From the Emory University School of Medicine, Atlanta, Georgia.
Department of Pediatrics, Division of Infectious Diseases, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia.
Pediatr Infect Dis J. 2022 Apr 1;41(4):306-311. doi: 10.1097/INF.0000000000003399.
This study aimed to determine the overall incidence and reinfection rates of sexually transmitted infections (STIs) and the discrepancy between self-reported exposure history and anatomic site positivity of STIs among adolescents and young adults (AYAs) with HIV in Atlanta, GA.
Retrospective chart review was conducted on all patients 13-24 years of age at the Grady Ponce and Family Youth Clinic from January 1, 2009 to December 31, 2018. Data were collected on patient demographics, self-reported sexual history and STI events. First STI incidence and incidence of reinfections were calculated by dividing new cases over corresponding person follow-up time.
A total of 626 sexually active AYAs with HIV were included in analysis. The mean age at first observation was 18.9 (SD: ±2.8) years; 72% were male, 92% were Black and 80% were horizontally infected. The cumulative first STI incidence rate was 45.49 cases per 100 person-years, and the recurrent STI incidence rate was 119.86 cases per 100 person-years. Among all Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) cases, the most common site of infection was the rectum (48.6% and 49.6%, respectively). Disagreement between exposure history and presence of GC or CT infection was statistically significant for nearly all anatomic sites and types of intercourse.
AYAs with HIV in Atlanta have disproportionately high first and recurrent incidence rates of STIs, with many patients not reporting exposure at their site of infection. There is considerable need to increase screening for STIs, including routine extragenital testing for GC and CT, among AYAs with HIV regardless of self-reported exposure history.
本研究旨在确定佐治亚州亚特兰大地区感染艾滋病毒的青少年和年轻成年人（AYA）的性传播感染（STI）的总体发病率和再感染率，以及自我报告的接触史与 STI 的解剖部位阳性之间的差异。
对 2009 年 1 月 1 日至 2018 年 12 月 31 日期间在 Grady Ponce 和家庭青年诊所就诊的所有 13-24 岁的患者进行回顾性病历审查。收集患者的人口统计学资料、自我报告的性史和 STI 事件。通过将新病例除以相应的人员随访时间来计算首次 STI 发病率和再感染发病率。
共有 626 名有性行为的感染艾滋病毒的 AYA 纳入分析。首次观察时的平均年龄为 18.9（标准差：±2.8）岁；72%为男性，92%为黑人，80%为水平感染。累积首次 STI 发病率为 45.49 例/100 人年，复发性 STI 发病率为 119.86 例/100 人年。在所有淋病奈瑟菌（GC）和沙眼衣原体（CT）病例中，感染最常见的部位是直肠（分别为 48.6%和 49.6%）。几乎所有解剖部位和性交类型的暴露史与 GC 或 CT 感染的存在之间均存在统计学显著差异。
亚特兰大的感染艾滋病毒的 AYA 首次和复发性 STI 的发病率极高，许多患者在感染部位没有报告接触史。无论自我报告的接触史如何，都需要增加对感染艾滋病毒的 AYA 的 STI 筛查，包括常规对 GC 和 CT 进行非生殖器检测。
