Hiransuthikul Akarin, Pattanachaiwit Supanit, Teeratakulpisarn Nipat, Chamnan Parinya, Pathipvanich Panita, Thongpaen Suchart, Pengnonyang Supabhorn, Trachunthong Deondara, Nonenoy Siriporn, Lertpiriyasuwat Cheewanan, Phanuphak Praphan, Phanuphak Nittaya
1 The Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
2 Sunpasithiprasong Hospital, Ubonratchathani, Thailand.
Int J STD AIDS. 2019 Feb;30(2):140-146. doi: 10.1177/0956462418799213. Epub 2018 Oct 9.
We determined subsequent and recurrent sexually transmitted infections (STIs) among men who have sex with men (MSM) and transgender women (TGW) in the Test and Treat cohort. Thai MSM and TGW adults with previously unknown HIV status were enrolled and tested for HIV. Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and syphilis were tested at baseline, month 12, and month 24 to identify subsequent STIs (any STIs diagnosed after baseline) and recurrent STIs (any subsequent STIs diagnosed among those with positive baseline STIs). Among 448 participants, 17.8% were HIV-positive, the prevalence of subsequent STIs and recurrent STIs was 42% (HIV-positive versus HIV-negative: 66.3% versus 36.7%, p < 0.001) and 62.3% (81% versus 52.5%, p < 0.001), respectively. Common subsequent STIs by anatomical site were rectal CT infection (21.7%), rectal NG infection (13.8%), pharyngeal NG infection (13.1%), and syphilis (11.9%). HIV-positive status was associated with both subsequent STIs (adjusted hazard ratio [aHR] 2.38; 95%CI 1.64-3.45, p < 0.001) and recurrent STIs (aHR 1.83; 95%CI 1.16-2.87, p = 0.01). The results show that newly diagnosed HIV-positive MSM and TGW were at increased risk of STIs despite being in the healthcare system. STI educational counseling is necessary to improve STI outcomes among MSM and TGW in both HIV prevention and treatment programs.
我们在“检测与治疗”队列中确定了男男性行为者（MSM）和变性女性（TGW）后续发生及复发性性传播感染（STI）的情况。纳入了泰国此前未知HIV感染状况的成年MSM和TGW，并对其进行HIV检测。在基线、第12个月和第24个月检测沙眼衣原体（CT）、淋病奈瑟菌（NG）和梅毒，以确定后续STI（基线后诊断的任何STI）和复发性STI（基线STI检测呈阳性者中诊断出的任何后续STI）。在448名参与者中，17.8%为HIV阳性，后续STI和复发性STI的患病率分别为42%（HIV阳性与HIV阴性：66.3%对36.7%，p<0.001）和62.3%（81%对52.5%，p<0.001）。按解剖部位划分的常见后续STI为直肠CT感染（21.7%）、直肠NG感染（13.8%）、咽部NG感染（13.1%）和梅毒（11.9%）。HIV阳性状态与后续STI（调整后风险比[aHR]2.38；95%CI 1.64 - 3.45，p<0.001）和复发性STI（aHR 1.83；95%CI 1.16 - 2.87，p = 0.01）均相关。结果表明，新诊断为HIV阳性的MSM和TGW尽管处于医疗保健系统中，但STI风险增加。在HIV预防和治疗项目中，开展STI教育咨询对于改善MSM和TGW的STI结局是必要的。
