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