High rates of oral STIs among male sex workers in Vietnam.
High rates of oral STIs among male sex workers in Vietnam.
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越南男性性工作者口腔性传播感染率很高。
DOI：
10.1136/sextrans-2013-051423
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发表时间：
2014
影响因子：
3.6
通讯作者：
Yu,Gary
中科院分区：
文献类型：
--
作者：
Giang,LeMinh;Clatts,MichaelC;Goldsamt,LloydA;Yu,Gary
越南的男性性工作者（MSW）有复杂的性伴侣档案，包括男性和女性客户伴侣以及男性和女性选择性伴侣。虽然性行为因伴侣类型而异，但主动和接受性口交对所有伴侣类型都很常见。由于这种复杂性，医务人员感染口腔性传播感染以及将性传播感染传染给性伴侣的风险很高。在2009年和2011年之间，招募了一个16-35岁的社会性工作者样本，使用时间-地点抽样方法参与行为艾滋病毒风险的流行病学研究（n= 654）。使用结构化调查收集有关人口统计学特征、物质使用、性伴侣类型和性行为以及卫生服务利用的信息。此外，对每例受试者进行HIV和STI（包括口腔淋病、衣原体、HPV）筛查。总体而言，31.0%的参与者对一种或多种口腔性传播感染检测呈阳性（胡志明市为57.3%，河內为15.2%，芽庄为4%）; 99.5%的参与者在此期间进行过口交。以筛查前30天为重点，我们比较了一种或多种STI检测阳性与阴性的性行为; 56.4%的阳性者与5名或5名以上的嫖客发生过口交（42.2%的阴性者，p= 0.001），51.2%的人与五个或更多的客户伴侣进行了接受性肛交（33.6%的阴性者，p= 0.001）。插入肛交无差异。卫生计划强调了无保护的肛交在艾滋病毒传播中的作用，这可能有助于无意中假设口交对健康的风险很小。针对医务人员的预防方案应包括更加关注口腔性健康，包括关于更安全的口腔性行为、口腔性传播感染症状的教育，以及有针对性的干预措施，以改善对卫生服务的参与和保留。最后，我们注意到，在整个样本中，以及在他们的性伴侣中，都报告了很高的饮酒率。需要进一步的研究来评估酒精可能对口腔健康造成的临床影响，从而增加MSW中口腔性传播感染的风险。
Male sex workers (MSW) in Vietnam have complex sexual partner profiles, including both male and female client partners and both male and female elective partners. Although sex practices vary across partner types, both active and receptive oral sex is common with all partner types. As a consequence of this complexity, MSWs are at high risk for becoming infected with oral STIs as well as for transmitting STIs to sex partners. Between 2009 and 2011, a community sample of MSWs, age 16–35 years, was recruited for participation in an epidemiological study of behavioural HIV risk (n= 654) using time-location sampling methods. Information about demographic characteristics, substance use, types of sexual partners and practices, and health services utilisation was collected using structured surveys. Additionally, each subject was screened for HIV and STIs (including oral gonorrhoea, chlamydia, HPV). Overall, 31.0% of participants tested positive for one or more oral STI (57.3% in Ho Chi Minh City, 15.2% in Ha Noi, and4% in Nha Trang); 99.5% had engaged in oral sex during this period. Focusing on the 30days prior to screening, we compared the sexual practices of those who tested positive for one or more STI with those who tested negative; 56.4% of positives had oral sex with five or more client partners (vs 42.2% of negatives, p= 0.001), and 51.2% had receptive anal sex with five or more client partners (vs 33.6% of negatives, p= 0.001). No difference was seen in insertive anal sex. Health programmes have emphasised the role of unprotected anal intercourse in HIV transmission, perhaps contributing to the unintended assumption that oral sex confers little risk to health. Prevention programming for MSWs should include increased attention to oral sexual health, including education about safer oral sex practices, oral STI symptoms, and targeted interventions to improve engagement and retention in health services. Finally, we note that high rates of alcohol consumption were reported throughout this sample as well as among their sexual partners. Additional research is needed to assess the clinical impact that alcohol may have in compromising oral health, and thereby increasing risk for oral STIs among MSWs.