Varma Rick, Bradley Isabella, Patel Prital, McNulty Anna
From the Sydney Sexual Health Centre, Sydney Eye/Sydney Hospital, Nightingale Wing.
The Kirby Institute.
Sex Transm Dis. 2021 Dec 1;48(12):955-958. doi: 10.1097/OLQ.0000000000001487.
Mycoplasma genitalium (M. genitalium) is a sexually transmitted infection of importance because of the high prevalence rates and antimicrobial resistance (AMR) among men who have sex with men (MSM).
A prospective cross-sectional analysis was carried out on MSM who presented rectally asymptomatic at a central Sydney sexual health clinic or a community site for routine testing. Between March and May 2017, participants were asked to complete a questionnaire before testing. We used multivariable logistic regression to identify factors associated with awareness and concern toward M. genitalium and AMR.
Overall, 692 (92.5%) of 746 (95% confidence interval [CI], 90.7-94.5) MSM had no prior awareness of M. genitalium; 512 (68.6%) of 746 (95% CI, 65.2-72.0) were not concerned or were neutral about the infection; and 234 (31.4%) of 746 (95% CI, 28.0-34.8) were a little, somewhat, or very concerned. High partner numbers (adjusted odds ratio [AOR], 4.2; 95% CI, 2.1-8.2) and inconsistent condom users (AOR, 3.1; 95% CI, 1.2-8.2) and no condoms used (AOR, 3.9; 95% CI, 1.2-12.6) were associated with awareness of the infection. Time since arrival in Australia of more than 10 years (AOR, 1.73; 95% CI, 1.09-2.75), more than 12 months (AOR, 1.91; 95% CI, 1.31-2.79), and recreational drug use (AOR, 1.95; 95% CI, 1.17-3.24) were associated with concern around having M. genitalium. Overall, 61.6% (458/744; 95% CI, 58.2-65.3) MSM reported that they would increase condom use (38.6% agreed and 23.1% strongly agreed) after reading about AMR. Among the remaining 38.4% (286/744), 28.4% indicated a neutral response to increasing their condom use. Relative to MSM born in Australia, Latin American (AOR, 7.3; 95% CI, 2.9-18.4) or Asian MSM (AOR, 2.3; 95% CI, 1.4-3.3), were significantly more likely to increase condom use after reading a statement on AMR.
Knowledge of M. genitalium remains low among MSM. Targeted messages using AMR and treatment difficulties with M. genitalium is unlikely to change behavior for a large proportion of MSM.
生殖支原体（M. genitalium）是一种性传播感染，由于男男性行为者（MSM）中的高流行率和抗菌药物耐药性（AMR），其具有重要意义。
对在悉尼中央性健康诊所或社区场所进行直肠无症状常规检测的男男性行为者进行前瞻性横断面分析。2017年3月至5月期间，参与者在检测前被要求填写一份问卷。我们使用多变量逻辑回归来确定与对生殖支原体和抗菌药物耐药性的知晓及关注相关的因素。
总体而言，746名男男性行为者（95%置信区间[CI]，90.7 - 94.5）中有692名（92.5%）之前对生殖支原体没有认识；746名（95%CI，65.2 - 72.0）中有512名（68.6%）对该感染不关心或持中立态度；746名（95%CI，28.0 - 34.8）中有234名（31.4%）有点、有些或非常关心。性伴侣数量多（调整后的优势比[AOR]，4.2；95%CI，2.1 - 8.2）、不坚持使用避孕套者（AOR，3.1；95%CI，1.2 - 8.2）和不使用避孕套者（AOR，3.9；95%CI，1.2 - 12.6）与对该感染的认识相关。抵达澳大利亚超过10年（AOR，1.73；95%CI，1.09 - 2.75）、超过12个月（AOR，1.91；95%CI，1.31 - 2.79）以及使用消遣性药物（AOR，1.95；95%CI，1.17 - 3.24）与对感染生殖支原体的担忧相关。总体而言，61.6%（458/744；95%CI，58.2 - 65.3）的男男性行为者报告称，在阅读有关抗菌药物耐药性的内容后，他们会增加避孕套的使用（38.6%同意，23.1%强烈同意）。在其余38.4%（286/744）中，28.4%表示对增加避孕套使用持中立态度。相对于在澳大利亚出生的男男性行为者，拉丁美洲男男性行为者（AOR，7.3；95%CI，2.9 - 18.4）或亚洲男男性行为者（AOR，2.3；95%CI，1.4 - 3.3）在阅读有关抗菌药物耐药性的声明后显著更有可能增加避孕套的使用。
男男性行为者对生殖支原体的知晓率仍然较低。使用抗菌药物耐药性以及生殖支原体治疗困难等针对性信息不太可能改变很大一部分男男性行为者的行为。
