From the Department of Epidemiology, Emory University, Atlanta, GA.
Sex Transm Dis. 2019 Jan;46(1):25-30. doi: 10.1097/OLQ.0000000000000896.
Prevention of bacterial sexually transmitted infections (STIs) among men who have sex with men (MSM) requires timely disease detection, but this is complicated by asymptomatic infection. We estimated screening/testing rates by symptomatic status to evaluate adherence to Centers for Disease Control and Prevention STI screening guidelines.
In a cross-sectional study of 2572 US MSM aged 15 to 65 years in 2017 to 2018, we measured the reported number of asymptomatic STI screens in the past 2 years versus tests prompted by disease symptoms. Using negative binominal regression within a hierarchical Bayesian framework, we estimated yearly rates of asymptomatic screening and symptomatic testing by geographic, demographic, and behavioral factors.
Human immunodeficiency virus (HIV) status was most strongly associated with all testing/screening frequency (incidence rate ratio [IRR], 1.72; 95% credible interval [Crl], 1.49, 1.97). The HIV-uninfected MSM had 0.14 (95% credible interval [CrI], 0.12-0.17) symptomatic tests and 0.88 (95% CrI, 0.77-1.01) asymptomatic screens per year. The HIV-infected MSM had 0.25 (95% CrI, 0.18-0.35) symptomatic tests and 1.53 (95% CrI, 1.24-1.88) asymptomatic screens per year. Rates of asymptomatic screening were higher among black compared with white MSM (IRR, 1.41; 95% CrI, 1.15-1.73), but weakly associated with number of past-year sexual partners (IRR, 1.01; 95% CrI, 1.00-1.01). Overall, 85% to 90% of diagnostic events were asymptomatic screens.
Self-reported rates of STI screening were close to Centers for Disease Control and Prevention's recommended overall annual screening frequency, but with gaps defined by demographics and behavioral risk. Targeted screening efforts may be indicated specifically for younger MSM and those with multiple partners.
预防男男性行为者（MSM）中的细菌性性传播感染（STI）需要及时发现疾病，但无症状感染使这变得复杂。我们根据症状状态估计了筛查/检测率，以评估对疾病控制和预防中心 STI 筛查指南的遵循情况。
在 2017 年至 2018 年期间，对 2572 名年龄在 15 至 65 岁之间的美国 MSM 进行了一项横断面研究，我们测量了过去 2 年中无症状 STI 筛查的报告数量与疾病症状提示的检测数量。使用分层贝叶斯框架内的负二项式回归，我们根据地理位置、人口统计学和行为因素估计了无症状筛查和有症状检测的年发生率。
人类免疫缺陷病毒（HIV）状况与所有检测/筛查频率最密切相关（发病率比[IRR]，1.72；95%可信区间[CrI]，1.49，1.97）。未感染 HIV 的 MSM 每年有 0.14 次（95%CrI，0.12-0.17）有症状的检测和 0.88 次（95%CrI，0.77-1.01）无症状筛查。感染 HIV 的 MSM 每年有 0.25 次（95%CrI，0.18-0.35）有症状的检测和 1.53 次（95%CrI，0.12-0.18）无症状筛查。与白人 MSM 相比，黑人 MSM 无症状筛查率更高（IRR，1.41；95%CrI，1.15-1.73），但与过去一年的性伴侣数量关系较弱（IRR，1.01；95%CrI，1.00-1.01）。总体而言，85%至 90%的诊断事件为无症状筛查。
自我报告的 STI 筛查率接近疾病控制和预防中心推荐的总体年度筛查频率，但在人口统计学和行为风险方面存在差距。可能需要针对年轻 MSM 和性伴侣较多的人群进行有针对性的筛查。
