墨西哥提华纳男男性行为者和跨性别女性中细菌性性传播感染和 HIV 合并感染的流行情况。
Prevalence of bacterial sexually transmitted infections and coinfection with HIV among men who have sex with men and transgender women in Tijuana, Mexico.
机构信息
Division of Infectious Diseases and Global Public Health, Department of Medicine, 8784University of California, San Diego, CA, USA.
Department of Medicine, Universidad Xochicalco, Tijuana, Baja California, Mexico.
出版信息
Int J STD AIDS. 2021 Jul;32(8):751-757. doi: 10.1177/0956462420987757. Epub 2021 Feb 3.
We estimated the prevalence of syphilis and (CT) and (NG) infections, as well as human immunodeficiency virus (HIV) coinfection among cisgender men who have sex with cisgender men (MSM) and transgender women (TW) in Tijuana, Mexico. MSM and TW ( = 212) recruited via respondent-driven and venue-based sampling for HIV testing underwent sexually transmitted infection (STI) testing and completed interviewer-administered surveys in this study (2017-2018). Treponemal rapid tests were used at the point-of-care with positives undergoing confirmatory testing following the reverse syphilis-testing algorithm. Nucleic acid amplification testing of urine and swabs (rectal and pharyngeal) was used to detect CT/NG at three anatomic sites. Chi-squared tests were used to compare STI prevalence by HIV status. Sexually transmitted infection prevalence was 39.6% overall but higher for newly diagnosed HIV-positive (55.7%; = 88) than HIV-negative (28.2%; = 124) participants (-value < 0.0001). Among newly diagnosed HIV-positive participants, the prevalence of syphilis was 35.2% (31/88), CT infection was 27.3% (24/88; nine urethral; 16 rectal; four pharyngeal), and NG infection was 26.1% (23/88; six urethral; 19 rectal; nine pharyngeal). Among HIV-negative participants, the prevalence of syphilis was 12.1% (15/124), CT infection was 13.7% (17/124; seven urethral; nine rectal; two pharyngeal), and NG infection was 9.7% (12/124; three urethral; seven rectal; seven pharyngeal). Over 60% of all CT (25/41) and NG (26/35) infections in the full sample occurred extragenitally in the absence of urethral infections, and over 80% of rectal (30/37) and pharyngeal (16/18) infections were asymptomatic. The high prevalence of syphilis, CT, and NG infections among MSM and TW in Tijuana suggests STI screening that includes extragenital tests, particularly at HIV diagnosis, may help curb HIV/STI transmission.
我们在墨西哥提华纳估计了与顺性别男性发生性关系的顺性别男性（MSM）和跨性别女性（TW）中的梅毒（CT）和淋病奈瑟菌（NG）感染以及人类免疫缺陷病毒（HIV）合并感染的流行率。MSM 和 TW（=212 人）通过基于应答者的和基于地点的 HIV 检测招募，在这项研究中接受了性传播感染（STI）检测和访谈者管理的调查（2017-2018 年）。在现场使用梅毒快速检测，阳性者根据反向梅毒检测算法进行确认检测。尿液和拭子（直肠和咽部）的核酸扩增检测用于检测三个解剖部位的 CT/NG。卡方检验用于比较 HIV 状态下 STI 的流行率。总体 STI 流行率为 39.6%，但新诊断的 HIV 阳性（55.7%，=88）参与者高于 HIV 阴性（28.2%，=124）参与者（值<0.0001）。在新诊断的 HIV 阳性参与者中，梅毒的流行率为 35.2%（31/88），CT 感染率为 27.3%（24/88；9 例尿道；16 例直肠；4 例咽部），NG 感染率为 26.1%（23/88；6 例尿道；19 例直肠；9 例咽部）。在 HIV 阴性参与者中，梅毒的流行率为 12.1%（15/124），CT 感染率为 13.7%（17/124；7 例尿道；9 例直肠；2 例咽部），NG 感染率为 9.7%（12/124；3 例尿道；7 例直肠；7 例咽部）。在所有样本中，超过 60%的 CT（25/41）和 NG（26/35）感染发生在生殖器外，没有尿道感染，超过 80%的直肠（30/37）和咽部（16/18）感染无症状。在提华纳的 MSM 和 TW 中，梅毒、CT 和 NG 感染的高流行率表明，包括生殖器外检测在内的 STI 筛查，特别是在 HIV 诊断时，可能有助于遏制 HIV/STI 的传播。
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