Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, Norway.
BMC Infect Dis. 2010 Sep 6;10:261. doi: 10.1186/1471-2334-10-261.
The incidences of reportable sexually transmitted infections (STI) among men who have sex with men (MSM) have increased since the late 1990 s in Norway. The objectives of our study were to assess factors, associated with recent selected STI among MSM, living in Norway in order to guide prevention measures.
We conducted a cross-sectional Internet-based survey during 1-19 October 2007 among members of a MSM-oriented Norwegian website using an anonymous questionnaire on demographics, sexual behaviour, drug and alcohol use, and STI. The studied outcomes were gonorrhoea, syphilis, HIV or Chlamydia infection in the previous 12 months. Associations between self-reported selected STI and their correlates were analysed by multivariable Poisson regression. P value for trend (p-trend), adjusted prevalence ratios (PR) with 95% confidence intervals [] were calculated.
Among 2430 eligible 16-74 years old respondents, 184 (8%) reported having had one of the following: syphilis (n = 17), gonorrhoea (n = 35), HIV (n = 42) or Chlamydia (n = 126) diagnosed in the past 12 months. Reporting Chlamydia was associated with non-western background (PR 2.8 [1.4-5.7]), number of lifetime male partners (p-trend < 0.001), unsafe sex under the influence of alcohol (PR 1.8 [1.1-2.9]) and with younger age (p-trend = 0.002). Reporting gonorrhoea was associated with unrevealed background (PR 5.9 [1.3-26.3]), having more than 50 lifetime male partners (PR 4.5 [1.3-15.6]) and more than 5 partners in the past 6 months (PR 3.1 [1.1-8.8]), while mid-range income was protective (PR 0.1 [0.0-0.6]). Reporting HIV was associated with residing in Oslo or Akershus county (PR 2.3 [1.2-4.6]), non-western background (PR 5.4 [1.9-15.3]), unrevealed income (PR 10.4 [1.5-71.4]), number of lifetime male partners (p-trend < 0.001) and being under the influence of selected drugs during sex in the past 12 months (PR 5.2 [2.7-11.4]). In addition, the frequency of feeling drunk was reversibly associated with HIV.
Our study demonstrates different associations of demographic and behavioural factors with different STI outcomes in the study population. Number of lifetime male partners was the most important potential predictor for Chlamydia and HIV. The STI prevention efforts among MSM should focus on Oslo and Akershus, promote safe sex practices and tackle sex-related drug and alcohol use.
自 20 世纪 90 年代末以来,挪威男男性行为者(MSM)报告的性传播感染(STI)发病率有所上升。我们的研究目的是评估与挪威 MSM 最近发生的特定 STI 相关的因素,以便指导预防措施。
我们于 2007 年 10 月 1 日至 19 日期间在一个面向 MSM 的挪威网站上进行了一项基于互联网的横断面调查,使用匿名问卷收集了人口统计学、性行为、药物和酒精使用以及 STI 方面的信息。研究结果是在过去 12 个月中淋病、梅毒、HIV 或衣原体感染。通过多变量泊松回归分析了自我报告的特定 STI 与其相关因素之间的关联。计算了趋势(p-trend)的 P 值、调整后的患病率比(PR)和 95%置信区间[]。
在 2430 名 16-74 岁符合条件的受访者中,184 人(8%)报告在过去 12 个月中患有以下一种疾病:梅毒(n=17)、淋病(n=35)、HIV(n=42)或衣原体(n=126)。报告衣原体感染与非西方背景(PR 2.8 [1.4-5.7])、终生男性伴侣数量(p-trend < 0.001)、受酒精影响的不安全性行为(PR 1.8 [1.1-2.9])和年龄较小(p-trend = 0.002)有关。报告淋病与未透露背景(PR 5.9 [1.3-26.3])、有超过 50 个终生男性伴侣(PR 4.5 [1.3-15.6])和过去 6 个月中有超过 5 个伴侣(PR 3.1 [1.1-8.8])有关,而中等收入则具有保护作用(PR 0.1 [0.0-0.6])。报告 HIV 与居住在奥斯陆或阿克什胡斯县(PR 2.3 [1.2-4.6])、非西方背景(PR 5.4 [1.9-15.3])、未透露收入(PR 10.4 [1.5-71.4])、终生男性伴侣数量(p-trend < 0.001)以及过去 12 个月中在性行为中受选定药物影响(PR 5.2 [2.7-11.4])有关。此外,醉酒频率与 HIV 呈可逆关联。
我们的研究表明,在研究人群中,人口统计学和行为因素与不同的 STI 结果存在不同的关联。终生男性伴侣数量是衣原体和 HIV 的最重要潜在预测因素。MSM 的 STI 预防工作应重点关注奥斯陆和阿克什胡斯,促进安全性行为,并解决与性相关的药物和酒精使用问题。