淋病奈瑟菌在性工作者和性顾客间传播的动力学：一项数学建模研究。

Dynamics of Neisseria gonorrhoeae transmission among female sex workers and clients: A mathematical modeling study.

机构信息

Department of Mathematics and Statistics, College of Arts and Sciences, Qatar University, Doha, Qatar.

Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.

出版信息

Epidemics. 2024 Sep;48:100785. doi: 10.1016/j.epidem.2024.100785. Epub 2024 Aug 5.

DOI:10.1016/j.epidem.2024.100785

PMID:39106639

Abstract

BACKGROUND

This study aimed to examine the transmission dynamics of Neisseria gonorrhoeae (NG) in heterosexual sex work networks (HSWNs) and the impact of variation in sexual behavior and interventions on NG epidemiology.

METHODS

The study employed an individual-based mathematical model to simulate NG transmission dynamics in sexual networks involving female sex workers (FSWs) and their clients, primarily focusing on the Middle East and North Africa region. A deterministic model was also used to describe NG transmission from clients to their spouses.

RESULTS

NG epidemiology in HSWNs displays two distinct patterns. In the common low-partner-number HSWNs, a significant proportion of NG incidence occurs among FSWs, with NG prevalence 13 times higher among FSWs than clients, and three times higher among clients than their spouses. Interventions substantially reduce incidence. Increasing condom use from 10 % to 50 % lowers NG prevalence among FSWs, clients, and their spouses from 12.2 % to 6.4 %, 1.2 % to 0.5 %, and 0.4 % to 0.2 %, respectively. Increasing symptomatic treatment coverage among FSWs from 0 % to 100 % decreases prevalence from 10.6 % to 4.5 %, 0.8 % to 0.4 %, and 0.3 % to 0.1 %, respectively. Increasing asymptomatic treatment coverage among FSWs from 0 % to 50 % decreases prevalence from 8.2 % to 0.4 %, 0.6 % to 0.1 %, and 0.2 % to 0.0 %, respectively, with very low prevalence when coverage exceeds 50 %. In high-partner-number HSWNs, prevalence among FSWs saturates at a high level, and the vast majority of incidence occurs among clients and their spouses, with a limited impact of incremental increases in interventions.

CONCLUSION

NG epidemiology in HSWNs is typically a "fragile epidemiology" that is responsive to a range of interventions even if the interventions are incremental, partially efficacious, and only applied to FSWs.

摘要

背景

本研究旨在探讨淋病奈瑟菌（NG）在异性性工作者网络（HSWNs）中的传播动态，以及性行为变化和干预措施对 NG 流行病学的影响。

方法

本研究采用基于个体的数学模型来模拟涉及性工作者（FSWs）及其客户的性网络中的 NG 传播动态，主要集中在中东和北非地区。还使用确定性模型来描述从客户到其配偶的 NG 传播。

结果

HSWNs 中的 NG 流行病学呈现出两种截然不同的模式。在常见的低伴侣数 HSWNs 中，很大一部分 NG 发病率发生在 FSWs 中，FSWs 中的 NG 流行率比客户高 13 倍，比客户的配偶高 3 倍。干预措施可显著降低发病率。将 condom 的使用率从 10%提高到 50%，可使 FSWs、客户及其配偶的 NG 流行率分别从 12.2%降至 6.4%、从 1.2%降至 0.5%、从 0.4%降至 0.2%。将 FSWs 的症状治疗覆盖率从 0%提高到 100%，可使流行率分别从 10.6%降至 4.5%、从 0.8%降至 0.4%、从 0.3%降至 0.1%。将 FSWs 的无症状治疗覆盖率从 0%提高到 50%，可使流行率分别从 8.2%降至 0.4%、从 0.6%降至 0.1%、从 0.2%降至 0.0%，当覆盖率超过 50%时，流行率非常低。在高伴侣数 HSWNs 中，FSWs 中的流行率达到饱和高水平，绝大多数发病率发生在客户及其配偶中，干预措施的增量增加影响有限。