The Impact of HIV Seroadaptive Behaviors on Sexually Transmissible Infections in HIV-Negative Homosexual Men in Sydney, Australia
The Impact of HIV Seroadaptive Behaviors on Sexually Transmissible Infections in HIV-Negative Homosexual Men in Sydney, Australia
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DOI：
10.1097/olq.0b013e3182401a2f
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发表时间：
2012-03-01
影响因子：
3.1
通讯作者：
Grulich, Andrew E.
中科院分区：
文献类型：
--
作者：
Jin, Fengyi;Prestage, Garrett P.;Grulich, Andrew E.
背景：人类免疫缺陷病毒（HIV）血清适应行为，例如血清分选和战略定位，越来越多地被男同性恋者所实践；然而，它们对性传播感染的影响尚不清楚。 方法：参与者为 1427 名最初为 HIV 阴性男性，从 2001 年至 2004 年入组，随访至 2007 年 6 月。每年对参与者进行肛门和尿道淋病、衣原体、单纯疱疹病毒和梅毒检测。此外，他们还报告了这些病症的诊断，以及每年就诊之间的生殖器和肛门疣以及性危险行为。结果：与报告没有无保护肛交 (UAI) 的男性相比，血清分选与尿道风险增加相关（发生率：每 100 人年 (PY) 6.06 比 3.56，风险比 (HR) = 1.97，95% 置信度间隔 [CI]：1.43-2.72）和肛门（发病率 3.95 vs. 2.80 每 100 PY，HR = 1.62，95% CI：1.11-2.36）衣原体。与报告与 HIV 不一致的伴侣发生 UAI 的男性相比，进行血清分选的男性发生梅毒的风险显着降低（每 100 PY 发生率 0.18 vs. 1.00，HR = 0.21，95% CI：0.05-0.81）和尿道淋病（每 100 PY 发生率 2.15 vs. 5.52，HR） = 0.61，95% CI：0.39-0.96）。与未报告 UAI 的男性相比，战略定位与尿道淋病（发病率 4.11 vs. 2.10 每 100 PY，HR = 1.72，95% CI：1.05-2.83）和衣原体风险增加相关（发病率 8.71 vs. 3.56 每 100 PY，HR = 2.22，95%） CI：1.55-3.18）。与报告接受性UAI的男性相比，肛门淋病（发病率1.48 vs. 3.83/100 PY，HR = 0.38，0.20-0.74）和衣原体（发病率3.10 vs. 6.30/100 PY，HR = 0.44，95% CI）： 0.27-0.69）在实行战略定位的人中显着较低。结论：对于报告血清适应行为的男性，某些细菌性传播感染的发生率高于未报告 UAI 的男性。然而，这一比例低于报告艾滋病毒高危行为的男性。
Background: Human immunodeficiency virus (HIV) seroadaptive behaviors, such as serosorting and strategic positioning, are, being increasingly practised by homosexual men; however, their, impact on sexually transmissible infections is unclear.Methods: Participants were 1427 initially HIV-negative men enrolled from 2001 to 2004 and followed to June 2007. Participants, were tested annually for anal and urethral gonorrhoea and chlamydia, herpes simplex virus, and syphilis. In addition, they reported diagnoses of these conditions, and of genital and anal warts between annual visits, and sexual risk behaviors.Results: Compared with men who reported no unprotected anal intercourse (UAI), serosorting was associated with an increased risk of urethral (incidence: 6.06 vs. 3.56 per 100 person-years (PY), hazard ratio (HR) = 1.97, 95% confidence interval [CI]: 1.43-2.72) and anal (incidence 3.95 vs. 2.80 per 100 PY, HR = 1.62, 95% CI: 1.11-2.36) chlamydia. Compared with men who reported UAI with HIV nonconcordant partners, men who practised serosorting had significantly lower risk of incident syphilis (incidence 0.18 vs. 1.00 per 100 PY, HR = 0.21, 95% CI: 0.05-0.81) and urethral gonorrhoea (incidence 2.15 vs. 5.52 per 100 PY, HR = 0.61, 95% CI: 0.39-0.96). Compared with men who reported no UAI, strategic positioning was associated with an increased risk of urethral gonorrhoea (incidence 4.11 vs. 2.10 per 100 PY, HR = 1.72, 95% CI: 1.05-2.83) and chlamydia (incidence 8.71 vs. 3.56 per 100 PY, HR = 2.22, 95% CI: 1.55-3.18). Compared with men who reported receptive UAI, the incidence of anal gonorrhoea (incidence 1.48 vs. 3.83 per 100 PY, HR = 0.38, 0.20-0.74) and chlamydia (incidence 3.10 vs. 6.30 per 100 PY, HR = 0.44, 95% CI: 0.27-0.69) was significantly lower in those who practised strategic positioning.Conclusion: For men who reported seroadaptive behaviors, rates of some bacterial sexually transmissible infections were higher than in men who reported no UAI. However, rates were lower than for men who reported higher HIV risk behaviors.