Pharyngeal gonorrhea among young people: Implication for prevention

描述(由申请人提供)：尽管目前和正在进行预防工作，但年轻人中包括淋病在内的性传播感染(STI)的发病率仍然很高。大多数预防工作主要集中在阴道性交上，尽管有相当数量的年轻人正在从事包括口交在内的非性交活动。尽管将口交与阴道或肛交进行比较时，性传播感染的风险降低了，但各种研究表明，口交仍然是包括淋病在内的一些性传播感染的潜在传播途径。由于年轻人口交的流行率相对较高，而有这种行为的避孕套使用率较低，尽管口交的传播率较低，但口交对淋病传播和这一人群中感染的维持可能比预期的更重要。在年轻人中检测咽部淋病特别重要，因为大多数感染是无症状的，咽部感染的治疗可能不同于泌尿生殖系统感染的治疗。此外，关于使年轻人面临咽部感染风险增加的因素的有限数据，使人们不清楚STI预防干预措施应该包括什么，以及应该如何制定降低风险的信息。这项拟议的研究将调查在公共性传播疾病(STD)诊所就诊的年轻人(即15-24岁)中与咽部淋病相关的危险因素，并确定使年轻人患咽部淋病风险增加的行为。这项形成性研究将用于调整和试点基于证据的性传播感染预防干预措施(项目SAFE)，以减少使年轻人面临包括咽部淋病在内的性传播感染风险增加的危险行为。这项获奖申请中描述的研究是第一个旨在通过纳入口交相关信息来扩大已经证明的循证干预对性传播感染预防的适用性的研究范例。本奖项申请旨在通过指导、健康相关行为改变、行为预防方法和干预措施来支持申请人的导师研究科学家发展奖(K01)，以减少STI传播。这项研究项目的长期目标是为性传播感染预防研究提供基础。在获奖期结束时，申请人将提交一份R01或R34提案，以在适当的随机试验中评估新的干预措施。这将是申请者下一个十年的研究议程的中心-成为一个独立的调查者，进行预防干预，减少高危人群，即年轻人中的性传播感染。

DESCRIPTION (provided by applicant): Despite current and ongoing prevention efforts, rates of sexually transmitted infections (STIs), including gonorrhea among young people remains high. The majority of the prevention efforts have focused primarily on vaginal intercourse, even though a substantial number of young people are engaging in non-coital activity including oral sex. Although the risk of transmission of STIs is reduced when comparing oral sex to vaginal or anal sex, various studies suggest that oral sex is still a potential transmission route for a number of STIs, including gonorrhea. Because the prevalence of oral sex among young people is relatively high and condom use with this behavior is low the contribution of oral sex to gonorrhea transmission and maintenance of infection among this population may be more important than expected despite the lower transmissibility with oral sex. Testing for pharyngeal gonorrhea among young people is particularly relevant given that the majority of infections are asymptomatic and treatment for pharyngeal infections maybe different from treatments used for urogenital infections. Furthermore, limited data on factors that place young people at increased risk for pharyngeal infections make it unclear what STI prevention interventions should include and how risk reduction messages should be framed. The proposed study will investigate risk factors associated with pharyngeal gonorrhea among young people (i.e., ages 15 - 24) attending public sexually transmitted disease (STD) clinics and identify behaviors that place young people at increased risk for pharyngeal gonorrhea. The formative research will be used to adapt and pilot test an evidence-based STI prevention intervention (Project SAFE) in order to reduce risky behaviors that place young people at increased risk for STIs, including pharyngeal gonorrhea. The study described in this award application is the first example of research designed to broaden the applicability of an already proven, evidence-based intervention for STI prevention by inclusion of messages surrounding oral sex. This award application is intended to support the applicant's Mentored Research Scientist Development Award (K01) through mentoring, formal training in health related behavior change, behavioral prevention methods, and interventions to reduce STI transmission. The long-term goals of this research project are to provide the foundation for STI prevention research. At the end of the award period, the applicant will submit a R01 or R34 proposal to evaluate the new intervention in an appropriately powered randomized trial. This will be the center the applicant's research agenda for the next decade - to become an independent investigator conducting prevention interventions that reduce STIs among populations at high risk, namely young people.