Division of STD Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Sex Transm Dis. 2011 Sep;38(9):865-70. doi: 10.1097/OLQ.0b013e31821d4ceb.
Episodic acyclovir therapy has been added to genital ulcer disease (GUD) syndromic management guidelines in several sub-Saharan African countries with human immunodeficiency virus (HIV) epidemics. We examined the correlates of health care seeking in men with GUD and its relationship to HIV-1 and herpes simplex virus type 2 outcomes.
Men with GUD (n = 615) were recruited from primary health care clinics in Gauteng province, South Africa for a randomized controlled trial of episodic acyclovir therapy. We used baseline survey and sexually transmitted infection/HIV-testing data to examine delay in health care seeking (defined as time from ulcer recognition to baseline study visit).
Median delay in health care seeking for GUD was 5 days, and one-quarter of men had previously sought care for the current ulcer. Previous care seekers were older, had more episodes of ulceration in the past year, and were more likely to test seropositive for HIV-1 and HSV-2. Delay in health care seeking was significantly associated with age, education level, and sex during the ulceration episode. Delays in care seeking were related to poorer HIV-1 outcomes; these findings were valid after controlling for advanced HIV.
Interventions to help shorten the duration between ulcer recognition and health care seeking for men with GUD are needed.
在一些受艾滋病毒（HIV）流行影响的撒哈拉以南非洲国家，生殖器溃疡病（GUD）综合征管理指南中增加了间歇性阿昔洛韦治疗。我们研究了 GUD 男性寻求医疗保健的相关因素及其与 HIV-1 和单纯疱疹病毒 2 结果的关系。
从南非豪登省的初级保健诊所招募了患有 GUD 的男性（n=615），参加间歇性阿昔洛韦治疗的随机对照试验。我们使用基线调查和性传播感染/艾滋病毒检测数据来检查寻求医疗保健的延迟（定义为从溃疡识别到基线研究就诊的时间）。
GUD 寻求医疗保健的中位延迟为 5 天，四分之一的男性曾因当前溃疡就诊。以前的就诊者年龄较大，过去一年溃疡发作次数较多，且 HIV-1 和单纯疱疹病毒 2 的血清阳性检测率更高。寻求医疗保健的延迟与年龄、教育水平和溃疡发作期间的性别显著相关。寻求医疗保健的延迟与 HIV-1 结局较差有关；这些发现在控制了 HIV 晚期后仍然有效。
需要采取干预措施，以缩短患有 GUD 的男性从溃疡识别到寻求医疗保健的时间。
