Ellen J M, Langer L M, Zimmerman R S, Cabral R J, Fichtner R
San Francisco STD Prevention and Control Program, University of California San Francisco Medical School 94143, USA.
Sex Transm Dis. 1996 Nov-Dec;23(6):511-6. doi: 10.1097/00007435-199611000-00013.
To determine whether personal and/or a partner's use of crack cocaine is associated with the diagnosis of early syphilis or gonorrhea independent of high-risk sex behaviors, and to determine whether the relationships between crack cocaine and associated sexually transmitted diseases (STDs) are similar for adolescents and adults.
A cross-sectional behavioral survey of hetero-sexual males and females attending public STD clinics in three cities. Logistic regression was used to identify risk behavior patterns associated with each STD compared with no STD.
Multivariate analysis revealed that men who were high on drugs, including crack cocaine, before or during sex were more likely to be diagnosed with syphilis (Odds Ratio [OR] = 1.49; Confidence Intervals [CI] = 1.06, 2.13). Males more likely to be diagnosed with gonorrhea were younger (OR = 0.94; CI = 0.92, 0.96), had sex with a crack cocaine user (OR = 1.99; CI = 1.36, 2.91), did not use condoms last time they had sex with a nonmain partner (OR = 1.59; CI = 1.09, 2.13), and did not have sex with an intravenous drug user (OR = 0.45; CI = 0.22, 0.95). For women, there were no independent risk factor for syphilis but younger age was a risk factor for gonorrhea (OR = 0.95; CI = 0.91, 0.99). The associations between crack cocaine and syphilis and gonorrhea in men and between crack cocaine and syphilis in women were not significant among adolescents in this study.
The results of this study highlight the differences in the crack cocaine-related behaviors of adults and adolescents at risk for gonorrhea and syphilis. The nature of these differences support the use of distinct intervention strategies for each STD and for adolescents and adults.
确定个人和/或性伴侣使用快克可卡因是否与早期梅毒或淋病的诊断相关，且独立于高危性行为，并确定快克可卡因与相关性传播疾病（STD）之间的关系在青少年和成年人中是否相似。
对三个城市公立性病诊所的异性恋男性和女性进行横断面行为调查。使用逻辑回归来确定与每种性病相关的风险行为模式，并与未患性病的情况进行比较。
多变量分析显示，在性行为前或性行为期间吸食包括快克可卡因在内毒品的男性更有可能被诊断为梅毒（优势比[OR]=1.49；置信区间[CI]=1.06,2.13）。更有可能被诊断为淋病的男性年龄更小（OR=0.94；CI=0.92,0.96），与快克可卡因使用者发生性行为（OR=1.99；CI=1.36,2.91），上次与非主要性伴侣发生性行为时未使用避孕套（OR=1.59；CI=1.09,2.13），且未与静脉吸毒者发生性行为（OR=0.45；CI=0.22,0.95）。对于女性，梅毒没有独立的风险因素，但年龄较小是淋病的一个风险因素（OR=0.95；CI=0.91,0.99）。在本研究中，青少年中男性快克可卡因与梅毒和淋病之间以及女性快克可卡因与梅毒之间的关联并不显著。
本研究结果突出了有淋病和梅毒风险的成年人及青少年在与快克可卡因相关行为方面的差异。这些差异的性质支持针对每种性病以及青少年和成年人采用不同的干预策略。
