Teker Buhari, Schim van der Loeff Maarten F, Boyd Anders, Hoornenborg Elske, Stam Arjen J, de Vries Henry J C, Jongen Vita Willemijn
Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, Netherlands.
Department of Dermatology, Amsterdam UMC Location AMC, Amsterdam, Netherlands.
Sex Transm Infect. 2025 Apr 15;101(3):152-159. doi: 10.1136/sextrans-2024-056276.
Various European countries noted increasing (Ng) positivity among cis-gender women and heterosexual men. We assessed changes over time in Ng among men who exclusively have sex with men (MSM), men who exclusively have sex with women (MSW), men who have sex with men and women (MSMW), women and transgender and gender diverse people (TGP).
We analysed data collected between 2018 and 2023 at the Centre for Sexual Health, Amsterdam. We modelled temporal changes in Ng positivity rates (ie, number of positive results per 100 tests) using relative risk regression with a covariate representing three time periods: pre-COVID-19 (1 January 2018-12 March 2020), during COVID-19 (13 March 2020-1 March 2022), and post-COVID-19 (2 March 2022-31 December 2023).
We included 110 878 consultations pre-COVID-19, 84 917 during COVID-19 and 108 282 post-COVID-19. Positivity rates of Ng went from 12.4% to 13.0% in MSM, 1.7% to 2.3% in MSW, 6.7% to 9.9% in MSMW, 1.3% to 2.9% in women and 8.1% to 10.4% in TGP pre-COVID-19 and post-COVID-19, respectively. Significant increases were observed among MSW (relative risk (RR)=1.31,95% CI 1.12 to 1.53), MSMW (RR=1.47, 95% CI 1.26 to 1.72) and women (RR=2.25, 95% CI 2.03 to 2.49). An increased number of sexual partners and inconsistent condom use were associated with an increased Ng risk.
A substantial relative increase in Ng risk among MSW, MSMW and women, but not MSM or TGP, was observed post-COVID-19. Changes in sexual behaviour were associated with these changes. Continuous surveillance of Ng in heterosexual individuals is needed to monitor changes, alongside implementing prevention strategies for sexually transmitted infections.
多个欧洲国家注意到顺性别女性和异性恋男性中淋病奈瑟菌（Ng）阳性率呈上升趋势。我们评估了男男性行为者（MSM）、男女皆有性行为的男性（MSMW）、女性以及跨性别和性别多样化人群（TGP）中Ng感染率随时间的变化情况，同时也评估了只与女性发生性行为的男性（MSW）的情况。
我们分析了2018年至2023年期间在阿姆斯特丹性健康中心收集的数据。我们使用相对风险回归模型来模拟Ng阳性率（即每100次检测中的阳性结果数量）的时间变化，该模型带有一个代表三个时间段的协变量：新冠疫情前（2018年1月1日至2020年3月12日）、新冠疫情期间（2020年3月13日至2022年1月1日）以及新冠疫情后（2022年3月2日至2023年12月31日）。
我们纳入了新冠疫情前的110878次咨询、新冠疫情期间的84917次咨询以及新冠疫情后的108282次咨询。在新冠疫情前和后，MSM中Ng的阳性率分别从12.4%升至13.0%，MSW从1.7%升至2.3%，MSMW从6.7%升至9.9%，女性从1.3%升至2.9%，TGP从8.1%升至10.4%。在MSW（相对风险（RR）=1.31，95%置信区间为1.12至1.53）、MSMW（RR=1.47，95%置信区间为1.26至1.72）和女性（RR=2.25，95%置信区间为2.03至2.49）中观察到显著增加。性伴侣数量增加和不坚持使用避孕套与Ng感染风险增加有关。
在新冠疫情后，观察到MSW、MSMW和女性中Ng感染风险有大幅相对增加，但MSM和TGP没有。性行为的变化与这些变化相关。需要持续监测异性恋个体中的Ng感染情况以监测变化，同时实施性传播感染的预防策略。
