Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Department of Epidemiology, Emory University, Atlanta, GA.
Ann Epidemiol. 2021 Jun;58:1-6. doi: 10.1016/j.annepidem.2021.02.002. Epub 2021 Feb 14.
Prescription opioid misuse is associated with behaviors which increase bacterial sexually transmitted diseases (STD) risk among men who have sex with men (MSM). Annual syphilis, gonorrhea, and chlamydia screening is recommended for sexually active MSM at anatomical sites of contact, regardless of condom use. We describe the prevalence of self-reported bacterial STD testing and diagnoses in the past 12 months among sexually active MSM who report prescription opioid misuse.
We used data from the 2017 and 2018 American Men's Internet Survey to examine the prevalence of self-reported bacterial STD testing and diagnoses in the past 12 months. We calculated unadjusted prevalence ratios, adjusted prevalence ratios (APR), and 95% confidence intervals (CI) to compare bacterial STD testing prevalence across demographic, clinical, and behavioral factors.
Of 932 sexually active MSM who reported prescription opioid misuse, 433 (46.5%) self-reported bacterial STD testing in the past 12 months. Of those who reported being tested, 131 (30.2%) self-reported ≥ 1 bacterial STD. Approximately 50% of respondents who reported condomless anal sex (CAS), casual sex, or exchange sex reported bacterial STD testing in past 12 months. Factors associated with bacterial STD testing among MSM who misused prescription opioids included visiting a healthcare provider in the past 12 months (APR = 1.70, 95% CI = 1.09-2.67), ever disclosing same-sex behavior to a healthcare provider (APR = 1.78, 95% CI = 1.27-2.50), and CAS in the past 12 months (APR = 1.51, 95% CI = 1.10-2.04).
Prevalence of self-reported bacterial STD testing in this sample was low and one-third of tested MSM reported ≥ 1 bacterial STD in the past 12 months. Innovative approaches to identify MSM who misuse prescription opioids and expand bacterial STD testing in this population are needed.
处方类阿片类药物滥用与性行为有关，这些行为会增加男男性行为者（MSM）中细菌性性传播疾病（STD）的风险。建议对有性行为的活跃 MSM 在接触部位进行年度梅毒、淋病和衣原体筛查，无论是否使用安全套。我们描述了报告处方类阿片类药物滥用的活跃 MSM 中，过去 12 个月内自我报告的细菌性 STD 检测和诊断的流行率。
我们使用 2017 年和 2018 年美国男性互联网调查的数据，检查了过去 12 个月内自我报告的细菌性 STD 检测和诊断的流行率。我们计算了未经调整的流行率比、调整后的流行率比（APR）和 95%置信区间（CI），以比较不同人口统计学、临床和行为因素下的细菌性 STD 检测流行率。
在 932 名报告处方类阿片类药物滥用的活跃 MSM 中，有 433 名（46.5%）在过去 12 个月内自我报告了细菌性 STD 检测。在那些接受过检测的人中，有 131 名（30.2%）自我报告了≥1 种细菌性 STD。大约 50%报告无保护肛交（CAS）、随意性行为或性交易的受访者在过去 12 个月内接受了细菌性 STD 检测。与滥用处方类阿片类药物的 MSM 进行细菌性 STD 检测相关的因素包括在过去 12 个月内就诊于医疗保健提供者（APR=1.70，95%CI=1.09-2.67）、曾向医疗保健提供者披露过同性性行为（APR=1.78，95%CI=1.27-2.50）和过去 12 个月内 CAS（APR=1.51，95%CI=1.10-2.04）。
在这个样本中，自我报告的细菌性 STD 检测的流行率较低，三分之一接受检测的 MSM 在过去 12 个月内报告了≥1 种细菌性 STD。需要创新方法来识别滥用处方类阿片类药物的 MSM，并扩大该人群中的细菌性 STD 检测。
