男性性工作者尿液筛查沙眼衣原体和淋球菌及危险因素分析

目的:了解男性性工作者沙眼衣原体和淋球菌感染情况,为预防干预提供依据。方法:对男性性工作者采取知情同意进行问卷调查,取尿液进行生殖道沙眼衣原体及淋球菌检测。结果:95例男性性工作者,生殖道沙眼衣原体、淋球菌感染阳性率分别是12.6%、8.4%;两者混合感染2.1%。同性服务时间≤12个月、曾服兴奋剂、性交选择浴池和有固定异性性伴是其危险因素。结论:根据本研究结果有必要对男性性工作者的沙眼衣原体和淋球菌感染进行监测。     

104例泌尿生殖道沙眼衣原体感染的临床分析

目的：分析近四年西京医院皮肤性病门诊患者中生殖道沙眼衣原体检测阳性的感染特点及混合感染状况。方法：回顾性分析2007年11月～2011年6月确诊的104例生殖道沙眼衣原体感染者临床资料。结果：104例生殖道沙眼衣原体感染者中,男性感染者71例（68.27%）,女性感染者33例（31.73%）。单一衣原体感染39例（37.50%）,其中男性35例（89.74%）,占所有男性患者的49.30%（35/71）,女性4例（10.26%）,占所有女性患者的12.12%（4/33）。其余65例均为混合感染（62.50%）,其中男性36例（55.38%）,占所有男性患者的50.70%（36/71）,女性29例（44.62%）,占所有女性患者的87.88%（27/33）。女性的混合感染率高于男性,男、女性的混合感染率均高于单一衣原体感染率。结论：单一发生泌尿生殖道沙眼衣原体感染率不高,大多以混合感染形式存在,临床应对STI患者及其性伴做全面检查。     

汕头性病门诊患者泌尿生殖道沙眼衣原体检测

目的：了解2011-2017年本院11584例性病门诊患者泌尿生殖道沙眼衣原体感染特征。方法：对就诊患者的临床资料进行回顾性分析。结果：（1）11584例患者中沙眼衣原体阳性1480例,阳性率12.78%。6886例男性患者中泌尿生殖道沙眼衣原体感染1023例,阳性率14.86%,4698例女性患者中沙眼衣原体阳性457例,阳性率9.73%,男女患者阳性率比较有显著统计学差异;（2）感染率最高和最低的年龄段为≤19岁和≥60岁的患者,感染率分别为 28.29%（71/251）和9.16%（34/371）;（3）1480例泌尿生殖道沙眼衣原体阳性患者中有991例无症状的体检者（66.96 %）。结论：2011-2017年本院性病门诊患者泌尿生殖道沙眼衣原体感染率较高,泌尿生殖道沙眼衣原体阳性感染者中无症状感染者占比较高。     

云南省曲靖市暗娼人群艾滋病、性病感染状况及生殖道沙眼衣原体感染影响因素分析

目的 了解云南省曲靖市暗娼人群艾滋病、性病(梅毒、生殖道沙眼衣原体、淋球菌)的感染现状以及该人群对艾滋病知识的知晓情况,分析生殖道沙眼衣原体感染的相关影响因素.方法 2020年4-6月,在曲靖市麒麟区招募200名暗娼,进行现场一对一问卷调查,同时采集尿液和静脉血标本.其中尿液样本进行生殖道沙眼衣原体(CT)和淋球菌(N...     

2008-2011年上海市金山区卖淫人员性传播疾病疫情分析

目的 了解2008-2011年上海市金山区卖淫人员性传播疾病(STD)流行情况。方法 对2008-2011年金山区各派出所强制送检的431例专职卖淫人员进行淋病和生殖道沙眼衣原体感染、梅毒、尖锐湿疣、生殖器疱疹和艾滋病的检测和流行病学调查。结果 卖淫人员均为外省市人,文化程度低,≤初中占92.80%。共检出STD患者127例,患病率为29.47%。其中梅毒居首位,感染率为21.81%,且以TRUST阴性和TPPA阳性率居多。淋病感染率为4.87%,生殖道沙眼衣原体感染率为4.65%,尖锐湿疣感染率为0.70%,HIV感染率为0.23%。未检测到生殖器疱疹患者。结论 卖淫人员STD感染率高,尤其是梅毒。HIV感染在本地区卖淫人员中开始崭露头角,应加强对其主动监测和规范治疗。     

