男男性行为者中与艾滋病毒感染者相关的高风险性行为与性传播感染的关系。

Association of high-risk sexual behaviours with sexually transmitted infections among men who have sex with men living with HIV.

机构信息

Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy

Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy.

出版信息

Sex Transm Infect. 2023 Mar;99(2):120-123. doi: 10.1136/sextrans-2021-055365. Epub 2022 May 6.

DOI:10.1136/sextrans-2021-055365

PMID:35523576

Abstract

OBJECTIVES

To explore different sexual behaviours as risk factors for STI among men who have sex with men (MSM) living with HIV.

METHODS

This is a cross-sectional study on MSM living with HIV followed at the Infectious Diseases Unit of San Raffaele Hospital, Milan, with at least one diagnosis of gonorrhoea, syphilis, chlamydia or anal human papilloma virus (HPV), between July 2016 and February 2021. We conducted a survey on high-risk sexual behaviours with regard to (1) mean number of partners per month, (2) estimated percentage of condom use and (3) most frequent type of sexual intercourse during 2016-2021. Data on these variables were grouped as follows: (1a) ≤5 vs >5, (1b) >10 vs 10, (2a) 0% vs >0%, (2b) ≤50% vs >50%, (2c) 100% vs <100%, (3a) ≥50% vs <50% receptive, (3b) 100% vs <100% insertive, and (3c) 100% vs <100% receptive. A high-risk group was defined as >5 partners, <100% use of condom and ≥50% receptive intercourse. Univariate logistic regressions were applied to assess the association between sexual behaviours and the risk of each STI.

RESULTS

Out of 1051 MSM with at least one STI diagnosis, 580 (55%) answered the survey. The risk of chlamydia was lower among individuals with ≤5 partners (≤5 partners vs >5 partners: OR=0.43, 95% CI 0.28 to 0.66, p=0.001) and among those using condoms more frequently (≤50% use of condom vs >50% use of condom: OR=1.55, 95% CI 1.06 to 2.27, p=0.025; 100% vs <100%: OR=0.35, 95% CI 0.20 to 0.59, p=0.001). Individuals using condoms more frequently also had lower risk of gonorrhoea (100% use of condom vs <100% use of condom: OR=0.37, 95% CI 0.17 to 0.79, p=0.011). The risks of chlamydia (OR=3.07, 95% CI 1.92 to 4.90, p<0.001) and gonorrhoea (OR=2.05, 95% CI 1.12 to 3.75, p=0.020) were higher among individuals belonging to the high-risk group.

CONCLUSIONS

Chlamydia and gonorrhoea are more likely associated with high-risk sexual behaviours than syphilis and anal HPV among MSM living with HIV.

摘要

目的

探讨男男性行为者（MSM）中不同性行为与性传播感染（STI）的关系。

方法

这是一项对在米兰圣拉斐尔医院传染病科就诊的 HIV 合并 STI 的 MSM 进行的横断面研究。纳入标准为：2016 年 7 月至 2021 年 2 月期间至少有一次淋病、梅毒、衣原体或肛门 HPV 的诊断；有意愿完成调查问卷。我们对高危性行为进行了调查，包括：（1）每月性伴侣人数，（2）估计的 condom 使用比例，（3）2016-2021 年期间最常见的性行为类型。将这些变量分组如下：（1a）≤5 与>5，（1b）>10 与 10，（2a）0% 与>0%，（2b）≤50% 与>50%，（2c）100% 与<100%，（3a）≥50% 与<50%接受，（3b）100% 与<100%插入，（3c）100% 与<100%接受。高危组定义为：>5 个性伴侣、<100% condom 使用和≥50%接受性性行为。采用单因素 logistic 回归分析评估性行为与每种 STI 的风险之间的关系。

结果

在至少有一种 STI 诊断的 1051 名 MSM 中，有 580 名（55%）回答了问卷。每月性伴侣数≤5 的个体发生衣原体感染的风险较低（≤5 与>5：OR=0.43，95%CI 0.28-0.66，p=0.001）， condom 使用频率较高的个体发生淋病和衣原体感染的风险较低（≤50% condom 使用与>50% condom 使用：OR=1.55，95%CI 1.06-2.27，p=0.025；100% condom 使用与<100% condom 使用：OR=0.35，95%CI 0.20-0.59，p=0.001）。 condom 使用频率较高的个体发生淋病的风险也较低（100% condom 使用与<100% condom 使用：OR=0.37，95%CI 0.17-0.79，p=0.011）。在高危组中，个体发生衣原体感染（OR=3.07，95%CI 1.92-4.90，p<0.001）和淋病（OR=2.05，95%CI 1.12-3.75，p=0.020）的风险更高。