在HIV暴露前预防使用者中,与获得梅毒相关的发病率和危险因素
Nathália Lima Pedrosa1, Patrícia Matias Pinheiro2, Fernando Wagner Brito Hortêncio Filho3
1Tropical Medicine Center, University of Brasília, Brasília, Brazil.
PloS one
|July 5, 2024
概括
梅毒仍然是使用艾滋病毒暴露前预防药物 (PrEP) 的人群的一个重大问题. 这项研究发现PrEP使用者中梅毒和再感染率很高,突出了针对性预防策略的必要性.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 获得的梅毒影响全球数百万人,需要在HIV暴露前预防 (PrEP) 的背景下进行研究.
- 在有关PrEP用户的文献中,建议增加性传播感染的风险行为.
- 了解PrEP使用者的梅毒发病率和相关因素对于公共卫生目标至关重要.
研究的目的:
- 调查使用PrEP的个体中获得梅毒的发病率.
- 确定与梅毒的获取和重新感染相关的社会人口统计学和行为因素.
主要方法:
- 一项回顾性队列研究分析了来自巴西 (2018-2020) 全国抗逆转录病毒物流系统的PrEP用户的数据.
- 使用描述性,双变量和多变量分析计算PrEP前梅毒比例,随访期间的发病率,再感染和相关因素.
- 估计的原始相对风险和调整的几率比率 (aOR) 具有95%的置信区间 (95%CI).
主要成果:
- 在34000名开始PrEP的个人中,8.3%有先前的梅毒,4%在使用30天内被诊断出患有梅毒. 观察到高比例的失败梅毒测试 (33.4%-38.8%).
- 在19,820名有效监测的个体中,梅毒发病率为每100人/年19.1,再感染率为1.9%.
- 保护因素包括女性性别和白人或黑人. 风险因素包括同性恋/同性恋/女同性恋身份,先前的梅毒,换取物品的性行为,不规则的避孕套使用,以及娱乐性药物使用 (流行药).
结论:
- 在PrEP使用者群体中,梅毒的发病率和再感染率很高.
- 社会人口统计学和行为因素在这个群体中显著影响梅毒风险.
- 建议进行进一步的研究和有针对性的预防策略,以减少PrEP使用者中梅毒的数字.
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