Crystal methamphetamine use predicts incident STD infection among men who have sex with men recruited online: a nested case-control study.
Crystal methamphetamine use predicts incident STD infection among men who have sex with men recruited online: a nested case-control study.
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水晶甲基苯丙胺的使用预测与在网上招募的男性发生性关系的男性中的事件感染：一项嵌套的病例对照研究。
DOI：
10.2196/jmir.6.4.e41
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发表时间：
2004-11-29
影响因子：
7.4
通讯作者：
Chiasson, Mary Ann
中科院分区：
文献类型：
--
作者：
Hirshfield, Sabina;Remien, Robert H;Walavalkar, Imelda;Chiasson, Mary Ann
自1999年以来，在男男性行为者（MSM）中，新诊断的人类免疫缺陷病毒（HIV）感染人数增加了约60%。可能导致这种复苏的因素包括广泛报道的艾滋病毒阳性和艾滋病毒阴性男男性行为者中细菌性性传播疾病（性病）的增加，以及不安全的性行为。 本研究旨在了解男男性接触者发生性病后的危险行为。 一个巢式病例对照研究，使用的数据从横断面互联网调查的男男性接触者（N=2643），调查在2001年6个月期间的危险行为。卡方和逻辑回归方法被用来估计获得一个事件STD与没有STD的可能性。 85%的受访者是白色，46%的人年龄在30岁以下，80%的人在网上认识了性伴侣; 7%的人是艾滋病毒阳性。患有性病的男性比没有性病的男性更有可能报告吸毒（冰毒比值比3.8; 95%置信区间2.1-6.7;可卡因OR 2.3; 95% CI 1.2-4.2;摇头丸OR 2.2; 95% CI 1.3-3.8;伟哥OR 2.1; 95% CI 1.2-3.7），性行为前或性行为中饮酒（或1.9; 95% CI 1.2-2.9）和高风险性行为（无保护肛交OR 5.0; 95% CI 2.8-8.9;多个性伴侣OR 5.9; 95% CI 2.5-13.8）。在多变量分析中，与STD事件相关的重要独立预测因素是使用甲基苯丙胺晶体（调整OR 2.0; 95%CI 1.1-3.8），无保护的肛交（调整OR 3.4; 95%CI 1.9-6.3），以及研究期间有6名或更多性伴侣（调整OR 3.3; 95%CI 1.4-7.8）。 识别和治疗患有性传播疾病的男男性行为者，或感染性传播疾病的风险增加的人，对于预防疾病的进一步传播至关重要。此外，有必要将艾滋病毒/性传播疾病和药物使用预防和教育纳入网络和社区场所。
Among men who have sex with men (MSM), the number of newly diagnosed human immunodeficiency virus (HIV) infections has increased by approximately 60% since 1999. Factors that may be contributing to this resurgence include a widely reported increase in bacterial sexually transmitted diseases (STDs) among HIV-positive and HIV-negative MSM, as well as unsafe sexual practices. This research was undertaken to learn more about risk behaviors associated with an incident STD among MSM. A nested case-control study was conducted, using data from a cross-sectional Internet survey of MSM (N=2643), which investigated risk behaviors during a 6-month period in 2001. Chi-square and logistic regression methods were used to estimate the likelihood of acquiring an incident STD versus no STD. Eighty-five percent of the respondents were white, 46% were under age 30, and 80% had met sex partners online; 7% were HIV-positive. Men with an incident STD were more likely than men without an STD to report drug use (crystal methamphetamine odds ratio 3.8; 95% confidence interval 2.1-6.7; cocaine OR 2.3; 95% CI 1.2-4.2; ecstasy OR 2.2; 95% CI 1.3-3.8; Viagra OR 2.1; 95% CI 1.2-3.7), alcohol before or during sex (OR 1.9; 95% CI 1.2-2.9), and high-risk sexual behavior (unprotected anal intercourse OR 5.0; 95% CI 2.8-8.9; multiple sex partners OR 5.9; 95% CI 2.5-13.8). In the multivariate analysis, significant independent predictors associated with an incident STD were crystal methamphetamine use (adjusted OR 2.0; 95% CI 1.1-3.8), unprotected anal intercourse (adjusted OR 3.4; 95% CI 1.9-6.3), and 6 or more sex partners during the study period (adjusted OR 3.3; 95% CI 1.4-7.8). Identifying and treating MSM who have STDs, or who are at increased risk for acquiring STDs, is crucial in preventing the further spread of disease. In addition, there is a need to integrate HIV/STD and substance use prevention and education into Web-based and community-based venues.