Institute for Collaboration on Health Intervention and Policy (InCHIP), 7712University of Connecticut, Storrs, CT, USA.
Int J STD AIDS. 2022 Jan;33(1):73-80. doi: 10.1177/09564624211046516. Epub 2021 Oct 11.
Undetected sexually transmitted infections (STIs) pose health threats to people living with HIV and when combined with uncontrolled HIV can amplify HIV transmission. The current study screened 174 self-identified men under age 36 living with HIV and receiving antiretroviral therapy (ART) for urethral and rectal incident chlamydia and gonorrhea infections. Participants were also screened for biomarkers indicating alcohol and other drug use, subclinical genital inflammation, and HIV viral load. ART adherence and sexual behaviors were also assessed prospectively over 1 month. Results detected an undiagnosed STI in 32 (18%) individuals. Participants with a previously undetected STI had significantly greater HIV viremia than those who did not have an STI after controlling for several confounding variables. Participants with an undetected STI also engaged in greater condomless anal intercourse with HIV negative and unknown status partners, including partners to whom they had not disclosed their HIV status. These findings show that undetected STI are associated with incomplete ART adherence and unsuppressed HIV, all of which are important for preventing HIV transmission.
未检测到的性传播感染（STIs）对 HIV 感染者的健康构成威胁，并且当与未得到控制的 HIV 合并时，会放大 HIV 的传播。本研究对 174 名年龄在 36 岁以下、自我认定的 HIV 感染者和接受抗逆转录病毒治疗（ART）的男性进行了筛查，以检测尿道和直肠衣原体和淋病感染的新发病例。参与者还接受了用于检测表明酒精和其他药物使用、亚临床生殖器炎症以及 HIV 病毒载量的生物标志物的检测。此外，还对参与者的 ART 依从性和性行为进行了为期 1 个月的前瞻性评估。结果发现，32 名（18%）个体存在未诊断的 STI。在控制了几个混杂变量后，与未感染 STI 的个体相比，先前未检测到 STI 的个体的 HIV 病毒载量明显更高。未检测到 STI 的个体与 HIV 阴性和未知状态的伴侣进行了更多的无保护肛交，包括与他们未透露 HIV 状况的伴侣。这些发现表明，未检测到的 STI 与不完全的 ART 依从性和未被抑制的 HIV 有关，这些都是预防 HIV 传播的重要因素。
