High incidence of new sexually transmitted infections in the year following a sexually transmitted infection: A case for rescreening
High incidence of new sexually transmitted infections in the year following a sexually transmitted infection: A case for rescreening
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DOI：
10.7326/0003-4819-145-8-200610170-00005
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发表时间：
2006-10-17
影响因子：
39.2
通讯作者：
Douglas, John M., Jr.
中科院分区：
文献类型：
--
作者：
Peterman, Thomas A.;Tian, Lin H.;Douglas, John M., Jr.
背景：研究表明，接受沙眼衣原体治疗的女性中有 11% 至 15% 在治疗后 3 至 4 个月内再次感染，表明需要重新筛查。关于男性感染、淋病奈瑟菌或阴道毛滴虫感染或长期随访的信息很少。目的：确定去性传播疾病 (STD) 诊所就诊后一年内新发性传播感染的发生率以及相关危险因素。设计：对随机对照试验 (RESPECT-2) 数据进行二次分析。地点：3 个城市 STD 诊所。患者：参加 HIV 预防的性活跃患者咨询试验。测量：初次就诊时的患者特征；随访期间的行为；以及在 4 次定期回访和任何其他临时访视期间检测到的沙眼衣原体、淋病奈瑟菌或阴道毛滴虫（仅限女性）新感染。 结果：2419 人接受了 8129 次为期三个月的随访。在 1236 名女性中，25.8% 患有 1 次或以上新感染（11.9% 获得沙眼衣原体，6.3% 获得淋病奈瑟菌，12.8% 获得阴道毛滴虫）；在 1183 名男性中，14.7% 患有 1 次或以上新感染（9.4% 获得沙眼衣原体，7.1% 获得淋病奈瑟菌）。黑人和基线时患有性传播感染的人复发感染的风险最高（调整后的比值比分别为 2.5 和 2.4）。对于基线感染者，感染风险在 3 个月和 6 个月时较高（每 100 人三个月间隔 16.3 人），在 9 个月和 12 个月时感染风险仍然很高（每 100 人三个月间隔 12.0 人）。大多数 (67.2%) 感染是在研究相关访视期间诊断出来的，其中 66.2% 的患者报告没有任何症状。 局限性：由于患者是从 STD 诊所招募的，因此结果可能无法推广。结论：接受沙眼衣原体、淋病奈瑟菌或阴道毛滴虫感染诊断的男性和女性应在 3 个月内返回进行重新筛查，因为他们有新的无症状性传播感染的高风险。尽管单剂量疗法可以充分治疗感染，但通常不能充分治疗患者。
Background: Studies show 11% to 15% of women treated for Chlamydia trachomatis are reinfected 3 to 4 months after treatment, suggesting the need for rescreening. There is little information on infections among men, infections with Neisseria gonorrhoeae or Trichomonas vaginalis, or long-term follow-up.Objective: To determine the incidence of new sexually transmitted infections during the year after a visit to a sexually transmitted disease (STD) clinic and associated risk factors.Design: Secondary analysis of data from a randomized, controlled trial (RESPECT-2).Setting: 3 urban STD clinics.Patients: Sexually active patients enrolled in an HIV prevention counseling trial.Measurements: Patient characteristics at the initial visit; behaviors during follow-up; and new infections with C. trachomatis, N. gonorrhoeae, or T. vaginalis (women only) detected during 4 scheduled return visits and any other interim visits.Results: 2419 persons had 8129 three-month follow-up intervals. Among 1236 women, 25.8% had 1 or more new infections (11.9% acquired C. trachomatis, 6.3% acquired N. gonorrhoeae, and 12.8% acquired T. vaginalis); among 1183 men, 14.7% had 1 or more new infections (9.4% acquired C trachomatis, and 7.1% acquired N. gonorrhoeae). Black persons and those with sexually transmitted infections at baseline were at highest risk for recurrent infection (adjusted odds ratio, 2.5 and 2.4, respectively). For persons infected at baseline, the risk for infection was high at 3 and 6 months (16.3 per 100 three-month intervals) and remained high at 9 and 12 months (12.0 per 100 three-month intervals). Most (67.2%) infections were diagnosed during study-related visits, and 66.2% of these patients reported no symptoms.Limitations: Because patients were recruited from STD clinics, results may not be generalizable.Conclusions: Men and women who receive diagnoses of C trachomatis, N. gonorrhoeae, or T vaginalis infections should return in 3 months for rescreening because they are at high risk for new asymptomatic sexually transmitted infections. Although single-dose therapy may adequately treat the infection, it often does not adequately treat the patient.