From the Department of Pathology, Johns Hopkins University School of Medicine.
Department of Medicine, Johns Hopkins University School of Medicine.
Sex Transm Dis. 2020 Oct;47(10):672-678. doi: 10.1097/OLQ.0000000000001229.
Several national guidelines consider illicit drug use as an indication for testing and/or counseling for some sexually transmitted infections (STIs). The legal and social landscape of marijuana use is changing, and its relevance with STI risk is unclear.
Sex-specific prevalence of T. vaginalis and/or C. trachomatis infection was examined by past-year marijuana use (no vs yes) among 2958 sexually experienced, 20- to 39-year-old participants of the 2013-2016 National Health and Nutrition Examination Surveys. Prevalence ratios (PRs) with 95% confidence intervals [CIs] were estimated by Poisson regression. Adjusted PRs (aPR) were estimated following propensity score covariate-adjustment accounting for sociodemographics, alcohol use, injection drug use, depression, and age at sexual debut.
Past-year marijuana use was reported by 27.3% and 36.3% of females and males, respectively. Male and female past-year marijuana users were more likely to have new and multiple sexual partners in the past year (P < 0.05). Past-year marijuana use was associated with prevalent C. trachomatis and/or T. vaginalis infection among females (7.4% vs. 2.9%; PR, 2.57 [95% CI, 1.62-4.07]) and males (4.0% vs. 1.1%; PR, 3.59 [95% CI, 1.96-6.58]), but this association was attenuated after propensity score covariate adjustment among females (aPR, 1.15 [95% CI, 0.72-1.83]) and males (aPR, 2.10 [95% CI, 0.88-5.02]). Additional adjustment for new or multiple sexual partners further attenuated the associations (aPRs, 1.02 [95% CI, 0.65-1.51] and 1.91 [95% CI, 0.82-4.47] for females and males, respectively).
Sexually transmitted infection prevalence was higher among persons with a past-year history of marijuana use; however, this association was not significant after accounting for measured confounders. Additional work is needed to characterize STI prevalence by the mode, duration, and frequency of marijuana use.
一些国家的指南认为，非法药物的使用是某些性传播感染（STI）进行检测和/或咨询的指征。大麻使用的法律和社会环境正在发生变化，但其与 STI 风险的相关性尚不清楚。
通过对 2958 名 20-39 岁有性经验的参与者进行的 2013-2016 年全国健康和营养调查，研究了过去一年中女性（无 vs 有）和男性（无 vs 有）中 T. vaginalis 和/或 C. trachomatis 感染的特定性别流行率。使用泊松回归估计了比值比（PR）及其 95%置信区间 [CI]。采用倾向评分协变量调整后，估计了调整后的 PR（aPR），该调整考虑了社会人口统计学、饮酒、注射毒品使用、抑郁和性初潮年龄等因素。
分别有 27.3%和 36.3%的女性和男性报告过去一年使用过大麻。过去一年使用大麻的男性和女性更有可能在过去一年中拥有新的和多个性伴侣（P < 0.05）。过去一年中使用大麻与女性（7.4% vs. 2.9%；PR，2.57 [95% CI，1.62-4.07]）和男性（4.0% vs. 1.1%；PR，3.59 [95% CI，1.96-6.58]）中 C. trachomatis 和/或 T. vaginalis 感染的流行率相关，但在对女性（aPR，1.15 [95% CI，0.72-1.83]）和男性（aPR，2.10 [95% CI，0.88-5.02]）进行倾向评分协变量调整后，这种相关性减弱。进一步调整新的或多个性伴侣，进一步减弱了这些关联（aPR，1.02 [95% CI，0.65-1.51] 和 1.91 [95% CI，0.82-4.47]，分别为女性和男性）。
过去一年有大麻使用史的人感染性传播感染的流行率较高；然而，在考虑到测量的混杂因素后，这种关联并不显著。需要进一步研究大麻使用的方式、持续时间和频率来描述 STI 的流行率。
