美国艾滋病毒护理中跨性别女性的生殖器和生殖器外衣原体和淋病的流行情况及相关因素，2005 年至 2016 年。

Prevalence of and Factors Associated With Genital and Extragenital Chlamydia and Gonorrhea Among Transgender Women in HIV Care in the United States, 2005 to 2016.

机构信息

From the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL.

Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA.

出版信息

Sex Transm Dis. 2021 Jun 1;48(6):410-416. doi: 10.1097/OLQ.0000000000001335.

DOI:10.1097/OLQ.0000000000001335

PMID:33229965

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8711312/

Abstract

BACKGROUND

Data on testing rates and prevalence of and factors associated with genital and extragenital chlamydia and gonorrhea among transgender women with HIV in the United States are limited.

METHODS

This retrospective cohort analysis included transgender women living with HIV enrolled in the US Centers for AIDS Research Network of Integrated Clinical Systems cohort between January 2005 and December 2016 with chlamydia or gonorrhea testing performed in HIV clinic. The primary outcome was a positive test result for chlamydia or gonorrhea at urogenital or extragenital (rectal/pharyngeal) sites. Factors associated with infection were examined using logistic regression and generalized estimating equations to account for multiple tests per woman.

RESULTS

Among 312 transgender women in HIV care, 252 (81%) were tested for chlamydia or gonorrhea at least once. Annual testing rates were low: 23% to 53% at genital sites and 24% to 47% at extragenital sites. A total of 88 infections were detected, and 22% of women (55/252) had at least one positive test result. Most infections occurred at extragenital sites (80% of chlamydia and 82% of gonorrhea positive test results). Factors associated with infection in an adjusted model were as follows: age 18 to 29 years compared with ≥50 years (adjusted odds ratio [aOR], 7.6; 95% confidence interval [CI], 1.8-31.2), CD4 count >350 compared with CD4 <200 (aOR, 5.5; 95% CI, 1.2-25.1), and higher engagement in HIV care (aOR, 2.2; 95% CI, 1.0-4.5).

CONCLUSIONS

Among transgender women living with HIV, testing rates for chlamydia and gonorrhea are inadequate, particularly at extragenital sites where most infections occur.

摘要

背景

在美国，有关艾滋病毒感染的跨性别女性的生殖道和非生殖道淋病和衣原体检测率、感染率及相关因素的数据有限。

方法

本回顾性队列分析纳入了 2005 年 1 月至 2016 年 12 月期间参加美国艾滋病研究联合会综合临床系统队列的艾滋病毒感染的跨性别女性，这些女性在艾滋病毒诊所进行了衣原体或淋病检测。主要结局是在泌尿生殖道或非生殖道（直肠/咽部）部位检测到衣原体或淋病阳性。使用逻辑回归和广义估计方程来分析感染的相关因素，以考虑每位女性的多次检测。

结果

在 312 名接受艾滋病毒护理的跨性别女性中，有 252 名（81%）至少接受过一次衣原体或淋病检测。年度检测率较低：生殖道部位为 23%至 53%，非生殖道部位为 24%至 47%。共发现 88 例感染，22%的女性（55/252）至少有一次检测结果阳性。大多数感染发生在非生殖道部位（80%的衣原体和 82%的淋病阳性检测结果）。在调整后的模型中，感染的相关因素如下：年龄 18 至 29 岁与≥50 岁（调整后的优势比 [aOR]，7.6；95%置信区间 [CI]，1.8-31.2），CD4 计数>350 与 CD4<200（aOR，5.5；95% CI，1.2-25.1），以及更高的艾滋病毒护理参与度（aOR，2.2；95% CI，1.0-4.5）。