Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead.
Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead.
Curr Opin Infect Dis. 2021 Feb 1;34(1):56-61. doi: 10.1097/QCO.0000000000000699.
This review considers the potential and demonstrated impacts of SARS-CoV-2 on the sexually transmissible infection (STI)/HIV transmission.
COVID-19 increases the vulnerability of those at highest risk of acquiring STI/HIV. Altered health-seeking behaviour, reductions in STI/HIV clinic capacity, service disruptions and redeployment of human resources to assist COVID-19 control efforts have impacted on STI/HIV control programmes. Reports of reduced STI incidence are emerging, but it is hard to determine whether this is real or due to decreased testing during COVID-19 lockdown periods. Fear of COVID-19 and implemented control measures have altered STI/HIV transmission dynamics. Sexual health services adapted to the pandemic by reducing face-to-face patient encounters in favour of telehealth and mail-based initiatives as well as more stringent triage practice. Many sexual health and HIV treatment services now operate at reduced capacity and experience ongoing service disruptions, which necessarily translates into poorer outcomes for patients and their communities.
In the short-term, COVID-19 related sexual behaviour change is driving STI/HIV transmission downwards. However, the impacts of the global COVID-19 response on sexual health-seeking behaviour and STI/HIV services threaten to drive STI/HIV transmission upwards. Ultimately, the expected rebound in STI/HIV incidence will require an appropriate and timely public health response.
本文综述了 SARS-CoV-2 对性传播感染(STI)/HIV 传播的潜在影响和已证实的影响。
COVID-19 增加了性传播感染/艾滋病病毒感染风险最高人群的脆弱性。就医行为的改变、性传播感染/艾滋病病毒诊所能力的下降、服务中断以及人力资源的重新部署以协助 COVID-19 控制工作,都对性传播感染/艾滋病病毒控制规划产生了影响。有报道称性传播感染的发病率有所下降,但很难确定这是真实的,还是由于 COVID-19 封锁期间检测减少所致。对 COVID-19 的恐惧和实施的控制措施改变了性传播感染/艾滋病病毒的传播动态。性健康服务通过减少面对面的患者接触,转而采用远程医疗和邮件为基础的举措以及更严格的分诊实践,适应了大流行。许多性健康和艾滋病毒治疗服务现在的能力降低,并且持续受到服务中断的影响,这必然会导致患者及其社区的结果恶化。
在短期内,与 COVID-19 相关的性行为改变正在导致性传播感染/艾滋病病毒的传播下降。然而,全球 COVID-19 应对措施对性健康寻求行为和性传播感染/艾滋病病毒服务的影响有可能导致性传播感染/艾滋病病毒的传播上升。最终,性传播感染/艾滋病病毒发病率的预期反弹将需要采取适当和及时的公共卫生应对措施。