Université de Ouahigouya, Ouahigouya, Burkina Faso
Association African Solidarité, Ouagadougou, Burkina Faso.
Sex Transm Infect. 2024 May 31;100(4):201-207. doi: 10.1136/sextrans-2023-056000.
Although oral pre-exposure prophylaxis (PrEP) for HIV is being rolled out in West Africa, data on sexually transmitted infections (STIs) in PrEP users are scarce. We assessed the prevalence, incidence and determinants of bacterial STIs in men who have sex with men (MSM) taking PrEP in Burkina Faso, Côte d'Ivoire, Mali and Togo.
A prospective cohort study among MSM initiating PrEP as part of a comprehensive HIV prevention package was conducted between 2017 and 2021 in community-based clinics in the four study countries. Molecular screening for (CT) and (NG) was performed at months 0, 6 and 12. Serological testing for syphilis was performed every 3 months over the first year of follow-up. Determinants of CT and/or NG incidence were identified using Poisson generalised linear mixed models.
A total of 598 participants with a median age of 24.7 years were included. Prevalence of CT and/or NG was 24.4% (95% CI 21.0 to 28.1), 22.4% (95% CI 18.4 to 26.8) and 29.0% (95% CI 24.2 to 34.1) at months 0, 6 and 12, respectively. The prevalence of syphilis ranged from 0.2% (95% CI 0.0 to 0.9) at month 0 to 0.8% (95% CI 0.2 to 2.4) at month 12. Ninety incident CT and/or NG infections occurred during a total follow-up time of 280.6 person-years (incidence rate 32.1 per 100 person-years, 95% CI 25.8 to 39.4). Three incident syphilis infections were detected during a total follow-up time of 459.7 person-years (incidence rate 0.7 per 100 person-years, 95% CI 0.1 to 1.9). CT and/or NG incidence was associated with condomless insertive anal sex (adjusted incidence rate ratio 1.96, 95% CI 1.04 to 3.71, p=0.038).
CT and NG were frequent but syphilis was very infrequent in MSM using HIV PrEP in West Africa. HIV programme managers should integrate STI services into PrEP programmes.
尽管在西非已推出针对艾滋病毒的口服暴露前预防（PrEP）措施，但有关 PrEP 使用者性传播感染（STI）的数据却十分匮乏。本研究评估了在布基纳法索、科特迪瓦、马里和多哥，接受 PrEP 作为综合艾滋病毒预防一揽子计划一部分的男男性行为者（MSM）中，细菌性 STI 的流行率、发病率及其决定因素。
2017 年至 2021 年期间，在四个研究国家的社区诊所中，开展了一项针对开始接受 PrEP 的 MSM 的前瞻性队列研究。在第 0、6 和 12 个月时，进行了针对 （CT） 和 （NG） 的分子筛查。在随访的第一年中，每 3 个月进行一次梅毒血清学检测。使用泊松广义线性混合模型确定 CT 和/或 NG 发病率的决定因素。
共纳入 598 名中位年龄为 24.7 岁的参与者。在第 0、6 和 12 个月时，CT 和/或 NG 的流行率分别为 24.4%（95%CI 21.0 至 28.1）、22.4%（95%CI 18.4 至 26.8）和 29.0%（95%CI 24.2 至 34.1）。梅毒的流行率从第 0 个月的 0.2%（95%CI 0.0 至 0.9）到第 12 个月的 0.8%（95%CI 0.2 至 2.4）不等。在 280.6 人年的总随访期间，共发生 90 例 CT 和/或 NG 感染（发病率为 32.1/100 人年，95%CI 25.8 至 39.4）。在 459.7 人年的总随访期间，共检出 3 例梅毒感染（发病率为 0.7/100 人年，95%CI 0.1 至 1.9）。CT 和/或 NG 发病率与无保护的插入性肛交行为相关（调整后的发病率比 1.96，95%CI 1.04 至 3.71，p=0.038）。
在西非使用艾滋病毒 PrEP 的 MSM 中，CT 和 NG 较为常见，但梅毒却极为罕见。艾滋病毒规划管理人员应将性传播感染服务纳入 PrEP 计划。
