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实验室视角下的性传播感染中的种族差异。

Laboratory Perspective on Racial Disparities in Sexually Transmitted Infections.

机构信息

Division of Microbiology, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA.

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

出版信息

J Appl Lab Med. 2021 Jan 12;6(1):264-273. doi: 10.1093/jalm/jfaa163.

Abstract

BACKGROUND

Rates of sexually transmitted infections (STI) have risen steadily in recent years, and racial and ethnic minorities have borne the disproportionate burden of STI increases in the United States. Historical inequities and social determinants of health are significant contributors to observed disparities and affect access to diagnostic testing for STI.

CONTENT

Public health systems rely heavily on laboratory medicine professionals for diagnosis and reporting of STI. Therefore, it is imperative that clinicians and laboratory professionals be familiar with issues underlying disparities in STI incidence and barriers to reliable diagnostic testing. In this mini-review, we will summarize contributors to racial/ethnic disparity in STI, highlight current epidemiologic trends for gonorrhea, chlamydia, and syphilis, discuss policy issues that affect laboratory and public health funding, and identify specific analytic challenges for diagnostic laboratories.

SUMMARY

Racial and ethnic disparities in STI in the US are striking and are due to complex interactions of myriad social determinants of health. Budgetary cuts for laboratory and public health services and competition for resources during the COVID-19 pandemic are major challenges. Laboratory professionals must be aware of these underlying issues and work to maximize efforts to ensure equitable access to diagnostic STI testing for all persons, particularly those most disproportionately burdened by STI.

摘要

背景

近年来,性传播感染(STI)的发病率稳步上升,在美国,少数族裔承受着 STI 发病率上升的不成比例的负担。历史上的不平等和健康的社会决定因素是造成观察到的差异的重要因素,并影响到 STI 诊断检测的获得。

内容

公共卫生系统严重依赖实验室医学专业人员进行 STI 的诊断和报告。因此,临床医生和实验室专业人员必须熟悉 STI 发病率差异的潜在问题和可靠诊断检测的障碍。在这个小型综述中,我们将总结导致 STI 种族/民族差异的因素,强调淋病、衣原体和梅毒的当前流行病学趋势,讨论影响实验室和公共卫生资金的政策问题,并确定诊断实验室的具体分析挑战。

总结

美国 STI 的种族和民族差异引人注目,这是由于无数健康社会决定因素的复杂相互作用造成的。实验室和公共卫生服务的预算削减以及 COVID-19 大流行期间资源竞争是主要挑战。实验室专业人员必须了解这些潜在问题,并努力最大限度地确保所有人群,特别是那些受 STI 负担最重的人群,都能公平获得 STI 诊断检测。

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Pandemics' historical role in creating inequality.大流行病在造成不平等方面的历史作用。
Science. 2020 Jun 19;368(6497):1322-1323. doi: 10.1126/science.abc8953.
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Assessing differential impacts of COVID-19 on black communities.评估 COVID-19 对黑人群体的差异化影响。
Ann Epidemiol. 2020 Jul;47:37-44. doi: 10.1016/j.annepidem.2020.05.003. Epub 2020 May 14.

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