From the Center for Child and Community Health Research (CCHR), Department of Pediatrics, Johns Hopkins School of Medicine.
Department of Infectious Disease, Johns Hopkins School of Medicine.
Sex Transm Dis. 2021 Aug 1;48(8S):S32-S39. doi: 10.1097/OLQ.0000000000001452.
In the context of increasing syphilis rates, particularly among Black men who have sex men (MSM), the objectives were to determine the associations between methamphetamine (meth) use and syphilis and HIV positivity, and to identify sex partner meeting venues as potential intervention access points among Black MSM in a mid-Atlantic US city.
This study is an ongoing longitudinal cohort study. Participants were recruited from clinical and nonclinical settings and included sexually active MSM aged 18 to 45 years. The baseline visit included a behavioral survey and testing for syphilis, HIV, gonorrhea, and chlamydia. Logistic regression analyses were used for hypothesis testing.
Among 359 MSM completing baseline, 74.4% (268) Black MSM were included; 31% (84) were aged 24 to 29 years, 43.7% (117) reported unprotected anal intercourse at last sex, and 15.3% (41) reported meth use in the past 3 months. Sixteen percent (43) had syphilis, 46.6% (125) were living with HIV, and 19.0% (51) had gonorrhea and/or chlamydia. Meth use was associated with sexual and drug risk behaviors and HIV, but not syphilis. In adjusted analyses, meth use increased the odds of HIV positivity by 6.43 (95% confidence interval, 2.30-17.98) and syphilis positivity by 2.57 (95% confidence interval, 1.23-5.37). Four online sex partner meeting venues were associated with meth use and HIV, whereas syphilis was associated with one.
Among Black MSM, meth use and syphilis positivity were associated with more than 6-fold and almost 3-fold increased adjusted odds of HIV positivity, respectively. Four specific sex partner meeting venues may be important access points for HIV/sexually transmitted infection and substance use prevention.
在梅毒发病率不断上升的背景下,特别是在性活跃的男男性行为者(MSM)中,黑人男性的发病率尤其高。本研究旨在确定美沙酮(meth)使用与梅毒和 HIV 阳性之间的关联,并确定在马里兰州中部的一个城市中,性活跃的黑人 MSM 可能的性伴侣会面场所,作为干预的切入点。
这是一项正在进行的纵向队列研究。参与者是从临床和非临床环境中招募的,包括年龄在 18 至 45 岁之间的性活跃的 MSM。基线访视包括行为调查和梅毒、HIV、淋病和衣原体检测。采用逻辑回归分析进行假设检验。
在完成基线调查的 359 名 MSM 中,有 74.4%(268 人)为黑人 MSM;31%(84 人)年龄在 24 至 29 岁之间,43.7%(117 人)报告在上一次性行为中未使用安全套,15.3%(41 人)报告在过去 3 个月内使用过美沙酮。16%(43 人)患有梅毒,46.6%(125 人)携带 HIV,19.0%(51 人)患有淋病和/或衣原体。美沙酮使用与性行为和药物风险行为以及 HIV 相关,但与梅毒无关。在调整后的分析中,美沙酮使用使 HIV 阳性的几率增加了 6.43 倍(95%置信区间,2.30-17.98),梅毒阳性的几率增加了 2.57 倍(95%置信区间,1.23-5.37)。四个在线性伴侣会面场所与美沙酮使用和 HIV 相关,而梅毒与一个场所相关。
在黑人 MSM 中,美沙酮使用和梅毒阳性与 HIV 阳性的调整后比值比分别增加了 6 倍和近 3 倍。四个特定的性伴侣会面场所可能是 HIV/性传播感染和药物使用预防的重要切入点。