德克萨斯州县级性病检测与控制：性传播疾病和计划生育诊所是否重要？

County-level sexually transmitted disease detection and control in Texas: do sexually transmitted diseases and family planning clinics matter?

机构信息

Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.

出版信息

Sex Transm Dis. 2011 Oct;38(10):970-5. doi: 10.1097/OLQ.0b013e3182215615.

DOI:10.1097/OLQ.0b013e3182215615

PMID:21934575

Abstract

BACKGROUND

Sexually transmitted disease (STD) detection and control have traditionally been performed by STD and family planning (FP) clinics. However, the magnitude of their impact (or the lack thereof) has not been examined. We examine the association between having STD and/or FP clinics and county-level STD detection and control in the state of Texas.

METHODS

We used county-level STD (chlamydia, gonorrhea, and primary and secondary syphilis) morbidity data from the National Electronic Telecommunications System for Surveillance for 2000 and 2007. We applied spatial regression techniques to examine the impact of the presence of STD/FP clinic(s) (included as dichotomous variables) on STD detection (i.e., morbidity) and control. We included county-level demographic characteristics as control variables.

RESULTS

Our results indicated that counties with STD or FP clinics were associated with at least 8% (P < 0.05) increase in the transformed chlamydia and gonorrhea rates, 20% (P < 0.01) increase in transformed syphilis rates in 2000, and at least 6% (P < 0.05) increase in transformed gonorrhea and Chlamydia rates in 2007. From 2000 to 2007, the transformed incidence rates of chlamydia declined by 4% (P < 0.10), 8% (P < 0.01) for gonorrhea, and 8% (P < 0.05) for primary and secondary syphilis for the counties that had at least 1 STD or FP clinic.

CONCLUSIONS

The results from this ecological study are associations and do not establish a causal relationship between having an STD/FP clinic and improved STD detection and control. Finer level analyses (such as census block or cities) may be able to provide more detail information.

摘要

背景

性传播疾病（STD）检测和控制传统上是由 STD 和计划生育（FP）诊所进行的。然而，其影响的大小（或缺乏影响）尚未得到检验。我们检查了在德克萨斯州，拥有 STD 和/或 FP 诊所与县一级 STD 检测和控制之间的关联。

方法

我们使用了 2000 年和 2007 年国家电子电信系统监测的县一级 STD（衣原体、淋病、原发性和继发性梅毒）发病率数据。我们应用空间回归技术来检验 STD/FP 诊所（作为二分类变量）的存在对 STD 检测（即发病率）和控制的影响。我们将县一级的人口统计学特征作为控制变量。

结果

我们的结果表明，拥有 STD 或 FP 诊所的县与转化后的衣原体和淋病发病率至少增加 8%（P < 0.05），2000 年转化后的梅毒发病率增加 20%（P < 0.01），以及 2007 年转化后的淋病和衣原体发病率至少增加 6%（P < 0.05）。从 2000 年到 2007 年，衣原体的转化发病率下降了 4%（P < 0.10），淋病下降了 8%（P < 0.01），原发性和继发性梅毒下降了 8%（P < 0.05），对于至少有 1 个 STD 或 FP 诊所的县。