From the Centers for Disease Control and Prevention, Atlanta, GA.
Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA.
Sex Transm Dis. 2024 Aug 1;51(8):534-539. doi: 10.1097/OLQ.0000000000001968. Epub 2024 Mar 14.
Shigellosis is diarrheal disease caused by highly infectious Shigella bacteria. Shigella can spread in multiple ways, including sexual contact. Gay, bisexual, and other men who have sex with men are particularly at risk for shigellosis.
To evaluate the acceptability of 3 Centers for Disease Control and Prevention-developed behavioral recommendations for the prevention of sexually transmitted shigellosis, virtual in-depth interviews were conducted among 26 gay or bisexual men in March to May 2021.
Participants had a median age of 25 years; 65% were non-Hispanic White, 12% were Hispanic White, 12% Asian, 4% Hispanic Black, and 8% multiracial/other. Respondents indicated willingness to engage in certain prevention behaviors (e.g., washing hands, genitals, and anus before and after sex), but were less willing to engage in behaviors that were viewed as outside social norms or difficult to practice (e.g., dental dams for oral-anal contact; latex gloves for fingering or fisting). Respondents thought recommendations may be more feasible if knowledge of shigellosis was greater; however, some perceived that the severity of shigellosis is low and did not warrant the effort of engaging in prevention behaviors.
Educational efforts to increase awareness of shigellosis and other enteric diseases spread through sexual contact are needed and public health practitioners should consider the acceptability of how realistic it is for individuals to engage in certain prevention behaviors. Rather than recommending behaviors that do not have buy-in, it may be more efficacious to focus recommendations on adopting behaviors reported as acceptable to the target audience.
志贺菌病是一种由高度传染性的志贺氏菌引起的腹泻病。志贺氏菌可以通过多种途径传播，包括性接触。男同性恋、双性恋和其他与男性发生性关系的男性特别容易感染志贺菌病。
为了评估美国疾病控制与预防中心制定的 3 项预防性传播志贺菌病的行为建议的可接受性，2021 年 3 月至 5 月期间对 26 名男同性恋或双性恋男性进行了虚拟深入访谈。
参与者的中位年龄为 25 岁；65%是非西班牙裔白人，12%是西班牙裔白人，12%是亚裔，4%是西班牙裔黑人，8%是多种族/其他。受访者表示愿意采取某些预防措施（例如，在性行为前后洗手、生殖器和肛门），但不愿意采取被视为违反社会规范或难以实施的行为（例如，口腔与肛门接触时使用牙隔垫；手指或拳头插入时使用乳胶手套）。受访者认为，如果对志贺菌病的了解更多，建议可能更可行；然而，一些人认为志贺菌病的严重程度较低，不值得努力采取预防措施。
需要开展教育活动，提高对通过性接触传播的志贺菌病和其他肠道疾病的认识，公共卫生从业人员应考虑个人采取某些预防措施的可接受程度。与其推荐没有实际效果的行为，不如将重点放在目标受众认可的行为上，更能提高建议的效果。
