National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Level 2, 376 Victoria Street, Darlinghurst, New South Wales 2010, Australia.
J Acquir Immune Defic Syndr. 2010 Jan;53(1):144-9. doi: 10.1097/QAI.0b013e3181b48f33.
We examined a range of common bacterial and viral sexually transmitted infections as risk factors for HIV seroconversion in a community-based cohort of HIV-negative homosexual men in Sydney, Australia.
Detailed information about HIV risk behaviors was collected by interview twice yearly. Participants were tested annually for HIV, anal and urethral gonorrhea and chlamydia, herpes simplex virus types 1 and 2, and syphilis. In addition, they reported annual diagnoses of these conditions and of genital and anal warts.
Among 1427 enrolled participants, 53 HIV seroconverters were identified, giving an incidence of 0.78 per 100 person-years. After controlling for number of episodes of insertive and receptive nonseroconcordant unprotected anal intercourse, there were independent associations with anal gonorrhea (adjusted hazard ratio = 7.12, 95% confidence interval: 2.05 to 24.79) and anal warts (hazard ratio = 3.63, 95% confidence interval: 1.62 to 8.14).
Anal gonorrhea and anal warts were independently associated with HIV acquisition. The added HIV prevention value of more frequent screening of the anus to allow early detection and treatment of anal sexually transmitted infections in homosexual men should be considered.
我们研究了一系列常见的细菌和病毒性性传播感染，作为澳大利亚悉尼社区中 HIV 阴性同性恋男性队列中 HIV 血清转化的危险因素。
通过每年两次的访谈，详细收集有关 HIV 风险行为的信息。参与者每年接受一次 HIV、肛门和尿道淋病和衣原体、单纯疱疹病毒 1 型和 2 型以及梅毒检测。此外，他们还报告了这些疾病以及生殖器和肛门疣的年度诊断情况。
在 1427 名入组参与者中，发现 53 名 HIV 血清转化者，发病率为 0.78/100 人年。在控制了插入性和接受性非血清一致性无保护肛交的次数后，与肛门淋病（调整后的危险比=7.12，95%置信区间：2.05 至 24.79）和肛门疣（危险比=3.63，95%置信区间：1.62 至 8.14）存在独立关联。
肛门淋病和肛门疣与 HIV 感染的获得独立相关。应考虑更频繁地筛查肛门，以早期发现和治疗同性恋男性的肛门性传播感染，从而增加 HIV 预防的价值。
