Rates of Sexually Transmitted Infection Diagnoses Among US Youth With Perinatally and Nonperinatally Acquired HIV.
Rates of Sexually Transmitted Infection Diagnoses Among US Youth With Perinatally and Nonperinatally Acquired HIV.
复制标题
DOI：
10.1097/olq.0000000000001578
复制
发表时间：
2022-03-01
影响因子：
3.1
通讯作者：
Ciaranello AL
中科院分区：
文献类型：
--
作者：
Neilan AM;DeMonte JB;Foote JHA;Karalius B;Patel K;Kapogiannis BG;Rudy BJ;Huszti H;Fernandez MI;Hudgens MG;Ciaranello AL
在艾滋病毒/艾滋病干预措施青少年医学试验网络的3项研究中，与围产期感染艾滋病毒的青年相比，非围产期感染艾滋病毒的青年接受抗逆转录病毒治疗的时间较少，性传播感染率较高。补充数字内容可在文本中找到。在美国，50%的新发性传播感染发生在15至24岁的年轻人中。以前的研究中，青年艾滋病毒（YHIV）没有区分性传播感染的趋势与围产期（YPHIV）和非围产期（YNPHIV）获得艾滋病毒的个人。在2009年至2015年期间进行的3项艾滋病毒/艾滋病干预青少年医学试验网络（ATN）研究中，我们估计了按出生时性别分配、艾滋病毒感染方式分层的滴虫性、细菌性、病毒性和总体性传播感染的事件诊断。（围产期[YPHIV]和非围产期[YNPHIV]）、年龄（13-17岁和18-24岁）、CD 4计数（<200、200-499和≥500/μL）和HIV病毒载量（VL）（<400和≥400拷贝/mL）。在3项研究的3131例YHIV中，平均（SD）年龄为20.6（2.6）岁，888例（28%）为女性，2498例（80%）记录了非围产期HIV感染，2298例（73%）为非洲裔美国人/黑人。平均随访时间为0.9（0.3）年。与YPHIV相比，YNPHIV在VL <400拷贝/mL的患者中花费的时间更少（47% vs. 53%），停止抗逆转录病毒治疗的时间更长（49% vs. 15%），总体STI率更高（男性，65.9 vs. 8.5/100人-年[PY];女性，54.7 vs. 17.2/100 PY）。在YPHIV中，在VL ≥400拷贝/mL与<400拷贝/mL的患者中，细菌性STI更高（男性YPHIV，10.9与0.6/100 PY;女性YPHIV，11.2与2.9/100 PY）; YNPHIV之间没有观察到差异，这可能是由于同时获得HIV和其他STI以及随访有限。与YPHIV相比，YNPHIV在抗逆转录病毒治疗和病毒学抑制方面花费的时间更少; YNPHIV的STI诊断率也更高。青年艾滋病毒感染者，包括没有病毒学抑制的人，性传播感染的诊断率很高，这突出表明必须以青年为重点，努力支持持久的病毒学抑制，并查明和治疗性传播感染。
Among youth with HIV in 3 Adolescent Medicine Trials Network for HIV/AIDS Interventions studies, youth with nonperinatal HIV spent less time on antiretroviral therapy and had higher rates of sexually transmitted infections compared with youth with perinatal HIV. Supplemental digital content is available in the text. Of new sexually transmitted infections (STIs) in the United States, 50% occur among youth aged 15 to 24 years. Previous studies among youth with HIV (YHIV) do not distinguish STI trends among individuals with perinatally (YPHIV) and nonperinatally (YNPHIV) acquired HIV. Among 3 Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) studies conducted between 2009 and 2015, we estimated incident diagnoses of trichomonal, bacterial, viral, and overall STIs stratified by sex assigned at birth, mode of HIV acquisition (perinatal [YPHIV] and nonperinatal [YNPHIV]), age (13–17 and 18–24 years), CD4 count (<200, 200–499, and ≥500/μL), and HIV viral load (VL) (<400 and ≥400 copies/mL). Among 3131 YHIV, across the 3 studies, mean (SD) age was 20.6 (2.6) years, 888 (28%) were female, 2498 (80%) had nonperinatal HIV acquisition recorded, and 2298 (73%) were African American/Black. Mean follow-up was 0.9 (0.3) years. Compared with YPHIV, YNPHIV spent less person-time with VL <400 copies/mL (47% vs. 53%) and more time off antiretroviral therapy (49% vs. 15%), and had higher overall STI rates (males, 65.9 vs. 8.5/100 person-years [PY]; females, 54.7 vs. 17.2/100 PY). Among YPHIV, bacterial STIs were higher during person-time spent with VL ≥400 vs. <400 copies/mL (male YPHIV, 10.9 vs. 0.6/100 PY; female YPHIV, 11.2 vs. 2.9/100 PY); no difference was observed among YNPHIV, which may be due to concurrent acquisition of HIV and other STIs and limited follow-up. Compared with YPHIV, YNPHIV spent less time on antiretroviral therapy and virologically suppressed; YNPHIV also had higher STI diagnosis rates. Very high STI diagnosis rates among YHIV, including among those without virologic suppression, highlight the importance of youth-focused efforts to support durable virologic suppression and identify and treat STIs.