Gender Differences in Bacterial STIs in Canada.
Gender Differences in Bacterial STIs in Canada.
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DOI：
10.1186/1472-6874-4-s1-s26
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发表时间：
2004-08-25
期刊：
影响因子：
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通讯作者：
McMahon, Sharon
中科院分区：
文献类型：
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作者：
Wong, Thomas;Singh, Ameeta;McMahon, Sharon
健康问题：加拿大细菌性传播感染（STIs）的发病率正在上升。如果这些可治愈的感染得到预防和治疗，包括不孕症在内的严重长期后遗症以及相关的治疗费用就可以大大减少。性传播感染在许多方面对妇女造成的风险大于男子，而且在筛查和诊断方面存在进一步的性别差异。主要发现：报道的衣原体、淋病和传染性梅毒的发病率下降，直到1997年，这一趋势开始逆转。据报道，女性衣原体感染率远高于男性，而淋病和传染性梅毒的感染率则相反。1996年引入有效的艾滋病毒抑制疗法后，观察到男男性行为者中高危性行为的增加，但女性的行为变化有待进一步研究。数据差距和建议：加拿大的性传播感染监测需要改进。报告的发病率低估了真实发病率。必须监测针对性别的行为变化，以加强对风险最高的群体的反应能力，需要对促进安全性行为的有效战略进行更多的研究。必须解决地理和种族差异、差距和需求。尿液衣原体筛查应更广泛地适用于女性和男性，特别是高危男性，以防止其伴侣再次感染。由于妇女更有可能进行健康检查（如巴氏涂片检查），因此必须利用这些筛查机会。目前迫切需要由女性控制的性传播感染预防方法，例如更安全的局部杀微生物剂。
HEALTH ISSUE: The incidence of bacterial sexually transmitted infections (STIs) is rising in Canada. If these curable infections were prevented and treated, serious long-term sequelae including infertility, and associated treatment costs, could be dramatically reduced. STIs pose a greater risk to women than men in many ways, and further gender differences exist in screening and diagnosis. KEY FINDINGS: Reported incidence rates of chlamydia, gonorrhea, and infectious syphilis declined until 1997, when the trend began to reverse. The reported rate of chlamydia is much higher among women than men, whereas the reverse is true for gonorrhea and infectious syphilis. Increases in high-risk sexual behaviour among men who have sex with men were observed after the introduction of potent HIV suppressive therapy in 1996, but behavioural changes in women await further research. DATA GAPS AND RECOMMENDATIONS: STI surveillance in Canada needs improvement. Reported rates underestimate the true incidence. Gender-specific behavioural changes must be monitored to enhance responsiveness to groups at highest risk, and more research is needed on effective strategies to promote safer sexual practices. Geographic and ethnic disparities, gaps, and needs must be addressed. Urine screening for chlamydia should be more widely available for women as well as men, particularly among high-risk men in order to prevent re-infections in their partners. As women are more likely to present for health examinations (e.g. Pap tests), these screening opportunities must be utilized. Female-controlled methods of STI prevention, such as safer topical microbicides, are urgently needed.