Phillips Tiffany R, Abraham Esha, Fairley Christopher K, Tan Rayner Kay Jin, Aung Ei T, Ong Jason J, Chow Eric P F
Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
Open Forum Infect Dis. 2025 Jun 13;12(7):ofaf339. doi: 10.1093/ofid/ofaf339. eCollection 2025 Jul.
This study aimed to examine the sexual practices and sexually transmitted infection (STI) positivity among people who inject drugs (PWID).
This was a repeated cross-sectional study analyzing data collected at a sexual health center during 2012-2022. New clients who were aged 18 and older, sexually active, and had injected drugs in the last 12 months were eligible for inclusion. Clients were categorized as men who have sex with women only (MSWO), gay or bisexual men who have sex with men (gbMSM), or women. We calculated the 2-year positivity of HIV, STIs, hepatitis B virus (HBV), and hepatitis C virus (HCV), and temporal analyses were conducted using the chi-square trend test.
A total of 1229 clients (395 MSWO, 457 gbMSM, and 377 women) were included in the study. There was a significant rise in syphilis ( = .0033); however, no significant changes were observed for other infections. The 2-year positivity for syphilis increased significantly from 0.6% (1/156) in 2012/2013 to 10.0% (13/130) in 2020/2021 ( = .0033). gbMSM had higher positivity for any infection (29.1%, 133/457) than MSWO (19.8%, 78/395) and women (17.0%, 64/377; < .001). Positivity of new HIV was 2.6% (95% CI, 1.6%-3.8%; 22/861), infectious syphilis was 6.8% (95% CI, 5.2%-8.7%; 59/866), gonorrhea was 8.6% (95% CI, 6.8%-10.7%; 77/892), chlamydia was 8.7% (95% CI, 7.0%-10.5%; 95/1093), HBV was 0.6% (95% CI, 0.1%-1.6%; 3/545), and HCV antibody was 10.0% (95% CI, 7.4%-13.2%; 45/448). The HCV testing rate was 37.6% (462/1229).
PWID are highly susceptible to STIs and blood-borne infections. Future prevention programs directed at PWID must include increasing the rate of HCV testing and messages related to sexual risk practices to help reduce the burden of disease in PWID.
本研究旨在调查注射吸毒者（PWID）的性行为及性传播感染（STI）阳性情况。
这是一项重复横断面研究，分析了2012年至2022年期间在一家性健康中心收集的数据。年龄在18岁及以上、有性行为且在过去12个月内有注射吸毒史的新客户符合纳入标准。客户被分为仅与女性发生性行为的男性（MSWO）、与男性发生性行为的男同性恋或双性恋男性（gbMSM）或女性。我们计算了HIV、STIs、乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）的2年阳性率，并使用卡方趋势检验进行时间分析。
共有1229名客户（395名MSWO、457名gbMSM和377名女性）纳入研究。梅毒感染率显著上升（P = 0.0033）；然而，其他感染未观察到显著变化。梅毒的2年阳性率从2012/2013年的0.6%（1/156）显著增加到2020/2021年的10.0%（13/130）（P = 0.0033）。gbMSM的任何感染阳性率（29.1%，133/457）高于MSWO（19.8%，78/395）和女性（17.0%，64/377；P < 0.001）。新发HIV阳性率为2.6%（95%CI，1.6%-3.8%；22/861），感染性梅毒为6.8%（95%CI，5.2%-8.7%；59/866），淋病为8.6%（95%CI，6.8%-10.7%；77/892），衣原体为8.7%（95%CI，7.0%-10.5%；95/1093），HBV为0.6%（95%CI，0.1%-1.6%；3/545），HCV抗体为10.0%（95%CI，7.4%-13.2%；45/448）。HCV检测率为37.6%（462/1229）。
注射吸毒者极易感染性传播感染和血源性感染。未来针对注射吸毒者的预防项目必须包括提高HCV检测率以及与性风险行为相关的信息，以帮助减轻注射吸毒者的疾病负担。
