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.
BACKGROUND: We assessed prevalences of seven sexually transmitted infections (STIs) in Peru, stratified by risk behaviours, to help to define care and prevention priorities. METHODS: 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. FINDINGS: 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. INTERPRETATION: Defining of high-risk groups could guide targeting of interventions for communicable diseases-including STIs-in the general Peruvian population. FUNDING: Wellcome Trust-Burroughs Wellcome Fund Infectious Disease Initiative and US National Institutes of Health.
背景：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。
方法：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。
结果：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。
解释：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。
资金来源：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。
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