From the Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama.
London School of Hygiene and Tropical Medicine, United Kingdom.
Sex Transm Dis. 2019 Dec;46(12):780-787. doi: 10.1097/OLQ.0000000000001070.
There is scant information on sexually transmitted infection (STI) prevalence and risk factors among Latin American indigenous populations. We investigated STI prevalence and risk factors among adolescents of the Comarca Ngäbe-Buglé indigenous region of Panama.
A population-based cross-sectional study was conducted among school-going adolescents aged 14 to 19 years. Eligible consenting participants self-completed a questionnaire and provided blood and urine samples. Female participants provided additional self-administered genital swabs. Seroprevalences of human immunodeficiency virus (HIV), syphilis, hepatitis B (HBsAg, anti-HBc), and herpes simplex virus type 2 (HSV-2) were determined in all participants; genital Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) by PCR among participants who reported sexual experience or were seropositive for HIV/syphilis/HSV2/HBsAg; high-risk human papillomavirus (HPV) by qualitative DNA assay and bacterial vaginosis (BV) by Gram-stain among female participants. Risk factors were identified by estimating adjusted odds ratios (AOR) using random-effects logistic regression.
We enrolled 700 participants (median age, 17 years [female participants]; 18 years [male participants]) from 20 schools. Sexual experience was reported by 536 participants (76.6%). The HIV/STI prevalences among females and males were: HIV 0.4% and 1.0%, high-titer active syphilis 1.3% and 6.6%, HSV-2 16.1% and 16.1%, HBsAg 1.3% and 1.4%, anti-HBc 3.2% and 1.4%, NG 1.8% and 1.7%, CT 17.5% and 10.7%; among females: BV 42.9% and HPV 33.2%. CT was independently associated with being female (AOR, 2.02; 95% confidence interval [CI], 1.20-3.41); high-titer active syphilis with being male (AOR, 4.51; 95% CI, 1.17-17.40). Bacterial vaginosis was associated with sexual behavior (≥3 lifetime sex partners: AOR, 3.81; 95% CI, 1.29-11.26), HPV with sexual experience (AOR, 4.05; 95% CI, 1.62-10.09).
School-going indigenous adolescents in rural Panama have substantial STI burden. Targeted STI screening is required.
关于性传播感染（STI）在拉丁美洲土著人群中的流行情况和危险因素的信息很少。我们调查了巴拿马 Ngäbe-Buglé 土著地区青少年的 STI 流行情况和危险因素。
对 14 至 19 岁的在校青少年进行了一项基于人群的横断面研究。合格的同意参与者自行完成了一份问卷，并提供了血液和尿液样本。女性参与者还提供了额外的自行采集的生殖器拭子。所有参与者均检测了人类免疫缺陷病毒（HIV）、梅毒、乙型肝炎（HBsAg、抗-HBc）和单纯疱疹病毒 2 型（HSV-2）的血清流行率；报告过性经历或 HIV/梅毒/HSV2/ HBsAg 血清阳性的参与者进行了生殖器沙眼衣原体（CT）和淋病奈瑟菌（NG）的聚合酶链反应（PCR）检测；对女性参与者进行了高危型人乳头瘤病毒（HPV）的定性 DNA 检测和细菌性阴道病（BV）的革兰氏染色。使用随机效应逻辑回归估计调整后的比值比（AOR）确定危险因素。
我们从 20 所学校招募了 700 名参与者（中位数年龄，女性参与者为 17 岁；男性参与者为 18 岁）。536 名参与者报告了性经历（76.6%）。女性和男性的 HIV/性传播感染患病率分别为：HIV 0.4%和 1.0%，高滴度活动性梅毒 1.3%和 6.6%，HSV-2 16.1%和 16.1%，HBsAg 1.3%和 1.4%，抗-HBc 3.2%和 1.4%，NG 1.8%和 1.7%，CT 17.5%和 10.7%；女性中：BV 42.9%和 HPV 33.2%。CT 与女性（AOR，2.02；95%置信区间[CI]，1.20-3.41）独立相关；高滴度活动性梅毒与男性（AOR，4.51；95% CI，1.17-17.40）独立相关。细菌性阴道病与性行为有关（≥3 个性伴侣：AOR，3.81；95% CI，1.29-11.26），HPV 与性经历有关（AOR，4.05；95% CI，1.62-10.09）。
在巴拿马农村地区上学的土著青少年有很大的性传播感染负担。需要进行有针对性的性传播感染筛查。
