南非患有生殖器溃疡疾病的艾滋病毒阳性男性的人口统计学和行为风险因素：一项横断面研究。

Demographic and behavioural risk factors associated with among South African HIV-positive men with genital ulcer disease: a cross-sectional study.

作者信息

Abdallah Iddrisu, Armstrong-Mensah Elizabeth, Alema-Mensah Ernest, Jones Cheryl

机构信息

ICF International, Brookhaven, Georgia, USA.

School of Public Health, Georgia State University, Atlanta, Georgia, USA.

出版信息

BMJ Open. 2017 Aug 1;7(7):e013486. doi: 10.1136/bmjopen-2016-013486.

DOI:10.1136/bmjopen-2016-013486

PMID:28765124

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5577890/

Abstract

OBJECTIVES

Demographic and risky sexual behaviours may increase the risk for (TV) infection and, thus, enhance HIV transmission to uninfected partners. We assessed the demographic and behavioural risk factors associated with TV among South African HIV-positive men with genital ulcer disease.

METHODS

We conducted a cross-sectional study with data from a randomised controlled trial conducted by the Centers for Disease Control and Prevention and the London School of Hygiene and Tropical Medicine. The data were obtained from three primary healthcare clinics in South Africa. At baseline (n=387), participants reported on demographics, sexual behaviour, history of sexually transmitted infections and clinical ulcers. The outcome TV was measured using real-time multiplex PCR assays and a Rotor-gene 3000 platform from the first and past urine samples of all participants. Logistic regression model estimated ORs and 95% CIs adjusted for demographics, sexual risk behaviours and ulcer conditions.

RESULTS

An estimated 11.4% of TV was detected among the men. The odds of TV infection were significantly associated with high blister counts (OR 4.0, 95% CI 1.6 to 28, p=0.01), ulcer pain (OR 0.4, 95% CI 0.2 to 0.7, p=0.003), number of days with ulcers (OR 0.4, 95% CI 0.2 to 0.8, p=0.006), sought treatment before coming into clinics (OR 0.07, 95% CI 0.002 to 0.7, p=0.005) and being unqualified worker (OR 2.5, 95% CI 0.9 to 6.7 p=0.05). Multivariate analyses revealed that increased days with ulcers (OR 0.1, 95% CI 0.04 to 0.5, p=0.002) and ulcer pain intensity (OR 0.08, 95% CI 0.007 to 1.1, p=0.05) remained significantly associated with decreased odds of TV infection. Men from the Sotho ethnic group were eight times more likely to have TV infection (OR 8.6, 95% CI 1.3 to 55.7, p<0.02) than men from the other ethnic groups.

CONCLUSION

HIV-positive men with severe ulceration should be screened and treated for TV to minimise HIV transmission to uninfected partners.

摘要

目的

人口统计学特征和危险的性行为可能会增加沙眼衣原体（TV）感染风险，进而增加人类免疫缺陷病毒（HIV）传播给未感染伴侣的几率。我们评估了南非患有生殖器溃疡疾病的HIV阳性男性中与沙眼衣原体相关的人口统计学和行为风险因素。

方法

我们进行了一项横断面研究，数据来自美国疾病控制与预防中心和伦敦卫生与热带医学院开展的一项随机对照试验。数据取自南非的三家初级医疗诊所。在基线时（n = 387），参与者报告了人口统计学特征、性行为、性传播感染病史和临床溃疡情况。使用实时多重聚合酶链反应（PCR）检测法和Rotor - gene 3000平台对所有参与者首次及既往尿液样本中的沙眼衣原体进行检测。逻辑回归模型估计了校正人口统计学特征、性风险行为和溃疡状况后的比值比（OR）及95%置信区间（CI）。

结果

在这些男性中，估计有11.4%检测出沙眼衣原体。沙眼衣原体感染几率与水疱数量多（OR 4.0，95% CI 1.6至28，p = 0.01）、溃疡疼痛（OR 0.4，95% CI 0.2至0.7，p = 0.003）、溃疡天数（OR 0.4，95% CI 0.2至0.8，p = 0.006）、在就诊前寻求治疗（OR 0.07，95% CI 0.002至0.7，p = 0.005）以及为不合格工人（OR 2.5，95% CI 0.9至6.7，p = 0.05）显著相关。多变量分析显示，溃疡天数增加（OR 0.1，95% CI 0.04至0.5，p = 0.002）和溃疡疼痛强度（OR 0.08，95% CI 0.007至1.1，p = 0.05）仍与沙眼衣原体感染几率降低显著相关。与其他种族的男性相比，索托族男性感染沙眼衣原体的可能性高出八倍（OR 8.6，95% CI 1.3至55.7，p < 0.02）。