新加坡国立公共性传播感染诊所中异性恋青少年衣原体、淋病及合并感染的决定因素

Determinants of Chlamydia, Gonorrhea, and Coinfection in Heterosexual Adolescents Attending the National Public Sexually Transmitted Infection Clinic in Singapore.

作者信息

Lim Raymond Boon Tar, Wong Mee Lian, Cook Alex Richard, Brun Cyrille, Chan Roy K W, Sen Priya, Chio Martin

机构信息

From the *Saw Swee Hock School of Public Health, National University of Singapore, Singapore; and †Department of Sexually Transmitted Infections Control, National Skin Centre, Singapore.

出版信息

Sex Transm Dis. 2015 Aug;42(8):450-6. doi: 10.1097/OLQ.0000000000000316.

DOI:10.1097/OLQ.0000000000000316

PMID:26165437

Abstract

BACKGROUND

Amidst recent trends in rising rates of chlamydia and gonorrhea among Singaporean adolescents, there are limited data on risk factors associated with these infections that may inform prevention strategies in this population.

METHODS

A cross-sectional study of chlamydia and gonorrhea positivity was conducted among 1458 sexually active heterosexual adolescents between 14 and 19 years old attending the national public sexually transmitted infection clinic from 2006 to 2013. The association with demographic and behavioral characteristics was assessed by crude prevalence ratio, and negative binomial regression modeling was used to obtain adjusted prevalence ratios (aPRs).

RESULTS

Chlamydia positivity was found in 23.6% of males and 36.6% of females, gonorrhea positivity in 33.1% of males and 15.9% of adolescent girl, and coinfection positivity in 10.2% of males and 10.1% of females. In multivariable analysis, chlamydia was positively associated with being Malay (aPR, 1.6; 95% confidence interval [CI], 1.1-2.1) and inconsistent condom use for vaginal sex (aPR, 6.5; 95% CI = 2.4-17.4) in males and with being Malay (aPR, 1.9; 95% CI = 1.5-2.4), inconsistent condom use for vaginal sex (aPR, 2.0; 95% CI = 1.1-3.9), and number of lifetime partners in females (aPR, 1.1; 95% CI = 1.0-1.1). Gonorrhea was positively associated with being Malay (aPR, 3.2; 95% CI = 2.4-4.4), inconsistent condom use for vaginal sex (aPR, 5.4; 95% CI = 2.1-14.4), and number of lifetime partners (aPR, 1.1; 95% CI = 1.0-1.1) in males and with being Malay (aPR, 3.7; 95% CI = 2.4-5.7) in females. Malays had a higher proportion of sexual risk behaviors compared with the non-Malays.

CONCLUSIONS

Ethnicity and high-risk sexual behaviors are important determinants of chlamydia, gonorrhea, and coinfection for adolescents attending this clinic. Targeted interventions are needed to lower the prevalence of high-risk sexual behaviors for the Malay adolescents in this clinic.

摘要

背景

在新加坡青少年中，衣原体感染和淋病发病率呈上升趋势，然而关于这些感染相关危险因素的数据有限，这些数据可能为该人群的预防策略提供依据。

方法

对2006年至2013年期间在国家公共性传播感染诊所就诊的1458名年龄在14至19岁之间的性活跃异性恋青少年进行了衣原体和淋病阳性情况的横断面研究。通过粗患病率比评估与人口统计学和行为特征的关联，并使用负二项回归模型获得调整后的患病率比（aPRs）。

结果

衣原体阳性在23.6%的男性和36.6%的女性中被发现，淋病阳性在33.1%的男性和15.9%的青春期女孩中被发现，合并感染阳性在10.2%的男性和10.1%的女性中被发现。在多变量分析中，衣原体感染在男性中与马来族（aPR，1.6；95%置信区间[CI]，1.1 - 2.1）以及阴道性交时避孕套使用不规范（aPR，6.5；95% CI = 2.4 - 17.4）呈正相关，在女性中与马来族（aPR，1.9；95% CI = 1.5 - 2.4）、阴道性交时避孕套使用不规范（aPR，2.0；95% CI = 1.1 - 3.9）以及终身性伴侣数量（aPR，1.1；95% CI = 1.0 - 1.1）呈正相关。淋病在男性中与马来族（aPR，3.2；95% CI = 2.4 - 4.4）、阴道性交时避孕套使用不规范（aPR，5.4；95% CI = 2.1 - 14.4）以及终身性伴侣数量（aPR，1.1；95% CI = 1.0 - 1.1）呈正相关，在女性中与马来族（aPR，3.7；95% CI = 2.4 - 5.7）呈正相关。与非马来族相比，马来族有更高比例的性风险行为。