Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Sex Transm Infect. 2020 Mar;96(2):121-123. doi: 10.1136/sextrans-2019-054045. Epub 2019 Jul 26.
Within the context of rising rates of reportable STIs in the USA, we used national survey data to examine temporal trends in high-risk factors that indicate need for STI/HIV preventive services among key subpopulations with disproportionate STI rates.
We used data from the 2002 (n=12 571), 2006-2010 (n=22 682) and 2011-2015 (n=20 621) National Survey of Family Growth (NSFG). NSFG is a national probability survey of 15-44 year olds living in US households. We examined STI risk factors among sexually active men who have sex with men (MSM) and Hispanic, non-Hispanic black, 15-19 year old, 20-24 year old, and 25-29 year old women who have sex with men (WSM) and men who have sex with women (MSW). Risk behaviours included: received money or drugs for sex, gave money or drugs for sex, partner who injected drugs, partner who has HIV, non-monogamous partner (WSM, MSW only) and male partner who had sex with other men (WSM only). Endorsement of any of these behaviours was recoded into a composite variable focusing on factors indicating increased STI risk (yes/no). We used chi-squares and logistic regression (calculating predicted marginals to estimate adjusted prevalence ratios (aPRs)) to examine STI risk factors over time among the key subpopulations.
From 2002 to 2011-2015, reported STI risk factors did not change or declined over time among key subpopulations in the USA. In adjusted analyses comparing 2002 to 2011-2015, we identified significant declines among WSM: Hispanics (aPR=0.84 (0.68-1.04), non-Hispanic blacks (aPR=0.69 (0.58-0.82), adolescents (aPR=0.71 (0.55-0.91) and 25-29 year olds (aPR=0.76 (0.58-0.98); among MSW: Hispanics (aPR=0.53 (0.40-0.70), non-Hispanic blacks (aPR=0.74 (0.59-0.94) and adolescents (aPR=0.63 (0.49-0.82); and among MSM (aPR=0.53 (0.34-0.84).
While reported STIs have increased, STI risk factors among key subpopulations were stable or declined. Condom use related to these risk factors, sexual mixing patterns and STI testing should be examined.
在美国报告性传播感染 (STI) 率上升的背景下，我们使用全国性调查数据，在性传播感染/艾滋病毒预防服务需求较高的关键亚人群中，检查表明存在风险的因素的时间趋势。
我们使用了来自 2002 年（n=12571）、2006-2010 年（n=22682）和 2011-2015 年（n=20621）国家家庭成长调查（NSFG）的数据。NSFG 是对居住在美国家庭中的 15-44 岁人群进行的全国性概率调查。我们检查了性活跃的男男性行为者（MSM）和西班牙裔、非西班牙裔黑人、15-19 岁、20-24 岁和 25-29 岁的与男性发生性关系的女性（WSM）和与女性发生性关系的男性（MSW）中的性传播感染风险因素。风险行为包括：为性而获得金钱或毒品，为性而提供金钱或毒品，性伴侣注射毒品，性伴侣患有艾滋病毒，非单一性伴侣（仅适用于 WSM 和 MSW）和与其他男性发生性关系的男性伴侣（仅适用于 WSM）。任何这些行为的认可都被重新编码为一个综合变量，重点关注表明增加性传播感染风险的因素（是/否）。我们使用卡方检验和逻辑回归（计算预测边际来估计调整后的患病率比（aPR）），以检查关键亚人群中随时间变化的性传播感染风险因素。
从 2002 年到 2011-2015 年，美国关键亚人群中的报告性传播感染风险因素没有随时间变化或有所下降。在比较 2002 年和 2011-2015 年的调整分析中，我们发现 WSM 中的显著下降：西班牙裔（aPR=0.84（0.68-1.04）），非西班牙裔黑人（aPR=0.69（0.58-0.82）），青少年（aPR=0.71（0.55-0.91））和 25-29 岁（aPR=0.76（0.58-0.98））；MSW 中的显著下降：西班牙裔（aPR=0.53（0.40-0.70）），非西班牙裔黑人（aPR=0.74（0.59-0.94））和青少年（aPR=0.63（0.49-0.82））；MSM 中的显著下降：aPR=0.53（0.34-0.84）。
尽管报告的性传播感染有所增加，但关键亚人群中的性传播感染风险因素保持稳定或下降。应检查与这些风险因素相关的避孕套使用、性混合模式和性传播感染检测。
