, 95% CI 1.9 to 2.3).
Syphilis and gonorrhoea testing among MSM was low, despite specific testing recommendations in the STD treatment guidelines. To increase STD testing among MSM, healthcare providers should assess the risks of STD for male patients through routine enquiries about sexual activity.
美国疾病控制与预防中心在性传播疾病（STD）治疗指南中针对男男性行为者（MSM）提供了专门的性传播疾病检测指导，以应对美国男男性行为者中淋病和梅毒发病率不断上升的情况。该指南建议性活跃的男男性行为者至少每年进行梅毒、淋病和衣原体检测。对这些指南的实施情况进行了评估。
使用了国家艾滋病行为监测系统2003 - 2005年男男性行为者周期的数据。确定了在前一年报告进行梅毒和淋病检测的性活跃的HIV阴性男男性行为者的比例，并使用多变量逻辑回归来确定与检测相关的因素。
在10030名男男性行为者中，分别有39%和36%报告在前一年进行了梅毒和淋病检测。分别有四个因素与梅毒和淋病检测相关：18 - 24岁与≥45岁（比值比（OR）2.2，95%置信区间1.8至2.5；OR 2.7，95%置信区间2.3至3.2），黑人与白人种族（OR 1.3，95%置信区间1.1至1.4；OR 1.4，95%置信区间1.2至1.6），有私人保险与无保险（OR 1.3，95%置信区间1.1至1.4；OR 1.3，95%置信区间1.1至1.4）以及向医疗服务提供者披露男男性行为（OR 2.2，95%置信区间2.0至2.5；OR 2.1，95%置信区间1.9至2.3）。
尽管性传播疾病治疗指南中有具体的检测建议，但男男性行为者中的梅毒和淋病检测率较低。为了提高男男性行为者中的性传播疾病检测率，医疗服务提供者应通过对性活动的常规询问来评估男性患者感染性传播疾病的风险。
