College of Medicine, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA.
Urban Health Plan Inc, Bronx, NY, USA.
AIDS Behav. 2024 Dec;28(12):3984-3993. doi: 10.1007/s10461-024-04480-2. Epub 2024 Sep 6.
Bacterial sexually transmitted infections (BSTIs) are largely preventable, yet their rates remain high across the U.S., particularly among sexual minority men (SMM) living with HIV (LWH). We explored longitudinal factors associated with BSTI acquisition in a national online sample of SMM LWH with recent suboptimal adherence to antiretroviral therapy (ART) or virologic non-suppression, such as spread within sexual networks, drug use in a sexual context (chemsex), and mental health issues. Participants completed online surveys over 12 months as part of an eHealth intervention. Over 12 months, 30% of participants self-reported at least one BSTI, with 28-45% reporting recurrent infections in consecutive surveys. Using generalized estimating equations with a binomial distribution and an exchangeable correlation structure, we found that BSTI accumulation was associated with chemsex, a higher number of anal sex partners, participation in exchange sex, and depressive symptoms. To reduce the burden of BSTIs among SMM LWH, public health initiatives and clinical settings should adopt a comprehensive sexual health approach, addressing chemsex, exchange sex, and associated mental health conditions. Addressing these factors can mitigate BSTI recurrence and improve overall sexual health among SMM LWH.
细菌性性传播感染（BSTI）在很大程度上是可以预防的，但它们在美国的发病率仍然很高，尤其是在感染艾滋病毒（HIV）的性少数群体男性（SMM）中。我们研究了与最近接受抗逆转录病毒治疗（ART）或病毒学抑制不佳的 HIV 阳性性少数群体男性（SMM）中的 BSTI 获得相关的纵向因素，例如性网络内的传播、性背景下的药物使用（化学性行为）和心理健康问题。参与者作为电子健康干预的一部分，在 12 个月内完成了在线调查。在 12 个月内，30%的参与者自我报告至少患有一种 BSTI，28-45%的参与者在连续调查中报告反复感染。使用具有二项分布和可交换相关结构的广义估计方程，我们发现 BSTI 的积累与化学性行为、肛交伴侣数量增加、参与交换性和抑郁症状有关。为了减少 HIV 阳性性少数群体男性中的 BSTI 负担，公共卫生倡议和临床环境应采用综合性性健康方法，解决化学性行为、交换性和相关心理健康问题。解决这些因素可以减少 BSTI 的复发，并改善 HIV 阳性性少数群体男性的整体性健康。
