Pultorak E, Odoyo-June E, Hayombe J, Opiyo F, Odongo W, Ogollah J A, Moses S, Bailey R C, Mehta S D
Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL, USA.
Int J STD AIDS. 2011 Nov;22(11):640-4. doi: 10.1258/ijsa.2011.010483.
To identify factors associated with repeat visits among patients attending a clinic for sexually transmitted infections (STIs) in Kisumu, Kenya, we examined records of clinic visits from March 2009 to May 2010. Multivariable logistic regression identified factors associated with repeat visits occurring >30 days after the initial visit. Among 1473 clients (1296 single-visit individuals versus 177 individuals with repeat visits), the median age was 24 years, 67% were men and 8.6% self-reported being HIV-positive. In adjusted analyses, men with repeat visits were more likely to report ≥ 2 recent sexual partners (adjusted odds ratio [aOR] = 1.60) and being HIV-positive (aOR = 2.35). They were less likely to have been referred from other health facilities (aOR = 0.14) and more likely to have urethral discharge at their initial visit (aOR = 2.46). Among women, repeat visits were associated with vaginal discharge (aOR = 2.22), but attending the clinic with a partner was protective (aOR = 0.38). The association between sexual risk, HIV positivity and repeat visits among male clients highlights the need to focus intervention efforts on this group. For women, attending with a partner may reflect a decreased risk of re-infection if both partners are treated and counselled together.
为了确定肯尼亚基苏木一家性传播感染(STIs)诊所患者再次就诊的相关因素,我们查阅了2009年3月至2010年5月的诊所就诊记录。多变量逻辑回归分析确定了与初次就诊30天以上再次就诊相关的因素。在1473名患者中(1296名单次就诊者与177名再次就诊者),年龄中位数为24岁,67%为男性,8.6%的患者自我报告感染艾滋病毒。在调整分析中,再次就诊的男性更有可能报告近期有≥2个性伴侣(调整后的优势比[aOR]=1.60)以及感染艾滋病毒(aOR=2.35)。他们从其他医疗机构转诊而来的可能性较小(aOR=0.14),初次就诊时出现尿道分泌物的可能性较大(aOR=2.46)。在女性中,再次就诊与阴道分泌物有关(aOR=2.22),但与伴侣一同就诊具有保护作用(aOR=0.38)。男性患者中性风险、艾滋病毒阳性与再次就诊之间的关联凸显了将干预工作重点放在该群体上的必要性。对于女性而言,如果双方伴侣一起接受治疗和咨询,与伴侣一同就诊可能反映出再次感染的风险降低。