Epidemiology, STD, and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
Lancet Infect Dis. 2012 Oct;12(10):765-73. doi: 10.1016/S1473-3099(12)70144-5. Epub 2012 Aug 8.
We assessed prevalences of seven sexually transmitted infections (STIs) in Peru, stratified by risk behaviours, to help to define care and prevention priorities.
In a 2002 household-based survey of the general population, we enrolled randomly selected 18-29-year-old residents of 24 cities with populations greater than 50 000 people. We then surveyed female sex workers (FSWs) in these cities. We gathered data for sexual behaviour; vaginal specimens or urine for nucleic acid amplification tests for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis; and blood for serological tests for syphilis, HIV, and (in subsamples) herpes simplex virus 2 (HSV2) and human T-lymphotropic virus. This study is a registered component of the PREVEN trial, number ISRCTN43722548.
15 261 individuals from the general population and 4485 FSWs agreed to participate in our survey. Overall prevalence of infection with HSV2, weighted for city size, was 13·5% in men, 13·6% in women, and 60·6% in FSWs (all values in FSWs standardised to age composition of women in the general population). The prevalence of C trachomatis infection was 4·2% in men, 6·5% in women, and 16·4% in FSWs; of T vaginalis infection was 0·3% in men, 4·9% in women, and 7·9% in FSWs; and of syphilis was 0·5% in men, 0·4% in women, and 0·8% in FSWs. N gonorrhoeae infection had a prevalence of 0·1% in men and women, and of 1·6% in FSWs. Prevalence of HIV infection was 0·5% in men and FSWs, and 0·1% in women. Four (0·3%) of 1535 specimens were positive for human T-lymphotropic virus 1. In men, 65·0% of infections with HIV, 71·5% of N gonorrhoeae, and 41·4% of HSV2 and 60·9% of cases of syphilis were in the 13·3% who had sex with men or unprotected sex with FSWs in the past year. In women from the general population, 66·7% of infections with HIV and 16·7% of cases of syphilis were accounted for by the 4·4% who had been paid for sex by any of their past three partners.
Defining of high-risk groups could guide targeting of interventions for communicable diseases-including STIs-in the general Peruvian population.
Wellcome Trust-Burroughs Wellcome Fund Infectious Disease Initiative and US National Institutes of Health.
我们评估了秘鲁七种性传播感染（STI）的流行率，按风险行为分层，以帮助确定护理和预防重点。
在 2002 年针对人口的一项基于家庭的调查中，我们随机招募了 24 个人口超过 50000 人的城市的 18-29 岁居民。然后，我们在这些城市中调查了女性性工作者（FSW）。我们收集性行为数据；阴道标本或尿液用于核酸扩增试验检测淋病奈瑟菌、沙眼衣原体和阴道毛滴虫；以及血液用于梅毒、艾滋病毒和（在亚样本中）单纯疱疹病毒 2（HSV2）和人 T 淋巴细胞病毒的血清学检测。本研究是 PREVEN 试验的一个已注册组成部分，编号为 ISRCTN43722548。
来自普通人群的 15261 人和 4485 名 FSW 同意参加我们的调查。经城市规模加权的 HSV2 感染总患病率为男性 13.5%、女性 13.6%、FSW 为 60.6%（FSW 中所有值均按普通人群中女性的年龄构成标准化）。沙眼衣原体感染的患病率为男性 4.2%、女性 6.5%、FSW 为 16.4%；阴道毛滴虫感染的患病率为男性 0.3%、女性 4.9%、FSW 为 7.9%；梅毒的患病率为男性 0.5%、女性 0.4%、FSW 为 0.8%。淋病奈瑟菌感染在男性和女性中的患病率为 0.1%，在 FSW 中的患病率为 1.6%。艾滋病毒感染的患病率为男性和 FSW 为 0.5%，女性为 0.1%。在 1535 份标本中，有 4 份（0.3%）为人类 T 淋巴细胞病毒 1 阳性。在男性中，65.0%的艾滋病毒感染、71.5%的淋病奈瑟菌感染、41.4%的 HSV2 和 60.9%的梅毒感染发生在过去一年中与男性发生性行为或与 FSW 发生无保护性行为的 13.3%的人身上。在普通人群中的女性中，66.7%的艾滋病毒感染和 16.7%的梅毒感染归因于过去三个性伴侣中有 4.4%的人因性交易而获得报酬。
定义高危人群可以指导针对秘鲁普通人群中传染病（包括性传播感染）的干预措施。
惠康信托基金-伯劳斯惠康基金传染病倡议和美国国立卫生研究院。
