Sexually Transmitted Infections Diagnosed Among Sexual and Gender Minority Communities During the First 11 Months of the COVID-19 Pandemic in Midwest and Southern Cities in the United States.
Sexually Transmitted Infections Diagnosed Among Sexual and Gender Minority Communities During the First 11 Months of the COVID-19 Pandemic in Midwest and Southern Cities in the United States.
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DOI：
10.1097/olq.0000000000001681
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发表时间：
2022-10-01
影响因子：
3.1
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中科院分区：
文献类型：
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COVID-19大流行对性健康服务产生不利影响。考虑到性传播感染（STI）对性少数群体和性别少数群体（SGM）的负担，我们估计了在大流行的第一年，SGM中自我报告的STI诊断的发生率以及与STI诊断相关的因素。于2020年4月至2021年2月期间，在芝加哥、密尔沃基、底特律、明尼阿波利斯及休斯顿招募的426名年龄≥25岁的SGM人员完成了五项在线调查。在每次调查中，人们自我报告了所有医疗保健提供者的性传播感染诊断。Kaplan-Meier用于估计STI诊断的累积风险，按HIV状态分层。与STI诊断相关的因素采用纵向负二项回归进行评估。中位年龄为37岁，27.0%为艾滋病毒感染者（PLH）。参与者报告了63例性传播感染，PLH和HIV阴性者的累积发病率分别为0.19（95%置信区间（CI）0.13-0.29）和0.12（95%CI 0.09-0.17）。无论是否感染艾滋病毒，年龄较小和医疗保健使用的变化与性传播感染的诊断有关。在HIV阴性人群中，休斯顿的STI诊断率高于中西部城市（调整相对危险度（aRR）2.37，95%CI 1.08-5.20）。在PLH中，医疗保健使用的减少也与性传播感染诊断相关（aRR 3.53，95%CI 1.01-12.32，而医疗保健服务没有变化），西班牙裔和使用约会应用程序来认识性伴侣也是如此。COVID-19大流行期间与STI诊断相关的因素通常反映了大流行前与STI发病率相关的因素，如地理、艾滋病毒、年龄和种族。一项针对中美洲性和性别少数群体的在线队列研究发现，在2019冠状病毒病大流行期间，艾滋病毒阳性和艾滋病毒阴性人群的STI累积发病率分别为19%和12%。
The COVID-19 pandemic adversely affected sexual health services. Given the burden of sexually transmitted infections (STI) on sexual and gender minorities (SGM), we estimated incidence of self-reported STI diagnoses and factors associated with STI diagnoses among SGMs during the pandemic’s first year. A cohort of 426 SGM persons, aged ≥25 years, recruited in Chicago, Milwaukee, Detroit, Minneapolis, and Houston completed five online surveys from April 2020 to February 2021. Persons self-reported on each survey all healthcare provider STI diagnoses. Kaplan-Meier was used to estimate the cumulative risk of STI diagnoses, stratified by HIV status. Factors associated with STI diagnoses were assessed with a longitudinal negative binomial regression. Median age was 37 years and 27.0% were persons living with HIV (PLH). Participants reported 63 STIs for a cumulative incidence for PLH and HIV-negative persons of 0.19 (95% Confidence Interval (CI) 0.13–0.29) and 0.12 (95%CI 0.09–0.17), respectively. Regardless of HIV, a younger age and changes in healthcare use were associated with STI diagnoses. Among HIV-negative persons, the rate of STI diagnoses was higher in Houston than the Midwest cities (adjusted relative risk (aRR) 2.37, 95%CI 1.08–5.20). Among PLH, a decrease in healthcare use was also associated with STI diagnoses (aRR 3.53, 95%CI 1.01–12.32 vs no change in healthcare services), as was Hispanic ethnicity and using a dating app to meet a sex partner. Factors associated with STI diagnoses during the COVID-19 pandemic generally reflected factors associated with STI incidence before the pandemic like geography, HIV, age, and ethnicity. An online cohort study with sexual and gender minorities in Middle America observed STI cumulative incidence during the COVID-19 pandemic was 19% and 12% among HIV-positive and HIV-negative persons, respectively.