Centro Nacional de Referencia para el SIDA (CNRS), Departamento de Microbiología, Parasitología e Inmunología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, Piso 11, C1121ABG, Buenos Aires, Argentina.
Int J Infect Dis. 2011 Sep;15(9):e635-40. doi: 10.1016/j.ijid.2011.05.007. Epub 2011 Jul 13.
OBJECTIVES: Due to the scarce data on the prevalence of sexually transmitted infections (STIs) among male-to-female trans-sex workers (TSW) and male sex workers (MSW) in Argentina, the present study aimed to estimate the incidence of human immunodeficiency virus (HIV), and the prevalence of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), and Treponema pallidum. Human papillomavirus (HPV) and Chlamydia trachomatis infections were tested among TSW. METHODS: Two hundred and seventy-three TSW and 114 MSW were recruited by nongovernmental organizations. HIV incidence was estimated by STARHS (serologic testing algorithm for recent HIV seroconversion). HPV and C. trachomatis infections were tested in anal cells from TSW. RESULTS: TSW showed significantly higher prevalences of HIV (34.1 vs. 11.4%), HBV (40.2 vs. 22.0%), and T. pallidum (50.4 vs. 20.4%) than MSW. TSW tested positive for HPV in 111/114 cases and for C. trachomatis in 4/80 cases. Investigation of HBV, HCV, HIV, and T. pallidum co-infections showed that 72% of TSW and 39% of MSW had at least one STI. T. pallidum was the most frequent mono-infection. The estimated HIV incidence was 10.7 per 100 person-years (95% confidence interval (CI) 3.8-17.7) for TSW and 2.3 per 100 person-years (95% CI 0-6.7) for MSW. CONCLUSIONS: The high prevalence of STIs and the high incidence of HIV demonstrate the great vulnerability of these high-risk populations and indicate the urgent need for preventive strategies on intervention and facilitation of access to healthcare programs.
目的：由于阿根廷男变女跨性别性工作者（TSW）和男性性工作者（MSW）中性传播感染（STI）的流行数据稀缺，本研究旨在估计人类免疫缺陷病毒（HIV）的发病率，以及 HIV、乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和梅毒螺旋体的流行率。对 TSW 进行了人乳头瘤病毒（HPV）和沙眼衣原体感染检测。
方法：通过非政府组织招募了 273 名 TSW 和 114 名 MSW。HIV 发病率通过 STARHS（近期 HIV 血清转换的血清学检测算法）进行估计。对 TSW 的肛门细胞进行了 HPV 和 C. trachomatis 感染检测。
结果：TSW 的 HIV（34.1%比 11.4%）、HBV（40.2%比 22.0%）和梅毒螺旋体（50.4%比 20.4%）的流行率明显高于 MSW。114 例 TSW 中有 111 例 HPV 阳性，80 例 C. trachomatis 中有 4 例阳性。对 HBV、HCV、HIV 和梅毒螺旋体混合感染的调查显示，72%的 TSW 和 39%的 MSW 至少有一种性传播感染。梅毒螺旋体是最常见的单一感染。TSW 的估计 HIV 发病率为每 100 人年 10.7 例（95%置信区间[CI] 3.8-17.7），MSW 为每 100 人年 2.3 例（95%CI 0-6.7）。
结论：性传播感染的高流行率和 HIV 的高发病率表明这些高危人群非常脆弱，这表明迫切需要采取预防策略，以干预和促进获得医疗保健计划。
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