High burden of self-reported sexually transmitted infections among key populations in Mozambique: the urgent need for an integrated surveillance system
High burden of self-reported sexually transmitted infections among key populations in Mozambique: the urgent need for an integrated surveillance system
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DOI：
10.1186/s12879-020-05276-0
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发表时间：
2020-08-27
影响因子：
3.7
通讯作者：
Luchters, Stanley
中科院分区：
文献类型：
--
作者：
Boothe, Makini A. S.;Come, Charlotte;Luchters, Stanley
背景资料：关键人群-男男性行为者、女性性工作者和注射毒品者-由于其性风险行为沿着以及在预防、护理和治疗服务方面的社会、法律的和结构性障碍，他们面临性传播感染的高风险。二次分析的目的是评估自我报告的性传播感染的患病率，并描述相关的风险因素之间的参与者的第一次生物行为监测（BBS）在Mozambique.Methods：从2011年至2014年进行的第一次BBS调查的答复汇总调查城市，以产生汇总估计每个人口。计算加权估计数，以分析自我报告的性传播感染流行率。在多变量逻辑回归中使用未加权的汇总估计值，以确定与自我报告的STI相关的风险因素。结果MSM、FSW和PWID的STI患病率分别为11.9%（95%CI，7.8-16.0）、33.6%（95%CI，29.0-41.3）和22.0%（95%CI，17.0-27.0）。男男性接触者中，接受过包皮环切术、感染过艾滋病毒、报告过吸毒、报告过肛交以及与最后一个男性伴侣不使用安全套的人，自我报告性传播感染的几率更大。性传播感染自我报告的女性性工作者与生活在贝拉，已婚，就业以外的性工作，身体暴力，性暴力，吸毒，获得全面的艾滋病毒预防服务，不使用安全套与最后一个客户，和性关系与非客户的浪漫伴侣。在PWID中，自我报告的性传播感染的风险因素包括生活在楠普拉/纳卡拉，获得艾滋病毒预防服务，和sexualwork.Conclusion：调查参与者之间的性传播感染的高负担，需要综合艾滋病毒和性传播感染的预防，治疗和减少危害的服务，解决重叠的风险行为，特别是注射吸毒和性工作。强有力的公共卫生应对措施需要建立一个国家性传播感染监测系统，以便在这些脆弱人群中进行更好的筛查和诊断程序。
Background: Key populations - men who have sex with men (MSM), female sex workers (FSW) and people who inject drugs (PWID) - are at high risk for sexually transmitted infections (STI) given their sexual risk behaviours along with social, legal and structural barriers to prevention, care and treatment services. The purpose of this secondary analysis is to assess the prevalence of self-reported STIs and to describe associated risk factors among participations of the first Biological Behavioural Surveillance (BBS) in Mozambique.Methods: Responses from the first BBS surveys conducted in 2011-2014 were aggregated across survey-cities to produce pooled estimates for each population. Aggregate weighted estimates were computed to analyse self-reported STI prevalence. Unweighted pooled estimates were used in multivariable logistic regression to identify risk factors associated with self-reported STI. Results The prevalence of self-reported STI was 11.9% (95% CI, 7.8-16.0), 33.6% (95% CI, 29.0-41.3), and 22.0% (95% CI, 17.0-27.0) among MSM, FSW and PWID, respectively. MSM who were circumcised, had HIV, reported drug use, reported receptive anal sex, and non-condom use with their last male partner had greater odds of STI self-report. STI-self report among FSW was associated with living in Beira, being married, employment aside from sex work, physical violence, sexual violence, drug use, access to comprehensive HIV prevention services, non-condom use with last client, and sexual relationship with a non-client romantic partner. Among PWID, risk factors for self-reported STI included living in Nampula/Nacala, access to HIV prevention services, and sex work.Conclusion: The high-burden of STIs among survey participants requires integrated HIV and STI prevention, treatment, and harm reduction services that address overlapping risk behaviours, especially injection drug use and sex work. A robust public health response requires the creation of a national STI surveillance system for better screening and diagnostic procedures within these vulnerable populations.