BACKGROUND & AIMS:
BACKGROUND:Although chlamydia (CT) and gonorrhea (GC) infections are increasing in the United States, there are limited data on their incidence, testing rates, and associated risk factors among persons living with HIV (PLWH), including by anatomic site among men who have sex with men (MSM).
METHODS:We analyzed 2007-2017 medical records data from Human Immunodeficiency Virus (HIV) Outpatient Study (HOPS) participants in care at 9 HIV clinics. We calculated CT (and GC) incidence and testing rates and assessed associations with sociodemographic and clinical factors using log-linear regression.
RESULTS:Among 4727 PLWH, 397 had 881 CT infections and 331 had 861 GC infections, with an incidence of 2.95 and 2.88 per 100 person-years, respectively. From 2007 to 2017, incidence and testing rates increased by approximately 3.0- and 1.9-fold for CT and GC, respectively. Multivariable factors associated with incident CT (GC) included younger age, MSM, and prior diagnoses of sexually transmitted diseases (STDs). Among 1159 MSM, 583 (50.3%) had 844 CT and 843 GC tests during 2016-2017, and 26.6% of tests were 3-site (urethra, rectum, and pharynx), yielding the highest rates of CT (GC) detection. Multivariable factors associated with CT (GC) testing included younger age, non-Hispanic/Latino black race, and having prior STDs.
CONCLUSIONS:Recent CT and GC incidence and testing increased among PLWH; however, only half of MSM were tested for CT or GC during 2016-2017 and less than a third of tests were 3-site. To promote sexual health and STD prevention among PLWH who are MSM, research regarding the added value of CT and GC testing across 3 anatomic sites is needed.
背景与目标:
背景:尽管在美国,衣原体(CT)和淋病(GC)感染正在增加,但关于艾滋病毒感染者(PLWH)的发病率,检测率和相关危险因素的数据有限,包括男性的解剖部位与男人发生性关系的人(MSM)。
方法:我们分析了来自9个HIV诊所护理中的人类免疫缺陷病毒(HIV)门诊研究(HOPS)参与者的2007-2017年病历数据。我们计算了CT(和GC)的发生率和测试率,并使用对数线性回归评估了与社会人口统计学和临床因素的相关性。
结果:在4727例PLWH中,397例CT感染,331例861 GC感染,每100人年的发生率分别为2.95和2.88。从2007年到2017年,CT和GC的发生率和检测率分别增加了约3.0倍和1.9倍。与事件CT(GC)相关的多因素包括年龄较小,MSM以及先前诊断为性传播疾病(STD)。在1159名MSM中,2016年至2017年间,有583名(50.3%)进行了844项CT和843项GC检查,其中26.6%的检查是3位(尿道,直肠和咽),其CT(GC)检出率最高。与CT(GC)测试相关的多变量因素包括年龄较小,非西班牙裔/拉丁美洲黑人种族以及先前患有性病。
结论:PLWH中最近的CT和GC发生率和检测增加;但是,在2016-2017年间,只有一半的MSM进行了CT或GC测试,只有不到三分之一的测试是在3点进行的。为了在MSM的PLWH中促进性健康和性病的预防,需要研究3个解剖部位的CT和GC检测的附加值。