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的预防工作，性传播感染（STI），包括淋病在年轻人中的发病率仍然很高。大多数预防工作主要侧重于阴道性交，尽管相当多的年轻人从事包括口交在内的非性交活动。虽然口交与阴道或肛交相比，性传播感染的风险降低了，但各种研究表明，口交仍然是许多性传播感染的潜在传播途径，包括淋病。由于年轻人中口交的流行率相对较高，并且这种行为的安全套使用率较低，因此尽管口交的传播率较低，但口交对淋病传播的贡献以及该人群中感染的维持可能比预期的更重要。由于大多数感染是无症状的，咽部感染的治疗可能与泌尿生殖道感染的治疗不同，因此在年轻人中进行咽部淋病的检测尤为重要。此外，关于使年轻人咽部感染风险增加的因素的数据有限，因此不清楚性传播感染预防干预措施应包括哪些内容，以及应如何构建减少风险的信息。这项拟议的研究将调查与年轻人咽部淋病相关的风险因素（即，年龄在15 - 24岁之间的年轻人到公共性传播疾病（STD）诊所就诊，并确定使年轻人患咽部淋病的风险增加的行为。形成性研究将用于调整和试点测试基于证据的性传播感染预防干预措施（项目安全），以减少使年轻人面临性传播感染风险增加的危险行为，包括咽部淋病。本奖项申请中描述的研究是第一个旨在通过纳入有关口交的信息来扩大已被证明的基于证据的性传播感染预防干预措施的适用性的研究。该奖项申请旨在通过指导、与健康相关的行为改变、行为预防方法和干预措施来支持申请人的指导研究科学家发展奖（K 01）。本研究项目的长期目标是为性传播感染预防研究奠定基础。在奖励期结束时，申请人将提交R 01或R34提案，以在适当的随机试验中评估新的干预措施。这将是申请人未来十年的研究议程的中心-成为一名独立的调查员，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.