University of Bern, Institute of Social and Preventive Medicine (ISPM), Switzerland.
University of Bern, Institute of Social and Preventive Medicine (ISPM), Switzerland.
Epidemics. 2018 Sep;24:60-66. doi: 10.1016/j.epidem.2018.03.004. Epub 2018 Mar 31.
Heterosexual partners often differ in age. Integrating realistic patterns of sexual mixing by age into dynamic transmission models has been challenging. The effects of these patterns on the transmission of sexually transmitted infections (STI) including Chlamydia trachomatis (chlamydia), the most common bacterial STI are not well understood. We describe age mixing between new heterosexual partners using age- and sex-specific data about sexual behavior reported by people aged 16-63 years in the 2000 and 2010 British National Surveys of Sexual Attitudes and Lifestyles. We incorporate mixing patterns into a compartmental transmission model fitted to age- and sex-specific, chlamydia positivity from the same surveys, to investigate C. trachomatis transmission. We show that distributions of ages of new sex partners reported by women and by men in Britain are not consistent with each other. After balancing these distributions, new heterosexual partnerships tend to involve men who are older than women (median age difference 2, IQR -1, 5 years). We identified the most likely age combinations of heterosexual partners where incident C. trachomatis infections are generated. The model results show that in >50% of chlamydia transmitting partnerships, at least one partner is ≥25 years old. This study illustrates how sexual behavior data can be used to reconstruct detailed sexual mixing patterns by age, and how these patterns can be integrated into dynamic transmission models. The proposed framework can be extended to study the effects of age-dependent transmission on incidence in any STI.
异性伴侣的年龄往往存在差异。将真实的年龄相关的性混合模式整合到动态传播模型中一直具有挑战性。这些模式对性传播感染（STI）的传播的影响，包括最常见的细菌 STI 衣原体（chlamydia），尚不清楚。我们使用 2000 年和 2010 年英国性态度和生活方式全国调查中报告的 16-63 岁人群的性行为的特定年龄和性别数据，描述了新异性伴侣之间的年龄混合情况。我们将混合模式纳入到一个适用于相同调查中特定年龄和性别的衣原体阳性的部门传播模型中，以研究衣原体的传播。我们发现，英国女性和男性报告的新性伴侣的年龄分布并不一致。在平衡这些分布后，新的异性恋关系往往涉及比女性年龄大的男性（中位数年龄差 2 岁，IQR -1 岁，5 岁）。我们确定了异性恋伴侣中最有可能产生衣原体感染的年龄组合。模型结果表明，在超过 50%的衣原体传播伴侣中，至少有一方年龄≥25 岁。本研究说明了如何使用性行为数据来重建详细的年龄相关的性混合模式，以及如何将这些模式整合到动态传播模型中。该框架可以扩展到研究任何 STI 中年龄相关传播对发病率的影响。
