Davis Alissa, Goddard-Eckrich Dawn, Dasgupta Anindita, El-Bassel Nabila
1 HIV Center, Division of Gender, Sexuality, & Health, New York State Psychiatric Institute and Columbia University Medical Center, New York, NY, USA.
2 Social Intervention Group, School of Social Work, Columbia University, New York, NY, USA.
Int J STD AIDS. 2018 Jul;29(8):766-775. doi: 10.1177/0956462418755223. Epub 2018 Feb 22.
The number of women under community supervision in the United States has increased, and this population has a high risk for sexually transmitted infections (STIs). We examined STI prevalence and multiple risk factors among drug-involved women under community supervision in New York City. Data were from a randomized controlled trial testing the efficacy of a behavioral HIV/STI intervention (Women on the Road to Health [WORTH]) among drug-involved women in the community corrections system in New York City from 2009 to 2012. To be eligible for inclusion, women had to be under community supervision within the past 90 days, have used illicit drugs at least once in the past six months, and have unprotected sex at least once in the past 90 days. Participants completed a survey containing items on STI risk factors and were tested for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Multivariable regression was used to examine associations between risk factors and STI diagnosis. Of 333 women tested, 89 (26.7%) tested positive for an STI. Ten (3.0%) were positive for C. trachomatis, 4 (1.2%) for N. gonorrhoeae, and 77 (23.1%) for T. vaginalis. Women with any STI were more likely to be black (AOR: 2.02; 95% CI: 1.08-3.77), homeless in the past 90 days (AOR: 2.07; 95% CI: 1.01-4.26), arrested in the past 90 days (AOR: 1.97; 95% CI: 1.14-3.39), and have a greater number of sexual partners in the past 90 days (AOR: 1.24; 95% CI: 1.08-1.42). Drug-using women under community supervision have a high burden of STIs driven by multiple risk factors. Implementing STI screening, prevention, and treatment programs in community supervision settings could facilitate a reduction in STIs among this population.
在美国，接受社区监管的女性人数有所增加，而且这一人群感染性传播感染（STIs）的风险很高。我们调查了纽约市接受社区监管的涉毒女性中性传播感染的患病率及多种风险因素。数据来自一项随机对照试验，该试验测试了一项行为艾滋病毒/性传播感染干预措施（“健康之路女性”[WORTH]）对2009年至2012年纽约市社区矫正系统中涉毒女性的疗效。符合纳入条件的女性必须在过去90天内接受社区监管，在过去六个月内至少使用过一次非法药物，并且在过去90天内至少有过一次无保护性行为。参与者完成了一项包含性传播感染风险因素项目的调查，并接受了沙眼衣原体、淋病奈瑟菌和阴道毛滴虫检测。采用多变量回归分析来研究风险因素与性传播感染诊断之间的关联。在接受检测的333名女性中，89名（26.7%）性传播感染检测呈阳性。10名（3.0%）沙眼衣原体检测呈阳性，4名（1.2%）淋病奈瑟菌检测呈阳性，77名（23.1%）阴道毛滴虫检测呈阳性。患有任何性传播感染的女性更有可能是黑人（调整后比值比：2.02；95%置信区间：1.08 - 3.77），在过去90天内无家可归（调整后比值比：2.07；95%置信区间：1.01 - 4.26），在过去90天内被捕（调整后比值比：1.97；95%置信区间：1.14 - 3.39），并且在过去90天内有更多性伴侣（调整后比值比：1.24；95%置信区间：1.08 - 1.42）。接受社区监管的涉毒女性由于多种风险因素而承受着很高的性传播感染负担。在社区监管环境中实施性传播感染筛查、预防和治疗项目有助于减少这一人群中的性传播感染。
