Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Columbus, OH 43210, USA.
J Natl Med Assoc. 2011 Apr;103(4):313-21. doi: 10.1016/s0027-9684(15)30312-6.
The purpose of this cross-sectional study was to assess the 2009 prevalence of chlamydial and gonococcal infection in 2 populations in a midwestern city in the United States: patients at a public sexually transmitted disease (STD) clinic, and individuals seeking human immunodeficiency virus (HIV) counseling and testing services at an AIDS community organization. We characterized STD prevalence in a random sample of 592 STD clinic patients and a convenience sample of 471 individuals agreeing to STD testing through outreach efforts at the community organization. The STD clinic population was 59% male, 60% black, with 3.1 mean sex partners in the last year. The community organization population was 72% male, 19% black, with a mean of 4.3 partners in the last year. The prevalence of both chlamydial and gonococcal infections was consistently higher in STD clinic patients than at the community organization (18% vs 4%). Prevalence of chlamydial infection was higher than prevalence of gonococcal infection in both populations (chlamydial infection, 3% and 13% at the STD clinic and community organization, respectively; vs gonococcal infection, 1% and 7%, respectively). Factors significantly associated with increased odds of gonococcal/chlamydial infection at the STD clinic include unmarried status, younger age, at least 6 partners in the last year, and unprotected sex in the last year. At the community organization, the only factor significantly associated with increased odds of gonococcal/chlamydial infection was lower educational attainment. Our findings confirm that STD prevalence differs widely by population group. Given these differences, local approaches to STD control should also be carefully targeted to specific subgroups.
本横断面研究旨在评估美国中西部城市的两个群体中的衣原体和淋病感染 2009 年的流行率：一个是公共性传播疾病（STD）诊所的患者，另一个是艾滋病社区组织中寻求人类免疫缺陷病毒（HIV）咨询和检测服务的个体。我们对 STD 诊所的 592 名随机样本患者和通过社区组织外展工作同意进行 STD 检测的 471 名便利样本个体进行了 STD 流行率特征描述。STD 诊所人群中 59%为男性，60%为黑人，去年平均性伴侣为 3.1 人。社区组织人群中 72%为男性，19%为黑人，去年平均性伴侣为 4.3 人。衣原体和淋病感染的流行率在 STD 诊所患者中始终高于社区组织（18%比 4%）。在两个群体中，衣原体感染的流行率均高于淋病感染（衣原体感染，分别在 STD 诊所和社区组织中为 3%和 13%；淋病感染，分别为 1%和 7%）。在 STD 诊所中，与淋球菌/衣原体感染几率增加显著相关的因素包括未婚状态、年龄较小、去年至少有 6 个性伴侣和去年无保护性行为。在社区组织中，唯一与淋球菌/衣原体感染几率增加显著相关的因素是教育程度较低。我们的研究结果证实，性传播疾病的流行率因人群群体而异。鉴于这些差异，当地的性传播疾病控制方法也应针对特定的亚群进行精心定位。
