巴布亚新几内亚男男性行为者和变性女性中衣原体和淋病的高流行率以及性传播感染检测的必要性。
High Prevalence of Chlamydia and Gonorrhea and the Need for Sexually Transmitted Infection Testing Among Men Who Have Sex With Men and Transgender Women in Papua New Guinea.
作者信息
Hakim Avi J, Iwamoto Chelsea, Badman Steven G, Willie Barne, Pekon Simon, Aeno Herick, Neo-Boli Ruthy, Ase Sophie, Weikum Damian, Vallely Andrew J, Kelly-Hanku Angela
机构信息
From the US Centers for Disease Control and Prevention.
Kirby Institute, UNSW Sydney, Sydney, Australia.
出版信息
Sex Transm Dis. 2021 Feb 1;48(2):109-117. doi: 10.1097/OLQ.0000000000001300.
BACKGROUND
Papua New Guinea has among the highest prevalence of sexually transmitted infections in the world but no estimates of Chlamydia trachomatis, Neisseria gonorrhoeae, or hepatitis B virus (HBV) are available among men who have sex with men (MSM) or transgender women (TGW).
METHODS
We conducted respondent-driven sampling surveys among MSM and TGW in Port Moresby, Lae, and Mt Hagen (2016-2017) to characterize the prevalence of these infections. Eligibility criteria were as follows: aged ≥12 years, born male, could speak English or Tok Pisin, and had oral or anal sex with another person born male in the past 6 months. Participants were surveyed face-to-face and offered testing for anorectal and genital chlamydia and gonorrhea, syphilis, HIV, and HBV. All results are respondent-driven sampling weighted.
RESULTS
We enrolled 400 participants in Port Moresby, 352 in Lae, and 111 in Mt Hagen. Chlamydia prevalence rates in the 3 cities regardless of anatomical site were 19.9%, 19.2%, and 24.3%, respectively. Gonorrhea prevalence rates regardless of anatomical site were 10.3%, 9.4%, and 9.6%, respectively. Hepatitis B virus prevalence rates were 11.7%, 13.8%, and 13.6%, respectively. In multivariable analysis, syphilis was associated with having either chlamydia or gonorrhea in Port Moresby (adjusted odds ratio, 4.0; 95% confidence interval, 2.0-7.9) and Lae (adjusted odds ratio, 2.4; 95% confidence interval, 1.2-5.0).
CONCLUSIONS
There is a large unmet need among MSM and TGW in Papua New Guinea for chlamydia and gonorrhea detection and treatment. The high prevalence of HBV reinforces the importance of ensuring introduction and scale-up of HBV treatment and immunization. Urgent efforts are needed to introduce laboratory-based diagnosis for chlamydia and gonorrhea to ensure these populations have access to much needed treatment services.
背景
巴布亚新几内亚是世界上性传播感染患病率最高的国家之一，但男男性行为者（MSM）或变性女性（TGW）中沙眼衣原体、淋病奈瑟菌或乙型肝炎病毒（HBV）的感染率尚无相关估计数据。
方法
我们于2016 - 2017年在莫尔斯比港、莱城和哈根山对男男性行为者和变性女性开展了应答驱动抽样调查，以确定这些感染的患病率。入选标准如下：年龄≥12岁，出生时为男性，会说英语或托克皮辛语，且在过去6个月内与另一名出生时为男性的人有过口交或肛交。对参与者进行面对面调查，并提供肛门直肠和生殖器衣原体、淋病、梅毒、艾滋病毒和乙肝病毒检测。所有结果均为应答驱动抽样加权数据。
结果
我们在莫尔斯比港招募了400名参与者，在莱城招募了352名，在哈根山招募了111名。三个城市无论感染部位的衣原体患病率分别为19.9%、19.2%和24.3%。无论感染部位的淋病患病率分别为10.3%、9.4%和9.6%。乙型肝炎病毒患病率分别为11.7%、13.8%和13.6%。在多变量分析中，梅毒与莫尔斯比港（调整比值比，4.0；95%置信区间，2.0 - 7.9）和莱城（调整比值比，2.4；95%置信区间，1.2 - 5.0）的衣原体或淋病感染相关。
结论
巴布亚新几内亚的男男性行为者和变性女性对衣原体和淋病检测及治疗的需求远未得到满足。乙肝病毒高感染率凸显了确保引入和扩大乙肝治疗及免疫接种的重要性。迫切需要努力引入基于实验室的衣原体和淋病诊断方法，以确保这些人群能够获得急需的治疗服务。
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