Tran Julien, Fairley Christopher K, Bowesman Henry, Aung Ei T, Ong Jason J, Chow Eric P F
Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia.
Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
Front Med (Lausanne). 2022 Sep 20;9:952476. doi: 10.3389/fmed.2022.952476. eCollection 2022.
We assessed nonconventional interventions that did not traditionally focus on increasing condom use and/or testing among men who have sex with men (MSM) and the evidence for these interventions.
Guided by the Participants, Concept and Context (PCC) framework, we searched five online databases from inception to 9 August 2021 for original research on interventions that do not focus on increasing condom use and/or testing to prevent gonorrhea and/or syphilis in MSM. Two researchers screened titles and abstracts to assess eligibility, reviewed articles' full text and resolved discrepancies through discussion. We charted relevant study information, and the included studies were critically appraised.
Of 373 articles retrieved, 13 studies were included. These studies were conducted in Australia ( = 3), Belgium ( = 2), China ( = 3), the Netherlands ( = 1) and the US ( = 4). Two randomized controlled trials (RCTs) of doxycycline as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) reduced any STI incidence (gonorrhea, syphilis, or chlamydia), but only doxycycline PEP significantly reduced syphilis incidence. Six studies of interventions that facilitated self-collection, self-examination, and self-testing, found varied evidence for gonorrhea and/or syphilis prevention. Four RCTs and one single-arm trial examined the efficacy of mouthwash, but the evidence remains inconclusive on whether mouthwash use can prevent transmission between men.
We found evidence for doxycycline PEP in reducing syphilis incidence, evidence on the use of mouthwash to prevent gonorrhea transmission between men remains inconclusive. More evidence is needed for interventions that do not focus on increasing condom use and/or testing to prevent gonorrhea and/or syphilis.
我们评估了非传统干预措施，这些措施传统上并不侧重于增加男男性行为者（MSM）的避孕套使用和/或检测，并评估了这些干预措施的证据。
在参与者、概念和背景（PCC）框架的指导下，我们检索了五个在线数据库，从数据库创建至2021年8月9日，以查找关于不侧重于增加避孕套使用和/或检测以预防MSM淋病和/或梅毒的干预措施的原始研究。两名研究人员筛选标题和摘要以评估 eligibility，审查文章全文并通过讨论解决差异。我们绘制了相关研究信息，并对纳入的研究进行了严格评估。
在检索到的373篇文章中，纳入了13项研究。这些研究在澳大利亚（=3）、比利时（=2）、中国（=3）、荷兰（=1）和美国（=4）进行。两项多西环素作为暴露前预防（PrEP）和暴露后预防（PEP）的随机对照试验（RCT）降低了任何性传播感染（淋病、梅毒或衣原体）的发病率，但只有多西环素PEP显著降低了梅毒发病率。六项关于促进自我采集、自我检查和自我检测的干预措施的研究，发现了预防淋病和/或梅毒的不同证据。四项RCT和一项单臂试验研究了漱口水的疗效，但关于使用漱口水是否可以预防男性之间传播的证据仍然不确定。
我们发现多西环素PEP在降低梅毒发病率方面有证据，关于使用漱口水预防男性之间淋病传播的证据仍然不确定。对于不侧重于增加避孕套使用和/或检测以预防淋病和/或梅毒的干预措施，需要更多证据。
