Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
Sex Transm Dis. 2018 Aug;45(8):506-510. doi: 10.1097/OLQ.0000000000000800.
Receptive condomless anal sex is a known risk factor for anorectal chlamydia, but it remains unclear whether oroanal sex practices also contribute. We aimed to determine whether oroanal sex ("rimming"), fingering, or the use of saliva as anal lubricant are risk factors for anorectal chlamydia among men who have sex with men (MSM).
This cross-sectional study was conducted at Melbourne Sexual Health Centre from July 2014 to June 2015. Routinely collected computer-assisted self-interview data included demographics, number of sexual partners, and condom use. We added questions on receptive rimming, receptive fingering or penis "dipping," and the use of a partner's saliva as anal lubricant.
A total of 1691 MSM completed the questionnaire and tested for anorectal chlamydia. In univariable analyses, anorectal chlamydia was associated with using a partner's saliva as lubricant (odds ratio [OR] 1.97, 95% confidence interval [CI] 1.26-3.09), receptive rimming (OR 1.59; 95% CI 1.04-2.45), and receptive fingering or dipping (OR 1.90; 95% CI 1.06-3.43). In multivariable analysis, anorectal chlamydia was not associated with these sexual practices, after adjusting for number of sexual partners, HIV status, known contact with chlamydia, and condom use. However, collinearity between sexual practices likely obscured associations with anorectal chlamydia, and further analyses suggested weak associations between these sexual practices and anorectal chlamydia.
The use of a partner's saliva during receptive anal sex practices such as rimming, fingering, or penis dipping were weak risk factor for anorectal chlamydia in MSM. This contrasts with our previously reported findings that the use of saliva as anal lubricant is more strongly associated with anorectal gonorrhea.
接受无保护肛交是肛门直肠衣原体感染的已知风险因素，但目前尚不清楚口交行为是否也有影响。我们旨在确定男男性行为者（MSM）中，口交行为（“舔肛”）、手指插入或使用唾液作为肛门润滑剂是否是肛门直肠衣原体感染的危险因素。
本横断面研究于 2014 年 7 月至 2015 年 6 月在墨尔本性健康中心进行。计算机辅助的自我报告数据包括人口统计学特征、性伴侣数量和避孕套使用情况。我们还增加了关于接受舔肛、接受手指插入或阴茎“蘸取”以及使用伴侣唾液作为肛门润滑剂的问题。
共有 1691 名 MSM 完成了问卷并接受了肛门直肠衣原体检测。单变量分析显示，肛门直肠衣原体感染与使用伴侣唾液作为润滑剂（比值比[OR] 1.97，95%置信区间[CI] 1.26-3.09）、接受舔肛（OR 1.59；95% CI 1.04-2.45）和接受手指插入或阴茎蘸取（OR 1.90；95% CI 1.06-3.43）有关。多变量分析调整了性伴侣数量、HIV 状态、已知衣原体接触和避孕套使用情况后，肛门直肠衣原体感染与这些性行为无关。然而，性行为之间的共线性可能掩盖了与肛门直肠衣原体感染的关联，进一步的分析表明这些性行为与肛门直肠衣原体感染之间存在微弱关联。
在接受舔肛、手指插入或阴茎蘸取等接受性肛交行为中使用伴侣的唾液是 MSM 肛门直肠衣原体感染的一个较弱的危险因素。这与我们之前报告的发现形成对比，即使用唾液作为肛门润滑剂与肛门直肠淋病的关联更强。
