在西非参加季度艾滋病毒预防和护理方案的男男性接触者中，性传播感染症状的发病率下降（ANRS 12324-法国专家合作项目 CohMSM）。

Decrease in incidence of sexually transmitted infections symptoms in men who have sex with men enrolled in a quarterly HIV prevention and care programme in West Africa (CohMSM ANRS 12324-Expertise France).

机构信息

IRD, Inserm, Univ Montpellier, TransVIHMI, Montpellier, France

ARCAD-Santé Plus, Bamako, Mali.

出版信息

Sex Transm Infect. 2022 Mar;98(2):85-94. doi: 10.1136/sextrans-2020-054755. Epub 2021 Mar 22.

DOI:10.1136/sextrans-2020-054755

PMID:33753460

Abstract

OBJECTIVE

Although men who have sex with men (MSM) are at high risk of STI, their access to tailored healthcare services remains limited in West Africa. We assessed the change in STI symptoms incidence over time among MSM enrolled in a quarterly HIV prevention and care programme in four cities in Burkina Faso, Côte d'Ivoire, Mali and Togo.

METHODS

We performed a prospective cohort study in MSM followed up between 2015 and 2019. Men aged over 18 who reported anal sex with another man within the previous 3 months were offered quarterly syndromic diagnosis and treatment for STI, as well as HIV testing, peer-led counselling and support. Condoms and lubricants were also provided. The change in STI symptoms incidence during follow-up was investigated using a non-parametric trend test and mixed-effect Poisson regression models.

RESULTS

816 participants were followed for a total duration of 1479 person-years. 198 participants (24.3%) had at least one STI symptom during follow-up. Overall, STI symptoms incidence was 20.4 per 100 person-years (95% CI 18.4 to 22.6), ranging from 15.3 in Abidjan to 33.1 in Ouagadougou (adjusted incidence rate ratio (aIRR) 2.39, 95% CI 1.55 to 3.69, p<0.001). STI symptoms incidence was 16.8 and 23.0 per 100 person-years in HIV-positive and HIV-negative participants, respectively (aIRR 0.77, 95% CI 0.57 to 1.04, p=0.087). STI symptoms incidence decreased significantly from 29.9 per 100 person-years in the first 6 months to 8.6 at 30-35 months of follow-up (aIRR per 6-month increase 0.84, 95% CI 0.77 to 0.92, p<0.001).

CONCLUSION

STI symptoms incidence decreased over time but the overall burden of STI appeared to be very high in MSM followed up in West Africa. STI services including counselling, diagnosis and treatment should be reinforced. Laboratory tests that allow accurate diagnosis of STI are required. Strengthening STI services will be critical for controlling the HIV and STI epidemics in this vulnerable population and in the general population.

TRIAL REGISTRATION NUMBER

NCT02626286.

摘要

目的

尽管男男性行为者（MSM）存在较高的性传播感染（STI）风险，但他们获得量身定制的医疗服务的机会仍然有限。我们评估了在布基纳法索、科特迪瓦、马里和多哥的四个城市中参加季度艾滋病毒预防和护理计划的 MSM 中，STI 症状发生率随时间的变化。

方法

我们对 2015 年至 2019 年间随访的 MSM 进行了前瞻性队列研究。报告在过去 3 个月内与另一名男性发生肛交的年龄超过 18 岁的男性，每季度接受 STI 的综合征诊断和治疗，以及艾滋病毒检测、同伴主导的咨询和支持。还提供避孕套和润滑剂。使用非参数趋势检验和混合效应泊松回归模型研究随访期间 STI 症状发生率的变化。

结果

816 名参与者共随访了 1479 人年。198 名参与者（24.3%）在随访期间至少出现过一次 STI 症状。总体而言，STI 症状发生率为 20.4/100 人年（95%CI 18.4 至 22.6），从阿比让的 15.3 至瓦加杜古的 33.1（调整发病率比（aIRR）2.39，95%CI 1.55 至 3.69，p<0.001）。艾滋病毒阳性和艾滋病毒阴性参与者的 STI 症状发生率分别为 16.8 和 23.0/100 人年（aIRR 0.77，95%CI 0.57 至 1.04，p=0.087）。STI 症状发生率从第 1 至第 6 个月的 29.9/100 人年显著下降至 30 至 35 个月随访时的 8.6/100 人年（每 6 个月增加的 aIRR 0.84，95%CI 0.77 至 0.92，p<0.001）。