Sexually Transmitted Diseases in Men Who Have Sex with Men: An Epidemiologic Review.
Sexually Transmitted Diseases in Men Who Have Sex with Men: An Epidemiologic Review.
复制标题
DOI：
10.1007/s11908-003-0051-5
复制
发表时间：
2003-04-01
影响因子：
3.1
通讯作者：
Ciesielski, Carol A.
中科院分区：
文献类型：
--
作者：
Ciesielski, Carol A.
采用高效抗逆转录病毒疗法（HAART）导致艾滋病毒感染的发病率和死亡率大幅下降。然而，HAART产生的乐观情绪和健康状况的改善似乎导致了男男性行为者（MSM）的意想不到的后果：失去了对获得和传播艾滋病毒的恐惧，高风险性行为的增加，避孕套的使用减少，淋病和梅毒的死灰复燃。其他因素，如缺乏性传播疾病（STD）的知识，使用互联网作为寻找性伴侣的场所，越来越多地使用伟哥（Pfizer，纽约，NY）作为娱乐药物，以及口交在STD传播中的作用明显扩大，都助长了这些趋势。由于溃疡性和炎症性性病促进艾滋病毒的传播，一个新的艾滋病毒感染浪潮在男男性接触者可能是地平线上。在MSM人群中，无论是HIV感染者还是未感染者，STD发病率的上升和高危性行为的复发对公共卫生和这些患者的临床管理具有深远的意义。临床医生应该意识到这一转变，并实施新的筛查和咨询指南，这些指南是针对这些令人震惊的报告而发布的。
The introduction of highly active antiretroviral therapy (HAART) has led to dramatic reductions in morbidity and mortality due to HIV infection. However, the resulting optimism and improved health status produced by HAART appears to have contributed to unanticipated consequences in men who have sex with men (MSM): loss of fear of acquiring and transmitting HIV, an increase in high-risk sex, decreased use of condoms, and a resurgence of gonorrhea and syphilis. Other factors, such as lack of knowledge of sexually transmitted diseases (STDs), use of the Internet as a venue to find sex partners, the increasing use of Viagra (Pfizer, New York, NY) as a recreational drug, and the apparent expanding role of oral sex in STD transmission are fueling these trends. Since ulcerative and inflammatory STDs facilitate HIV transmission, a new wave of HIV infection in MSM may be on the horizon. The rising STD rates and relapses in high-risk sexual behaviors in MSM, both HIV-infected and -uninfected MSM, have profound implications for public health and the clinical management of these patients. Clinicians should be aware of this turn of events, and implement new screening and counseling guidelines that have been issued in response to these alarming reports.