AIDS mortality may have contributed to the decline in syphilis rates in the United States in the 1990s
AIDS mortality may have contributed to the decline in syphilis rates in the United States in the 1990s
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DOI：
10.1097/00007435-200305000-00008
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发表时间：
2003-05-01
影响因子：
3.1
通讯作者：
Aral, SO
中科院分区：
文献类型：
--
作者：
Chesson, HW;Dee, TS;Aral, SO
背景：与艾滋病相关的男性死亡率可能对美国男性的原发性和继发性梅毒趋势产生了影响，原因是该人群中感染或传播梅毒的高风险男性的减少和/或为应对艾滋病的威胁而促进了更安全的性行为。目的：本研究的目的是研究1984年至1997年美国男性艾滋病死亡率与原发性和继发性梅毒发病率之间的关系。研究设计：我们采用固定效应回归分析各州艾滋病死亡率和男性原发性和继发性梅毒发病率。结果：我们的分析显示，在控制了混杂因素后，较高的艾滋病死亡率和较低的梅毒发病率之间存在显著关联。我们的模型估计表明，每10万名成年男性中有20人死于艾滋病，与男性梅毒发病率下降约7%至12%有关。结论：在20世纪90年代早期，男性梅毒发病率下降的原因中，艾滋病相关死亡率的增加可能占了三分之一到一半。最近美国艾滋病死亡率的下降可能是最近梅毒爆发的原因之一，特别是在男男性行为者中。我们的研究结果强调了为感染艾滋病毒的男性提供性病预防服务的重要性，以及在梅毒暴发风险社区进行性病监测的必要性。
Background: The mortality associated with AIDS among men may have had an influence on primary and secondary syphilis trends among men in the United States, through the loss of men at high risk for acquisition or transmission of syphilis in this population and/or by prompting safer sexual behaviors in response to the threat of AIDS.Goal: The goal of this study was to examine the association between AIDS mortality rates and primary and secondary syphilis incidence rates among men in the United States from 1984 to 1997.Study Design: We used a fixed-effects regression analysis of state-level AIDS mortality rates and primary and secondary syphilis incidence rates for men.Results: Our analysis showed a significant association between higher AIDS mortality and lower rates of syphilis incidence, after we controlled for confounding factors. Our model estimates suggested that every 20 AIDS deaths per 100,000 adult men are associated with declines of about 7% to 12% in syphilis incidence rates among men.Conclusion: Increases in AIDS-associated mortality may have accounted for one-third to one-half of the decline in syphilis rates among men in the early 1990s. Recent declines in AIDS mortality in the United States may have contributed to the recent outbreaks of syphilis, particularly among men who have sex with men. Our findings underscore the importance of providing STD prevention services to men with HIV infection and the need for STD surveillance in communities at risk for syphilis outbreaks.