Adamson Paul C, Bui Hao T M, Pham Loc Q, Truong Phuong T, Le Ngan T, Le Giang M, Klausner Jeffrey D
Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Center for Training and Research on Substance Abuse and HIV, Hanoi Medical University.
AIDS. 2025 Jul 15;39(9):1152-1160. doi: 10.1097/QAD.0000000000004203. Epub 2025 Apr 3.
To assess the prevalence, anatomical distribution, and correlates of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infections within an HIV preexposure prophylaxis (PrEP) program in Hanoi, Vietnam.
Cross-sectional, observational study.
Between January and December 2022, HIV PrEP program clients who were male at birth, ≥16 years old, reported ≥1 male sex partner in the prior 12 months, were enrolled. A questionnaire collected sociodemographics, sexual behaviors, and clinical data. CT/NG testing was performed on self-collected urine, rectal, and pharyngeal specimens. Multivariate logistic regression was used to identify factors associated with infections.
Among 529 participants, the prevalence of CT or NG was 28.9% (153/529). The prevalence of NG was 14.4% (76/529) and highest for pharyngeal infections (11.7%; 62/528), while for CT, the prevalence was 20.4% (108/529) and highest for rectal infections (15.0%; 74/493). Symptoms in the prior week were reported by 45.8% (70/153) of those with CT or NG infections. Among asymptomatic participants, there was a low prevalence of urethral CT (3.1%; 14/457) and NG (0.9%; 4/457). Condomless anal sex [adjusted odds ratio (aOR) = 1.98; 95% confidence interval (CI): 1.27, 3.09] and sexualized drug use in the prior 6 months (aOR = 1.71; 95% CI: 1.09, 2.69) were associated with CT/NG infections.
The study found a high prevalence of CT/NG infections, particularly pharyngeal and rectal infections, within an HIV PrEP program in Hanoi, Vietnam. The findings suggest testing for urethral infections among asymptomatic individuals is of limited value. Further research is needed for STI prevention strategies and updated guidelines for CT/NG screening in HIV PrEP programs in low- and middle-income countries.
评估越南河内一项HIV暴露前预防（PrEP）项目中淋病奈瑟菌（NG）和沙眼衣原体（CT）感染的患病率、解剖学分布及相关因素。
横断面观察性研究。
在2022年1月至12月期间，纳入出生时为男性、年龄≥16岁、在过去12个月内报告有≥1名男性性伴侣的HIV PrEP项目参与者。通过问卷调查收集社会人口统计学、性行为和临床数据。对自行采集的尿液、直肠和咽部标本进行CT/NG检测。采用多因素逻辑回归分析确定与感染相关的因素。
在529名参与者中，CT或NG感染的患病率为28.9%（153/529）。NG感染的患病率为14.4%（76/529），咽部感染的患病率最高（11.7%；62/528）；而CT感染的患病率为20.4%（108/529），直肠感染的患病率最高（15.0%；74/493）。在CT或NG感染的参与者中，45.8%（70/153）报告在前一周有症状。在无症状参与者中，尿道CT感染的患病率较低（3.1%；14/457），尿道NG感染的患病率也较低（0.9%；4/457）。无保护肛交[调整优势比（aOR）=1.98；95%置信区间（CI）：1.27，3.09]和在过去6个月内有性化药物使用行为（aOR=1.71；95%CI：1.09，2.69）与CT/NG感染相关。
该研究发现，越南河内一项HIV PrEP项目中CT/NG感染的患病率较高，尤其是咽部和直肠感染。研究结果表明，对无症状个体进行尿道感染检测的价值有限。低收入和中等收入国家的HIV PrEP项目中，性传播感染预防策略和CT/NG筛查更新指南仍需进一步研究。
