2019年冠状病毒病（COVID-19）大流行期间城市男同性恋、双性恋和其他男男性行为者的性传播感染传播动态
Sexually Transmitted Infection Transmission Dynamics During the Coronavirus Disease 2019 (COVID-19) Pandemic Among Urban Gay, Bisexual, and Other Men Who Have Sex With Men.
作者信息
Schumacher Christina M, Thornton Nicole, Wagner Jessica, Tilchin Carla, Ghanem Khalil G, Hamill Matthew M, Latkin Carl, Rompalo Anne, Ruhs Sebastian, Greenbaum Adena, Jennings Jacky M
机构信息
Center for Child and Community Health Research, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
出版信息
Clin Infect Dis. 2022 Aug 24;75(1):e1137-e1144. doi: 10.1093/cid/ciab1053.
BACKGROUND
The impact of coronavirus disease 2019 (COVID-19) mitigation measures on sexually transmitted infection (STI) transmission and racial disparities remains unknown. Our objectives were to compare sex and drug risk behaviors, access to sexual health services, and STI positivity overall and by race during the COVID-19 pandemic compared with pre-pandemic among urban sexual minority men (MSM).
METHODS
Sexually active MSM aged 18-45 years were administered a behavioral survey and STI testing every 3-months. Participants who completed at least 1 during-pandemic (April 2020-December 2020) and 1 pre-pandemic study visit (before 13 March 2020) that occurred less than 6 months apart were included. Regression models were used to compare during- and pre-pandemic visit outcomes.
RESULTS
Overall, among 231 MSM, reports of more than 3 sex partners declined(pandemic-1: adjusted prevalence ratio 0.68; 95% confidence interval: .54-.86; pandemic-2: 0.65, .51-.84; pandemic-3: 0.57, .43-.75), substance use decreased (pandemic-1: 0.75, .61-.75; pandemic-2: 0.62, .50-.78; pandemic-3: 0.61, .47-.80), and human immunodeficiency virus/preexposure prophylaxis care engagement (pandemic-1: 1.20, 1.07-1.34; pandemic-2: 1.24, 1.11-1.39; pandemic-3: 1.30, 1.16-1.47) increased. STI testing decreased (pandemic-1: 0.68, .57-.81; pandemic-2: 0.78, .67-.92), then rebounded (pandemic-3: 1.01, .87-1.18). Nei-ther Chlamydia (pandemic-2: 1.62, .75-3.46; pandemic-3: 1.13, .24-1.27) nor gonorrhea (pandemic-2: 0.87, .46 1.62; pandemic-3: 0.56, .24-1.27) positivity significantly changed during vs pre-pandemic. Trends were mostly similar among Black vs. non-Black MSM.
CONCLUSIONS
We observed sustained decreases in STI risk behaviors but minimal change in STI positivity during compared with pre-pandemic. Our findings underscore the need for novel STI prevention strategies that can be delivered without in-person interactions.
背景
2019年冠状病毒病（COVID-19）缓解措施对性传播感染（STI）传播及种族差异的影响尚不清楚。我们的目标是比较COVID-19大流行期间与大流行前城市男男性行为者（MSM）的性和药物风险行为、获得性健康服务的情况以及总体和按种族划分的性传播感染阳性率。
方法
对年龄在18 - 45岁的性活跃男男性行为者每3个月进行一次行为调查和性传播感染检测。纳入在大流行期间（2020年4月至2020年12月）至少完成1次且在大流行前（2020年3月13日前）完成1次且间隔时间少于6个月的研究访视的参与者。使用回归模型比较大流行期间和大流行前访视的结果。
结果
总体而言，在231名男男性行为者中，报告有超过3个性伴侣的人数减少（大流行第1阶段：调整患病率比0.68；95%置信区间：0.54 - 0.86；大流行第2阶段：0.65，0.51 - 0.84；大流行第3阶段：0.57，0.43 - 0.75），药物使用减少（大流行第1阶段：0.75，0.61 - 0.75；大流行第2阶段：0.62，0.50 - 0.78；大流行第3阶段：0.61，0.47 - 0.80），且人类免疫缺陷病毒/暴露前预防护理参与度增加（大流行第1阶段：1.20，1.07 - 1.34；大流行第2阶段：1.24，1.11 - 1.39；大流行第3阶段：1.30，1.16 - 1.47）。性传播感染检测减少（大流行第1阶段：0.68，0.57 - 0.81；大流行第2阶段：0.78，0.67 - 0.92），然后反弹（大流行第3阶段：1.01，0.87 - 1.18）。在大流行期间与大流行前相比，衣原体（大流行第2阶段：1.62，0.75 - 3.46；大流行第3阶段：1.13，0.24 - 1.27）和淋病（大流行第2阶段：0.87，0.46 - 1.62；大流行第3阶段：0.56，0.24 - 1.27）阳性率均无显著变化。黑人与非黑人男男性行为者之间的趋势大多相似。
结论
与大流行前相比，我们观察到性传播感染风险行为持续下降，但性传播感染阳性率变化极小。我们的研究结果强调了需要能够在无需面对面互动的情况下实施的新型性传播感染预防策略。
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