Manavalan Preeti, Gadkowski L Beth, Sachdeva Archie, Guha Subharup, Porvasnik Stacy, Nelson John A, Janelle Jennifer W
Division of Infectious Diseases and Global Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL.
Department of Biostatistics, University of Florida, Gainesville, FL.
J Acquir Immune Defic Syndr. 2025 Mar 1;98(3):282-290. doi: 10.1097/QAI.0000000000003569. Epub 2025 Feb 5.
INTRODUCTION: The US state of Florida has the third highest rate of HIV and high rates of sexually transmitted infections (STIs) indicating critical HIV and STI prevention needs remain unmet. To address gaps in the STI care continuum in people with HIV (PWH), evidence-based interventions were implemented across 3 Ryan White HIV/AIDS Program (RWHAP)-funded clinics in Florida between August 2020 and August 2021. Interventions included comprehensive sexual health history (SHH) taking using audio computer-assisted self-interview (ACASI) software, self-collected extragenital gonorrhea and chlamydia testing, and the introduction of a lesbian, gay, bisexual, transgender, and queer (LGBTQ+) welcoming environment. METHODS: We (1) assessed the acceptability of these interventions and examined if acceptability differed among youth and sexual, racial, and ethnic minorities; (2) determined the proportion of appropriate STI testing completed based on the SHH assessment; (3) examined whether STI at-risk individuals underwent STI screening 3-6 months after initial evaluation; and (4) determined the proportion of positive STI test results among priority intervention groups in Florida. RESULTS: Acceptability of all interventions was high. Youth, lesbian, gay, and bisexual, and Hispanic individuals were significantly more likely to notice and like LGTBQ+ welcoming measures. The proportion of recommended tests completed was high, although only a subset of at-risk individuals completed rescreening. About 11.9% of rectal samples were positive for chlamydia, and 6.5% of pharyngeal samples were positive for gonorrhea. CONCLUSIONS: Our study highlights the importance of incorporating comprehensive sexual health care protocols, including extragenital STI testing, into the overall care of PWH.
引言:美国佛罗里达州的艾滋病毒感染率位居第三,性传播感染(STI)率也很高,这表明艾滋病毒和性传播感染的关键预防需求仍未得到满足。为了弥补艾滋病毒感染者(PWH)在性传播感染护理连续过程中的差距,2020年8月至2021年8月期间,在佛罗里达州3家由瑞安·怀特艾滋病毒/艾滋病项目(RWHAP)资助的诊所实施了循证干预措施。干预措施包括使用音频计算机辅助自我访谈(ACASI)软件进行全面的性健康史(SHH)采集、自我采集生殖器外淋病和衣原体检测,以及营造一个欢迎女同性恋、男同性恋、双性恋、跨性别者和酷儿(LGBTQ+)的环境。 方法:我们(1)评估了这些干预措施的可接受性,并检查了青年以及性、种族和少数民族之间的可接受性是否存在差异;(2)根据性健康史评估确定完成适当性传播感染检测的比例;(3)检查性传播感染高危个体在初次评估后3至6个月是否接受了性传播感染筛查;(4)确定佛罗里达州优先干预组中性传播感染检测阳性结果的比例。 结果:所有干预措施的可接受性都很高。青年、女同性恋、男同性恋和双性恋者以及西班牙裔个体明显更有可能注意到并喜欢LGTBQ+欢迎措施。推荐检测完成的比例很高,尽管只有一部分高危个体完成了重新筛查。约11.9%的直肠样本衣原体检测呈阳性,6.5%的咽部样本淋病检测呈阳性。 结论:我们的研究强调了将包括生殖器外性传播感染检测在内的综合性性健康护理方案纳入艾滋病毒感染者总体护理的重要性。
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