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在乌干达西南部农村地区,参与更安全受孕护理的 HIV 感染者男性中的性传播感染流行率。

STI prevalence among men living with HIV engaged in safer conception care in rural, southwestern Uganda.

机构信息

Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, United States of America.

Division of Infectious Diseases and General Internal Medicine, Brigham and Women's Hospital, Boston, MA, United States of America.

出版信息

PLoS One. 2021 Mar 3;16(3):e0246629. doi: 10.1371/journal.pone.0246629. eCollection 2021.


DOI:10.1371/journal.pone.0246629
PMID:33657120
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7928454/
Abstract

HIV care provides an opportunity to integrate comprehensive sexual and reproductive healthcare, including sexually transmitted infection (STI) management. We describe STI prevalence and correlates among men living with HIV (MLWH) accessing safer conception care to conceive a child with an HIV-uninfected partner while minimizing HIV transmission risks. This study reflects an ongoing safer conception program embedded within a regional referral hospital HIV clinic in southwestern Uganda. We enrolled MLWH, planning for pregnancy with an HIV-uninfected partner and accessing safer conception care. Participants completed interviewer-administered questionnaires detailing socio-demographics, gender dynamics, and sexual history. Participants also completed STI laboratory screening for syphilis (immunochromatographic testing confirmed by rapid plasma reagin), and chlamydia, gonorrhea, trichomoniasis, and HIV-RNA via GeneXpert nucleic acid amplification testing. Bivariable associations of STI covariates were assessed using Fisher's exact test. Among the 50 men who completed STI screening, median age was 33 (IQR 31-37) years, 13/50 (26%) had ≥2 sexual partners in the prior three months, and 46/50 (92%) had HIV-RNA <400 copies/mL. Overall, 11/50 (22%) had STIs: 16% active syphilis, 6% chlamydia. All participants initiated STI treatment. STI prevalence was associated with the use of threats/intimidation to coerce partners into sex (27% vs 3%; p = 0.03), although absolute numbers were small. We describe a 22% curable STI prevalence among a priority population at higher risk for transmission to partners and neonates. STI screening and treatment as a part of comprehensive sexual and reproductive healthcare should be integrated into HIV care to maximize the health of men, women, and children.

摘要

HIV 护理提供了一个机会,可以将全面的性健康和生殖健康护理,包括性传播感染(STI)管理整合在一起。我们描述了在乌干达西南部的一家地区转诊医院的 HIV 诊所中,正在进行的一项更安全的受孕计划,该计划旨在帮助 HIV 阳性男性(MLWH)与未感染 HIV 的伴侣怀孕,并最大限度地降低 HIV 传播风险。我们招募了计划与未感染 HIV 的伴侣怀孕并接受更安全的受孕护理的 MLWH。参与者完成了详细描述社会人口统计学、性别动态和性史的访谈问卷。参与者还接受了梅毒(免疫层析检测经快速血浆反应素确证)、衣原体、淋病、滴虫病和 HIV-RNA 的 STI 实验室筛查,采用 GeneXpert 核酸扩增检测。使用 Fisher 精确检验评估 STI 协变量的双变量关联。在完成 STI 筛查的 50 名男性中,中位年龄为 33(IQR 31-37)岁,13/50(26%)在过去三个月内有≥2 个性伴侣,46/50(92%)的 HIV-RNA <400 拷贝/ml。总的来说,11/50(22%)的人患有 STI:16%的人患有活动性梅毒,6%的人患有衣原体感染。所有参与者都开始接受 STI 治疗。STI 的患病率与使用威胁/恐吓强迫伴侣发生性行为有关(27%比 3%;p=0.03),尽管绝对数字较小。我们描述了在更易向伴侣和新生儿传播的高危人群中,22%的可治愈 STI 患病率。应将 STI 筛查和治疗作为全面性健康和生殖健康护理的一部分,纳入 HIV 护理中,以最大限度地提高男性、女性和儿童的健康水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ce6/7928454/20f65c1a6f1c/pone.0246629.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ce6/7928454/20f65c1a6f1c/pone.0246629.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ce6/7928454/20f65c1a6f1c/pone.0246629.g001.jpg

相似文献

[1]
STI prevalence among men living with HIV engaged in safer conception care in rural, southwestern Uganda.

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[2]
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[9]
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引用本文的文献

[1]
Sexually transmitted infection (STI) knowledge and perceptions among people in HIV-sero-different partnerships in rural southwestern Uganda.

PLOS Glob Public Health. 2024-1-30

[2]
Social and individual vulnerability factors associated with syphilis among populations living on islands in the Brazilian Amazon.

BMC Infect Dis. 2024-1-2

[3]
Sexually Transmitted Infection Point-of-Care Testing in Resource-Limited Settings: A Narrative Review Guided by an Implementation Framework.

Sex Transm Dis. 2023-10-1

[4]
Sexual and Relationship Benefits of a Safer Conception Intervention Among Men with HIV Who Seek to Have Children with Serodifferent Partners in Uganda.

AIDS Behav. 2022-6

本文引用的文献

[1]
Sexually Transmitted Infection Prevalence Among Women at Risk for HIV Exposure Initiating Safer Conception Care in Rural, Southwestern Uganda.

Sex Transm Dis. 2020-8

[2]
Measuring sexual relationship power equity among young women and young men South Africa: Implications for gender-transformative programming.

PLoS One. 2019-9-25

[3]
Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016.

Bull World Health Organ. 2019-6-6

[4]
Clients' experiences utilizing a safer conception service for HIV affected individuals: implications for differentiated care service delivery models.

Reprod Health. 2019-5-29

[5]
Prevalence of Active Syphilis Infection and Risk Factors among HIV-Positive MSM in Zhejiang, China in 2015: A Cross-Sectional Study.

Int J Environ Res Public Health. 2019-4-28

[6]
High Incidence of Intended Partner Pregnancy Among Men Living With HIV in Rural Uganda: Implications for Safer Conception Services.

J Acquir Immune Defic Syndr. 2019-8-15

[7]
Implementation of a comprehensive safer conception intervention for HIV-serodiscordant couples in Kenya: uptake, use and effectiveness.

J Int AIDS Soc. 2019-4

[8]
The Intersection of Men's Sexual Violence Perpetration and Sexual Risk Behavior: A Literature Review.

Aggress Violent Behav. 2018

[9]
The patient-centered medical home: a reality for HIV care in Nigeria.

Int J Qual Health Care. 2017-10-1

[10]
Beyond HIV-serodiscordance: Partnership communication dynamics that affect engagement in safer conception care.

PLoS One. 2017-9-7

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