使用社会人口统计和性行为数据的基于回归的风险评分不能预测HIV PrEP用户中无症状的性传播感染
Vita Willemijn Jongen1,2,3, Maarten Schim van der Loeff4,3,5,6, Daphne Amanda van Wees7
1Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands vjongen@ggd.amsterdam.nl.
Sexually transmitted infections
|June 6, 2025
概括
在暴露前预防 (PrEP) 用户中开发性传播感染 (STIs) 的准确风险评分是具有挑战性的. 常规的人口和行为数据没有有效地识别需要针对性STI查的个体.
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:
- 口服HIV暴露前预防 (PrEP) 用户表现出低的避孕套使用率和高的性传播感染 (STI) 发病率.
- 目前的指导方针建议对PrEP使用者进行频繁的性传播感染查 (每3-6个月).
- 对无症状性传播感染的有针对性的查可以优化资源配置并减少查负担.
研究的目的:
- 评估PrEP使用者中无症状性传播感染的人口和行为因素的可预测性.
- 开发和评估风险评分,以识别有针对性的性传播感染查高风险个体.
主要方法:
- 来自荷兰国家PrEP试点计划 (2019年7月 - 2022年6月) 数据的分析.
- 包括11,035人参加至少一次PrEP护理访问.
- 后勤回归模型用于识别无症状克拉米迪亚,淋病或梅毒感染的预测因素.
主要成果:
- 超过14,900个细菌性传播感染被诊断出,其中9,114个是在例行无症状查期间.
- 与无症状性传播感染风险增加相关的因素包括性工作,无避孕套的交,群体性,化学性和性行为期间的物质使用.
- 荷兰出生的PrEP使用者和拥有高等教育的人具有较低的性传播感染风险.
- 开发的风险评分表明预测能力有限 (灵敏度0.55,特异性0.55).
结论:
- 常规收集的人口和行为数据不足以创建有效的风险评分,以识别 PrEP 用户在无症状性传播感染的高风险.
- 需要进行进一步的研究,以探索其他因素,方法或分析方法,以改善该群体的STI风险预测.
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