Subsequent sexually transmitted infection in urban adolescents and young adults
Subsequent sexually transmitted infection in urban adolescents and young adults
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DOI：
10.1001/archpedi.155.8.947
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发表时间：
2001-08-01
影响因子：
--
通讯作者：
Fortenberry, JD
中科院分区：
文献类型：
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作者：
Orr, DP;Johnston, K;Fortenberry, JD
目的：比较一组高危青少年和年轻成人随后感染沙眼衣原体、淋病奈瑟菌或阴道毛滴虫的比率。方法：在治疗时，从一家城市性传播疾病诊所和3家社区初级保健诊所招募了444名13至25岁的未婚青少年和年轻人。受试者感染沙眼衣原体、淋病奈瑟菌或阴道T，被诊断患有非淋球菌性尿道炎（男性），或未与这些感染之一发生性接触。受试者于1、3、5和7个月返回。结果：继发感染率高。在登记时未受感染的接触者中，估计有40%的男性和53%的女性在7个月内被感染；估计入组时60%的男性感染者和73%的女性感染者会再次感染。在女性受试者中，与未感染的接触者（中位数，209天）相比，在入组时感染的受试者到后续感染的时间（中位数，140天）较短（P= 0.04）。在男性中，结果相似，但到随后感染的中位时间差异无统计学意义（P=.08）。预测再感染时间较短的基线特征是女性性别和入组时的感染。当每次随后的数据收集访问前2个月的性行为被纳入模型时，只有女性和报告至少有一个新的间隔性伴侣是随后性传播感染的重要预测因子。结论：这些数据支持最近的研究发现，高危青少年和年轻人的后续感染率很高。性传播感染的接触者与有个人感染史的接触者随后感染的风险似乎同样高。我们的数据表明，在高危青少年和年轻成人人群中，包括未受性传播感染的个体，应比每年更频繁地筛查淋球菌、沙眼原体和阴道T虫。
Objective: To compare the rates of subsequent infection with Chlamydia trachomatis, Neisseria gonorrhoeae, or Trichomonas vaginalis in a group of high-risk adolescents and young adults.Methods: At the time of treatment, 444 unmarried teenagers and young adults aged 13 to 25 years were enrolled from an urban sexually transmitted disease clinic and 3 community-based primary care clinics. Subjects were infected with C trachomatis, N gonorrhoeae, or T vaginalis, were diagnosed as having nongonococcal urethritis (in men), or were uninfected sexual contacts with one of these infections. Subjects returned at 1, 3, 5, and 7 months.Results: The rate of subsequent infection was substantial. Forty percent of men and 53% of women who were uninfected contacts at enrollment were estimated to be infected within 7 months; 60% of men and 73% of women infected at enrollment were estimated to be reinfected. Among women, subjects who were infected at enrollment had a shorter time to subsequent infection (median, 140 days) compared with uninfected contacts (median, 209 days) (P=.04). Among men, findings were similar, but the difference in median time to subsequent infection was not significant (P=.08). Baseline characteristics that predicted shorter time to reinfection were female sex and infection at enrollment. When sexual behaviors in the 2 months preceding each subsequent data collection visit were included in the model, only being female and reporting at least one new interval sexual partner were significant predictors of subsequent sexually transmitted infections.Conclusions: These data support recent research that has found high rates of subsequent infection among high-risk adolescents and young adults. Contacts of a sexually transmitted infection appear to be at equally high risk for subsequent infection as those with a personal history of infection. Our data suggest that more frequent than annual screening for N gonorrhoeae, C trachomatis, and T vaginalis would be appropriate in at-risk adolescent and young adult populations, including individuals who are uninfected sexual contacts to a sexually transmitted infection.