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与接受暴露前预防(PrEP)的男男性行为者(MSM)的性传播感染(STIs)伴侣通知相关的因素:法国 ANRS-IPERGAY 试验的一项横断面亚研究。

Factors associated with partner notification of STIs in men who have sex with men on PrEP in France: a cross-sectional substudy of the ANRS-IPERGAY trial.

机构信息

Aix-Marseille University, INSERM, IRD, SESSTIM, Marseille, France.

ORS PACA, Southeastern Health Regional Observatory, Marseille, France.

出版信息

Sex Transm Infect. 2018 Nov;94(7):490-493. doi: 10.1136/sextrans-2017-053304. Epub 2018 Jan 29.

Abstract

OBJECTIVES

Partner notification (PN) is a useful public health approach to enhance targeted testing of people at high risk of HIV and other STIs, and subsequent linkage to care for those diagnosed. In France, no specific PN guidelines exist and information about current practices is scarce. We used the ANRS-IPERGAY PrEP trial to investigate PN in HIV-negative men who have sex with men (MSM) reporting a bacterial STI.

METHODS

This substudy included 275 participants who completed a specific online PN questionnaire during the open-label extension study of the ANRS-Intervention Préventive de l'Exposition aux Risques avec et pour les Gays (IPERGAY) trial. Variables used as proxies of at-risk practices were defined using data collected at the previous follow-up visit about participants' most recent sexual encounter and preventive behaviours. χ or Fisher's exact test helped select variables eligible for multiple logistic models.

RESULTS

Of the 275 participants, 250 reported at least one previous STI. Among the latter, 172 (68.8%) had informed their partner(s) of their most recent STI. Of these, 138 (80.2%) and 83 (48.3%) had notified their casual and main partners, respectively. Participants were less likely to notify their main partner when their most recent sexual encounter involved unsafe anal sex with a casual partner (adjusted OR (aOR) (95% CI) 0.18 (0.06 to 0.54), P=0.02). Older participants were less likely to inform casual partners (aOR (95% CI) 0.44 (0.21 to 0.94), P=0.03), while those practising chemsex during their most recent sexual encounter were more likely to inform their casual partners (aOR (95% CI) 2.56 (1.07 to 6.09), P=0.03).

CONCLUSION

Unsafe sexual encounters with people other than main partners and street drugs use were two sociobehavioural factors identified, respectively, as a barrier to main PN and a motivator for casual PN, in a sample of high-risk MSM. These results provide an insight into current PN practices regarding STI in France and might inform future decisions about how to define feasible and acceptable PN programmes.

摘要

目的

伴侣通知(PN)是一种有用的公共卫生方法,可增强对艾滋病毒和其他性传播感染高危人群的针对性检测,并随后为诊断出的人群提供治疗。在法国,没有特定的 PN 指南,有关当前实践的信息也很少。我们利用 ANRS-IPERGAY PrEP 试验调查了报告细菌性性传播感染的男男性行为者(MSM)中 HIV 阴性人群的 PN。

方法

这项子研究包括 275 名参与者,他们在 ANRS-Intervention Préventive de l'Exposition aux Risques avec et pour les Gays(IPERGAY)试验的开放标签扩展研究期间完成了特定的在线 PN 调查问卷。使用在前一次随访中收集的关于参与者最近一次性接触和预防行为的数据,定义了作为高风险行为代表的变量。χ 或 Fisher 精确检验有助于选择有资格进行多项逻辑回归模型的变量。

结果

在 275 名参与者中,250 名报告了至少一次以前的性传播感染。在后者中,172 名(68.8%)告知了他们的伴侣(们)最近的性传播感染。其中,138 名(80.2%)和 83 名(48.3%)分别通知了他们的偶然伴侣和主要伴侣。当最近的性接触涉及与偶然伴侣的不安全肛交时,参与者不太可能通知他们的主要伴侣(调整后的比值比(aOR)(95%置信区间)0.18(0.06 至 0.54),P=0.02)。年龄较大的参与者不太可能通知偶然伴侣(aOR(95%CI)0.44(0.21 至 0.94),P=0.03),而在最近的性接触中使用化学性行为的参与者更有可能通知他们的偶然伴侣(aOR(95%CI)2.56(1.07 至 6.09),P=0.03)。

结论

与主要伴侣以外的人进行不安全的性接触和使用街头毒品是确定的两个社会行为因素,分别是主要 PN 的障碍和偶然 PN 的动机,在高危 MSM 样本中。这些结果提供了有关法国性传播感染伴侣通知实践的深入了解,并可能为未来如何定义可行和可接受的 PN 计划提供信息。

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