中国男男性行为者中性传播感染的差异与风险：一项荟萃分析与数据综合
Disparities and risks of sexually transmissible infections among men who have sex with men in China: a meta-analysis and data synthesis.
作者信息
Chow Eric P F, Tucker Joseph D, Wong Frank Y, Nehl Eric J, Wang Yanjie, Zhuang Xun, Zhang Lei
机构信息
The Kirby Institute, University of New South Wales, Sydney, NSW, Australia ; Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia ; Melbourne Sexual Health Centre, Alfred Hospital, Melbourne, VIC, Australia ; Comprehensive AIDS Research Center, School of Medicine, Tsinghua University, Beijing, China.
University of North Carolina Project-China, Guangzhou, China ; London School of Hygiene and Tropical Medicine, London, United Kingdom.
出版信息
PLoS One. 2014 Feb 24;9(2):e89959. doi: 10.1371/journal.pone.0089959. eCollection 2014.
BACKGROUND
Sexually transmitted infections (STIs), including Hepatitis B and C virus, are emerging public health risks in China, especially among men who have sex with men (MSM). This study aims to assess the magnitude and risks of STIs among Chinese MSM.
METHODS
Chinese and English peer-reviewed articles were searched in five electronic databases from January 2000 to February 2013. Pooled prevalence estimates for each STI infection were calculated using meta-analysis. Infection risks of STIs in MSM, HIV-positive MSM and male sex workers (MSW) were obtained. This review followed the PRISMA guidelines and was registered in PROSPERO.
RESULTS
Eighty-eight articles (11 in English and 77 in Chinese) investigating 35,203 MSM in 28 provinces were included in this review. The prevalence levels of STIs among MSM were 6.3% (95% CI: 3.5-11.0%) for chlamydia, 1.5% (0.7-2.9%) for genital wart, 1.9% (1.3-2.7%) for gonorrhoea, 8.9% (7.8-10.2%) for hepatitis B (HBV), 1.2% (1.0-1.6%) for hepatitis C (HCV), 66.3% (57.4-74.1%) for human papillomavirus (HPV), 10.6% (6.2-17.6%) for herpes simplex virus (HSV-2) and 4.3% (3.2-5.8%) for Ureaplasma urealyticum. HIV-positive MSM have consistently higher odds of all these infections than the broader MSM population. As a subgroup of MSM, MSW were 2.5 (1.4-4.7), 5.7 (2.7-12.3), and 2.2 (1.4-3.7) times more likely to be infected with chlamydia, gonorrhoea and HCV than the broader MSM population, respectively.
CONCLUSION
Prevalence levels of STIs among MSW were significantly higher than the broader MSM population. Co-infection of HIV and STIs were prevalent among Chinese MSM. Integration of HIV and STIs healthcare and surveillance systems is essential in providing effective HIV/STIs preventive measures and treatments.
TRIAL REGISTRATION
PROSPERO NO: CRD42013003721.
背景
包括乙型和丙型肝炎病毒在内的性传播感染在中国正成为日益严重的公共卫生风险，尤其是在男男性行为者（MSM）中。本研究旨在评估中国男男性行为者中性传播感染的流行程度和风险。
方法
在2000年1月至2013年2月期间，对五个电子数据库中经同行评审的中英文文章进行检索。使用荟萃分析计算每种性传播感染的合并患病率估计值。获取男男性行为者、HIV阳性男男性行为者和男性性工作者（MSW）中性传播感染的风险。本综述遵循PRISMA指南，并在PROSPERO中进行了注册。
结果
本综述纳入了88篇文章（11篇英文，77篇中文），这些文章调查了28个省份的35203名男男性行为者。男男性行为者中性传播感染的患病率分别为：衣原体感染6.3%（95%CI：3.5 - 11.0%），尖锐湿疣1.5%（0.7 - 2.9%），淋病1.9%（1.3 - 2.7%），乙型肝炎（HBV）8.9%（7.8 - 10.2%），丙型肝炎（HCV）1.2%（1.0 - 1.6%），人乳头瘤病毒（HPV）66.3%（57.4 - 74.1%），单纯疱疹病毒2型（HSV - 2）10.6%（6.2 - 17.6%），解脲脲原体4.3%（3.2 - 5.8%）。HIV阳性男男性行为者感染所有这些疾病的几率始终高于更广泛的男男性行为者群体。作为男男性行为者的一个亚组，男性性工作者感染衣原体、淋病和丙型肝炎病毒的可能性分别比更广泛的男男性行为者群体高2.5倍（1.4 - 4.7）、5.7倍（2.7 - 12.3）和2.2倍（1.4 - 3.7）。
结论
男性性工作者中性传播感染的患病率显著高于更广泛的男男性行为者群体。HIV与性传播感染的合并感染在中国男男性行为者中很普遍。整合HIV和性传播感染的医疗保健及监测系统对于提供有效的HIV/性传播感染预防措施和治疗至关重要。
试验注册
PROSPERO编号：CRD42013003721。
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