哥伦比亚境内委内瑞拉难民和移民中梅毒的流行情况及感染相关因素：一项横断面生物行为调查的结果
Syphilis prevalence and correlates of infection among Venezuelan refugees and migrants in Colombia: findings of a cross-sectional biobehavioral survey.
作者信息
Stevenson Megan, Guillén José, Ortíz Jennifer, Ramírez Correa Jhon Fredy, Page Kathleen R, Barriga Talero Miguel Ángel, López Jhon Jairo, Fernández-Niño Julián Alfredo, Núñez Ricardo Luque, Spiegel Paul, Wirtz Andrea L
机构信息
Bloomberg School of Public Health, Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins University, Baltimore, MD, USA.
Red Somos, Bogotá, Colombia.
出版信息
Lancet Reg Health Am. 2024 Jan 16;30:100669. doi: 10.1016/j.lana.2023.100669. eCollection 2024 Feb.
BACKGROUND
Population-based estimates of syphilis prevalence are critical to informing public health response. We aimed to measure syphilis prevalence among Venezuelan refugees and migrants in Colombia to inform public health programming.
METHODS
Between July 2021 and February 2022, we surveyed 6221 adult Venezuelan refugees and migrants in four cities in Colombia using respondent-driven sampling (RDS). Participants completed a survey and dual-rapid HIV/treponemal syphilis screening. Confirmatory laboratory-based rapid plasma reagin testing was conducted on whole blood samples. Active syphilis infection was defined as RPR titer ≥ 1:8 and no self-reported syphilis treatment. We used multivariable regression models to identify associations with active syphilis infection among subgroups by gender and history of pregnancy (cisgender men n = 2123, cisgender women n = 4044, transgender/nonbinary people n = 47, pregnant women n = 150).
FINDINGS
Population (RDS-weighted) prevalence of laboratory-confirmed syphilis was 5.1% (95% CI: 4.6-5.6). Syphilis prevalence was 5.8% (weighted) among men; lifetime sexually transmitted infections (STI) diagnosis, same-sex relationships, HIV infection, and partner number were independently associated with syphilis infection. Syphilis prevalence was 4.6% (weighted) in women; correlates of infection included: lifetime STI diagnosis, food insecurity, current engagement in sex work, current pregnancy, any unsafe night in Colombia, irregular migration status, and no healthcare utilization in Colombia. 14.9% (unweighted) of transgender participants had syphilis infection; correlates of infection included partner number and HIV infection. The prevalence of syphilis was 9.0% (weighted) among pregnant women, which was associated with lifetime STI diagnosis.
INTERPRETATION
Syphilis among Venezuelans in Colombia is high. Correlates of infection are distinct among demographic groups, spanning sexual and social vulnerabilities, suggesting tailored public health strategies.
FUNDING
US President's Emergency Plan for AIDS Relief through the U.S. Centers for Disease Control and Prevention.
背景
基于人群的梅毒患病率估计对于指导公共卫生应对措施至关重要。我们旨在测量哥伦比亚境内委内瑞拉难民和移民中的梅毒患病率，以为公共卫生规划提供信息。
方法
2021年7月至2022年2月期间，我们在哥伦比亚的四个城市使用应答者驱动抽样（RDS）方法对6221名成年委内瑞拉难民和移民进行了调查。参与者完成了一项调查以及艾滋病毒/梅毒螺旋体双重快速筛查。对全血样本进行了基于实验室的梅毒快速血浆反应素确证检测。活动性梅毒感染定义为快速血浆反应素滴度≥1:8且无自我报告的梅毒治疗史。我们使用多变量回归模型来确定按性别和妊娠史划分的亚组中与活动性梅毒感染的关联（顺性别男性n = 2123，顺性别女性n = 4044，跨性别/非二元性别者n = 47，孕妇n = 150）。
研究结果
实验室确诊梅毒的人群（RDS加权）患病率为5.1%（95%置信区间：4.6 - 5.6）。男性梅毒患病率为5.8%（加权）；终身性传播感染（STI）诊断、同性关系、艾滋病毒感染和性伴侣数量与梅毒感染独立相关。女性梅毒患病率为4.6%（加权）；感染相关因素包括：终身性传播感染诊断、粮食不安全、当前从事性工作、当前怀孕、在哥伦比亚有任何不安全的夜晚、移民身份不正规以及在哥伦比亚未使用医疗保健服务。14.9%（未加权）的跨性别参与者患有梅毒感染；感染相关因素包括性伴侣数量和艾滋病毒感染。孕妇中梅毒患病率为9.0%（加权），这与终身性传播感染诊断有关。
解读
哥伦比亚境内委内瑞拉人中梅毒感染率很高。不同人口群体的感染相关因素各不相同，涵盖性和社会脆弱性，这表明需要制定针对性的公共卫生策略。
资助
美国总统艾滋病紧急救援计划，通过美国疾病控制与预防中心提供。
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