Rutgers School of Nursing, Newark, New Jersey, USA.
AIDS Patient Care STDS. 2022 Nov;36(S2):92-103. doi: 10.1089/apc.2022.0131.
In response to rising rates of bacterial sexually transmitted infections (STIs) in the United States, this evaluative study of the implementation of four evidence-based interventions was developed and implemented. In three STI and HIV high-incidence jurisdictions of the United States, nine federally funded Health Resources and Services Administration Ryan White HIV/AIDS Program clinical demonstration sites implemented (1) audio computer-assisted self-interview sexual history taking, (2) patient self-collection of urogenital and extragenital site chlamydia/gonorrhea nucleic acid amplification test specimens, (3) sexual and gender minority welcoming indicators, and (4) provider training, to make STI screening, testing, and treatment routine in their HIV primary care clinics. The priority populations of young adults, men who have sex with men, and sexual and gender minority patients were found to have risk behaviors identified in the self-interview sexual history, to prefer to self-collect urogenital and extragenital site specimens for STI testing, and to notice and like the sexual and gender minority welcoming indicators. Testing positive for a bacterial STI was significantly associated with using alcohol or recreational drugs before sex, being younger than 50 years, and having two or more sexual partners with other concurrent sexual partners. Of 255 cases of chlamydia, gonorrhea, and syphilis infections, only 13.73% of patients reported related symptoms when screened and tested.
针对美国细菌性性传播感染 (STI) 发病率上升的情况,本研究对四项基于证据的干预措施的实施情况进行了评估。在美国三个 STI 和 HIV 高发地区,九个由联邦资助的健康资源和服务管理局 Ryan White HIV/AIDS 计划临床示范站点实施了 (1) 音频计算机辅助自我访谈性病史采集、(2) 患者自行采集泌尿生殖道和外生殖道部位衣原体/淋病核酸扩增检测样本、(3) 性和性别少数群体欢迎指标、以及 (4) 提供者培训,以使 STI 筛查、检测和治疗成为其 HIV 初级保健诊所的常规服务。研究发现,优先人群中的年轻人、男男性行为者和性与性别少数群体患者在自我访谈性病史中存在风险行为,他们更喜欢自行采集泌尿生殖道和外生殖道样本进行 STI 检测,并且注意到并喜欢性与性别少数群体欢迎指标。检测出细菌性 STI 与性行为前饮酒或使用娱乐性药物、年龄小于 50 岁以及有两个或更多同时伴有其他性伴侣的性伴侣显著相关。在 255 例衣原体、淋病和梅毒感染病例中,只有 13.73%的患者在筛查和检测时报告有相关症状。