The authors are with the Philadelphia Department of Public Health, Philadelphia, PA. At the time of the study, Melinda E. Salmon and Andrew De Los Reyes were also with Centers for Disease Control and Prevention, Atlanta, GA.
Am J Public Health. 2013 Oct;103(10):1874-81. doi: 10.2105/AJPH.2013.301463. Epub 2013 Aug 15.
We estimated the risk of HIV associated with sexually transmitted infection (STI) history during adolescence.
We retrospectively studied a cohort of adolescents (n = 75 273, born in 1985-1993) who participated in the Philadelphia High School STD Screening Program between 2003 and 2010. We matched the cohort to STI and HIV surveillance data sets and death certificates and performed Poisson regression to estimate the association between adolescent STI exposures and subsequent HIV diagnosis.
Compared with individuals reporting no STIs during adolescence, adolescents with STIs had an increased risk for subsequent HIV infection (incidence rate ratio [IRR] for adolescent girls = 2.6; 95% confidence interval [CI] = 1.5, 4.7; IRR for adolescent boys = 2.3; 95% CI = 1.7, 3.1). Risk increased with number of STIs. The risk of subsequent HIV infection was more than 3 times as high among those with multiple gonococcal infections during adolescence as among those with none.
Effective interventions that reduce adolescent STIs are needed to avert future STI and HIV acquisition. Focusing on adolescents with gonococcal infections or multiple STIs might have the greatest impact on future HIV risk.
我们评估了青少年时期性传播感染（STI）史与 HIV 相关的风险。
我们回顾性地研究了一个队列的青少年（n=75273，出生于 1985-1993 年），他们在 2003 年至 2010 年间参加了费城高中 STD 筛查计划。我们将队列与 STI 和 HIV 监测数据集以及死亡证明相匹配，并进行泊松回归以估计青少年 STI 暴露与随后 HIV 诊断之间的关联。
与报告在青少年时期没有 STI 的个体相比，有 STI 的青少年随后感染 HIV 的风险增加（青少年女孩的发病率比[IRR] = 2.6；95%置信区间[CI] = 1.5，4.7；青少年男孩的 IRR = 2.3；95%CI = 1.7，3.1）。风险随着 STI 的数量而增加。在青少年时期有多次淋病感染的人群中，随后感染 HIV 的风险是没有淋病感染的人群的 3 倍以上。
需要有效的干预措施来减少青少年 STI，以避免未来的 STI 和 HIV 感染。针对青少年淋病感染或多种 STI 的干预措施可能对未来的 HIV 风险产生最大影响。
