Institute for Women's Health, University College London, London, United Kingdom.
PLoS One. 2012;7(8):e43576. doi: 10.1371/journal.pone.0043576. Epub 2012 Aug 27.
Our objective was to estimate for the first time the prevalence and determinants of human immunodeficiency virus type 1 (HIV-1) and sexually transmitted infections (STIs) among male migrants in India.
METHODOLOGY/PRINCIPAL FINDINGS: We conducted a multi-stage stratified probability sample survey of migrant (defined as not born in Surat city) men aged 18 to 49 years working in the diamond and textile industries in Surat city. Behavioural and biological data were collected. Biological data included laboratory diagnosed herpes simplex virus type 2 (HSV-2), syphilis, chlamydia, gonorrhoea, Trichomonas vaginalis (together defined as 'any STI') and HIV-1. Likely recently acquired STIs included chlamydia, gonorrhoea, T. vaginalis and syphilis with rapid plasma reagin ≥1:8. The response rate was 77% (845/1099). Among 841 participants, HIV-1 prevalence was 1.0%, 'any STI' prevalence was 9.5% and 38.9% of these STIs were likely to have been recently acquired. Being a diamond worker, Surat resident for 10+ years and recent antibiotic use were each associated with higher odds of 'any STI' (aORs 1.83 (95% CI 1.09-3.09), 1.98 (95% CI 1.22-3.22) and 2.57 (95% CI 1 .17-5.64), respectively) after adjusting for the other two factors and age. The main study limitation was social desirability bias for self-reported sexual behaviour; STIs were diagnosed in some self-reported virgins.
CONCLUSIONS/SIGNIFICANCE: HIV and STI prevalence were lower than expected, but prevention interventions remain necessary in Surat since almost 40% of STIs among participants were probably recently acquired and sentinel surveillance HIV prevalence remains high. The participants had a similar HIV prevalence to Surat antenatal clinic attendees, a proxy for the general population. This suggests migrants are not always at higher risk of HIV compared to the general population in their migration destination. Our findings highlight the need to contextualise research findings from a specific setting with other local information to guide HIV/STI prevention interventions.
我们的目标是首次评估印度男性移民中人类免疫缺陷病毒 1 型（HIV-1）和性传播感染（STIs）的流行率和决定因素。
方法/主要发现：我们对在苏拉特市从事钻石和纺织行业的 18 至 49 岁移民（定义为非苏拉特市出生）男性进行了多阶段分层概率抽样调查。收集了行为和生物学数据。生物学数据包括实验室诊断的单纯疱疹病毒 2 型（HSV-2）、梅毒、衣原体、淋病、阴道毛滴虫（统称为“任何 STI”）和 HIV-1。最近可能感染的 STIs 包括衣原体、淋病、阴道毛滴虫和梅毒，快速血浆反应素≥1:8。应答率为 77%（845/1099）。在 841 名参与者中，HIV-1 流行率为 1.0%，“任何 STI”流行率为 9.5%，其中 38.9%的 STIs 可能是最近感染的。作为钻石工人、在苏拉特居住 10 年以上和最近使用抗生素与“任何 STI”的更高几率相关（调整其他两个因素和年龄后，比值比分别为 1.83（95%置信区间 1.09-3.09）、1.98（95%置信区间 1.22-3.22）和 2.57（95%置信区间 1.17-5.64））。主要研究局限性是自我报告性行为的社会期望偏差；一些自我报告的处男也被诊断出患有 STIs。
结论/意义：HIV 和 STI 的流行率低于预期，但由于参与者中近 40%的 STIs 可能是最近感染的，哨点监测 HIV 流行率仍然很高，因此苏拉特仍需要开展预防干预措施。参与者的 HIV 流行率与苏拉特产前诊所就诊者相似，后者是一般人群的代表。这表明移民在移民目的地与一般人群相比并不总是面临更高的 HIV 风险。我们的研究结果强调需要根据具体情况将特定环境中的研究结果与其他当地信息相结合，以指导 HIV/STI 预防干预措施。
