Villamagna Angela Holly, Beste Lauren A, Borgerding Joleen, Lowy Elliott, Hauser Ronald G, Ross David, Maier Marissa M
From the Division of Infectious Diseases, Department of Medicine, Oregon Health and Science University, Portland, OR (AHV, MMM); Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA (LAB); General Medicine Service, VA Puget Sound Health Care System, Seattle, WA (LAB, JB, EL); Pathology and Laboratory Medicine Department, VA Connecticut Health Care System, New Haven, CT (RGH); Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT (RGH); Infectious Diseases Section, VA Portland Health Care System, Portland, OR (MMM); Department of Health Services, University of Washington School of Public Health, Seattle, WA (EL); Office of Specialty Care Services, Veterans Health Administration, Washington, DC (DR).
J Addict Med. 2023;17(4):387-393. doi: 10.1097/ADM.0000000000001134. Epub 2023 Jan 12.
Little is known about national patterns of sexually transmitted infection (STI) testing and infections among people with substance use disorders (SUDs).
This study used a national retrospective analysis of people with SUDs receiving healthcare in the Veterans Health Administration in 2019 (N = 485,869). We describe testing rates, test positivity, and case rates for gonorrhea, chlamydia, syphilis, and HIV among individuals with alcohol, opioid, cocaine, and noncocaine stimulant use disorders in a national cohort of Veterans Health Administration patients.
Test and case rates for all STIs were highest among people with noncocaine stimulant use. People with alcohol use disorder had the lowest testing rates but intermediate incidence for all STIs. People with multiple SUDs had higher incidence of all STIs than those with single SUDs. Mental health diagnoses and houselessness were common. The HIV test positivity was 0.14% to 0.36% across SUD groups.
Sexually transmitted infection testing rates between SUD groups were discordant with their respective case rates. High STI rates in people with SUDs suggest a need for more comprehensive testing, particularly for those with noncocaine stimulant use and those with comorbid houselessness or mental health diagnoses.
关于物质使用障碍（SUDs）患者的性传播感染（STI）检测和感染的全国模式知之甚少。
本研究对2019年在退伍军人健康管理局接受医疗保健的SUDs患者进行了全国性回顾性分析（N = 485,869）。我们描述了退伍军人健康管理局患者全国队列中患有酒精、阿片类药物、可卡因和非可卡因兴奋剂使用障碍的个体中淋病、衣原体、梅毒和艾滋病毒的检测率、检测阳性率和病例率。
所有性传播感染的检测率和病例率在非可卡因兴奋剂使用者中最高。酒精使用障碍患者的检测率最低，但所有性传播感染的发病率处于中等水平。患有多种物质使用障碍的患者所有性传播感染的发病率高于患有单一物质使用障碍的患者。心理健康诊断和无家可归情况很常见。各物质使用障碍组的艾滋病毒检测阳性率为0.14%至0.36%。
物质使用障碍组之间的性传播感染检测率与其各自的病例率不一致。物质使用障碍患者的高性传播感染率表明需要进行更全面的检测，特别是对于那些使用非可卡因兴奋剂的患者以及那些合并有无家可归或心理健康诊断的患者。
