东环素预防预防妇女预防性传播感染
Jenell Stewart1, Kevin Oware1, Deborah Donnell1
1From the Division of Infectious Diseases, Hennepin Healthcare Research Institute, and the Department of Medicine, University of Minnesota - both in Minneapolis (J.S.); Kenya Medical Research Institute, Kisumu (K.O., J.O., V.O., F.O.M., E.A.B.); Fred Hutchinson Cancer Research Center (D.D.) and the Departments of Epidemiology (L.R.V., F.A.S., R.S.M.), Global Health (O.O.S., C.W.S., R.S.M., E.A.B., J.M.B.), Medicine (Infectious Diseases) (L.R.V., O.O.S., R.S.M., J.M.B.), and Obstetrics and Gynecology (E.A.B.), University of Washington, Seattle; and the Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco (M.S., M.G.).
在肯尼亚的女性中,多西环素暴露后预防 (PEP) 并没有显著减少性传播感染 (STIs). 通过头发样本分析证实,对多西环林PEP的依从性较低,这可能解释了在预防性传播感染方面缺乏益处.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 临床试验 临床试验
背景情况:
- 多西环素暴露后预防 (PEP) 是有效的预防性传播感染 (STIs) 在 cisgender 男人和跨性别女性.
- 关于多西环素PEP在 cisgender 女性中的疗效的数据有限.
研究的目的:
- 评估多西环素PEP在预防肯尼亚 cisgender 妇女发生性传播感染方面的有效性.
- 用头发样本分析来评估对多西环林PEP的坚持.
主要方法:
- 在18-30岁的肯尼亚妇女中进行了一项随机的开放性试验,这些妇女接受了HIV暴露前预防.
- 参与者接受了多西环林PEP (200毫克在性行为后72小时内) 或标准护理.
- 主要终点是发生的感染,其中包括Chlamydia trachomatis,Neisseria gonorrhoeae或Treponema pallidum. 毛发样本评估了多西环林的使用.
主要成果:
- 总共有449名女性被随机分配. 发生了109例性传播感染事件 (多西环素-PEP组50例,标准护理组59例),发生率没有显著差异.
- 克拉米迪亚是最常见的性传播疾病. 在多克西环素-PEP组的头发样本中,只检测到29%的多克西环素.
- 没有报告严重的不良事件或HIV感染事件. 所有的N. gonorrhoeae分离物都对多西环素有耐药性.
结论:
- 与标准护理相比,多西环素PEP并没有显著降低 cisgender 女性的性病发病率.
- 根据头发样本分析表明,对多西环林PEP的依从性较低,可能导致没有观察到益处.
- 需要进一步的研究,以了解坚持障碍,并优化STI预防策略的cisgender妇女.
相关概念视频
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