Sexually transmitted infections amongst men who have sex with men (MSM) in South Africa.
Sexually transmitted infections amongst men who have sex with men (MSM) in South Africa.
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DOI：
10.1371/journal.pgph.0001782
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发表时间：
2023
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关于撒哈拉以南非洲 MSM 人群中细菌性性病的数据有限。我们的回顾性分析使用了 HVTN 702 HIV 疫苗临床试验（2016 年 10 月至 2021 年 7 月）的数据。我们评估了多个变量。每6个月对尿液和直肠样本进行聚合酶链反应检测，检测淋病奈瑟菌（NG）和沙眼衣原体（CT）。在第 0 个月进行梅毒血清学检查，此后每 12 个月进行一次。我们计算了随访 24 个月之前的 STI 患病率和相关的 95% 置信区间。该试验招募了 183 名男性或变性女性、同性恋或双性恋取向的参与者。其中，173 人在第 0 个月进行了 STI 检测，中位年龄为 23 (IQR 20-25) 岁，中位随访 (FU) 个月为 20.5 (IQR 17.5-24.8) 个月。该临床试验还招募了 3389 名女性参与者并进行了第 0 个月的 STI 检测，其中女性参与者的中位年龄为 23 (IQR 21-27) 岁，中位 FU 的时间为 24.8 (IQR 18.8-24.8) 个月，以及 1080 名非 MSM 男性，中位年龄为 27 (IQR 24-31) 岁，中位 FU 的时间为 24.8 (IQR 23-24.8) 个月。第 0 个月时，MSM 和女性的 CT 患病率相似（26.0% vs 23.0%，p = 0.492），但与非 MSM 男性相比，MSM 中的 CT 患病率更高（26.0% vs 14.3%，p = 0.001）。 CT 是 MSM 中第 0 个月和第 6 个月最常见的性传播感染，但从第 0 个月到第 6 个月有所下降（26.0% vs 17.1%，p = 0.023）。相比之下，第 0 个月到第 6 个月期间，MSM 的 NG 没有下降（8.1% vs 7.1%，p = 0.680），第 0 个月到 12 个月期间梅毒患病率也没有下降（5.2% vs 3.8%，p = 0.588）。与非 MSM 男性相比，MSM 中的细菌性 STI 负担更高，而 CT 是 MSM 中最常见的细菌性 STI。预防性性病疫苗，特别是针对 CT 的疫苗，可能有助于开发。
There is limited data about bacterial STIs in MSM populations in sub-Saharan Africa. Our retrospective analysis used data from the HVTN 702 HIV vaccine clinical trial (October 2016 to July 2021). We evaluated multiple variables. Polymerase chain reaction testing was conducted on urine and rectal samples to detect Neisseria gonorrhoea (NG) and Chlamydia trachomatis (CT) every 6 months. Syphilis serology was conducted at month 0 and thereafter every 12 months. We calculated STI prevalence and the associated 95% confidence intervals until 24 months of follow-up. The trial enrolled 183 participants who identified as male or transgender female, and of homosexual or bisexual orientation. Of these, 173 had STI testing done at month 0, median age was 23 (IQR 20–25) years, with median 20.5 (IQR 17.5–24.8) months follow-up (FU). The clinical trial also enrolled and performed month 0 STI testing on 3389 female participants, median age 23 (IQR 21–27) years, median 24.8 (IQR 18.8–24.8) months FU and 1080 non-MSM males with a median age of 27 (IQR 24–31) years, median 24.8 (IQR 23–24.8) months FU. At month 0, CT prevalence was similar in MSM and females (26.0% vs 23.0%, p = 0.492) but was more prevalent in MSM compared to non-MSM males (26.0% vs 14.3%, p = 0.001). CT was the most prevalent STI among MSM at months 0 and 6 but declined from month 0 to month 6 (26.0% vs 17.1%, p = 0.023). In contrast, NG did not decline in MSM between months 0 and 6 (8.1% vs 7.1%, p = 0.680) nor did syphilis prevalence between months 0 and 12 (5.2% vs 3.8%, p = 0.588). Bacterial STI burden is higher in MSM compared to non-MSM males, and CT is the most prevalent bacterial STI amongst MSM. Preventive STI vaccines, especially against CT, may be helpful to develop.