广州地区MSM和FSWs的性病知晓情况及梅毒艾滋病感染因素分析

目的:了解广州地区男男同性性行为者(MSM)、女性性工作者(FSWs)的性病知晓情况及梅毒、艾滋病病毒感染现况,并分析感染因素。方法:经知情同意后,2017年4-8月对广州地区MSM和FSWs两类高危人群进行面对面问卷调查,采集静脉血检测梅毒及HIV抗体,并进行统计学分析。结果:314例MSM的性病相关疾病知晓率、性病传播途径知晓率、性病防止感染方式知晓率分别为62.10%、44.59%、41.08%,408例FSWs以上知晓率分别为49.02%、22.06%、31.13%。264例MSM参与梅毒及HIV抗体检测,梅毒感染率为1.52%,HIV感染率为10.23%;多因素Logistic逐步回归分析结果显示,学历高中及以上(OR=0.360,95%CI:0.131~0.989),知晓性病相关疾病(OR=0.373,95%CI:0.157~0.881)是感染HIV的保护因素,认为自己可能感染艾滋病(OR=3.440,95%CI:1.401~8.443)和梅毒检测结果阳性(OR=14.151,95%CI:1.745~114.736)是危险因素。FSWs梅毒感染率为3.92%,HIV感染率为0.25%;场所为中高档是感染梅毒的保护因素(OR=0.166,95%CI:0.052~0.526)。结论:广州地区MSM和FSWs的梅毒、艾滋病病毒感染率高,性病知识知晓率低,应扩大高危人群梅毒、艾滋病病毒筛查范围,并加强性病知识宣教。     

深圳市男男性接触人群梅毒合并HIV感染状况及其危险因素分析

目的：了解深圳市近6个月内发生过同性临时性行为的MSM人群梅毒合并HIV感染状况及其相关影响因素。方法：运用滚雪球法和同伴推动抽样法招募MSM进行问卷调查和血清学检测,采用χ2检验和Logistic回归分析梅毒HIV合并感染的相关影响因素。结果：共调查434例MSM,梅毒和HIV感染率分别为16.4%和12.2%,梅毒合并HIV感染率为7.3%。年龄越大（OR=4.0,P=0.0007）、高中/中专文化者（OR=6.5,P=0.0081）、性角色以被动方为主者（OR=12.1,P=0.0017）、多个同性肛交性伴者（OR=1.5,P=0.0455）、不能坚持每次使用安全套者（OR=2.9,P=0.0236）,其梅毒合并HIV感染风险越高。结论：需要采取更大努力来应对该人群的梅毒和HIV双重感染问题。     

568名性罪错人员性传播疾病监测结果分析

对2008-2010年被德清县公安部门收押的568名性罪错人员进行泌尿生殖道分泌物与血液检测.273名女性人员中梅毒、淋病、生殖道沙眼农原体的感染率分别为17.58％,1.47％,4.76％;295名男性中梅毒、淋病、生殖道沙眼衣原体的感染率分别为5.42％,0％,0.34％,均未检出HIV抗体阳性者.性罪错人员特别是女性的梅毒患病率最高.需要加强对老年人群进行性病健康教育与行为干预.     

ClearView CT快速诊断女性生殖道沙眼衣原体感染的评价

目的:对C learV iew CT快速诊断试剂盒检测女性生殖道的沙眼衣原体进行方法学评价。方法:采集每名受试者宫颈分泌物拭子2份,将之随机分为2组,以荧光定量PCR为参比试验,评价C lear-V iew CT快速诊断试剂盒在女性生殖道沙眼衣原体感染的应用性能。结果:设置荧光定量PCR为参比试验,C learV iew快速诊断试剂盒检测女性生殖道衣原体的敏感性为32.73%,特异性为88.52%,约登指数为0.2125。在感染率为28.95%的性服务工作者人群中应用该试剂盒检测生殖道沙眼衣原体时,其验后概率为53.74%。结论:C learV iew CT快速试剂盒的特异性尚可,但其敏感性差;在感染率达28.95%的女性性服务工作者人群应用C learV iew快速试剂盒检测生殖道衣原体感染,检测阳性者来诊断衣原体感染的把握度为53.74%。     

402名女性性工作者HIV、梅毒感染状况及危险因素调查分析

目的了解我市城区女性性工作者HIV和梅毒感染状况及其危险因素,为更好的在女性性工作者中,有针对性地开展行为干预工作提供依据。方法采用随机抽样法随机抽取卡拉OK厅、歌舞厅等场所,对女性性工作者采取一对一问卷调查并采取血液样本检测HIV和梅毒。结果调查女性性工作者402名,HIV阳性13例,感染率3.2%,梅毒阳性9例,感染率2.2%,其中有固定性伴43.1%,最后一次与固定性伴性交时,使用和不使用安全套HIV阳性率及梅毒阳性率的差异有显著性意义。文盲与高中以上相比HIV阳性率差异有显著性意义,而不同年龄、不同婚姻状况无显著差异。结论女性性工作者是HIV感染的重要人群,不安全性行为是其感染HIV和梅毒的主要原因,与固定性伴安全套使用低,存在HIV通过高危人群向一般人群传播的危险。     

Family planning services in developing countries: an opportunity to treat asymptomatic and unrecognised genital tract infections?

OBJECTIVE: To determine the prevalence of asymptomatic and unrecognised genital tract infections among women attending a family planning clinic in rural South Africa. METHODS: 189 consecutive women had genital samples taken to diagnose infection with Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Candida albicans, Treponema pallidum, and HIV, and to diagnose bacterial vaginosis. RESULTS: Mean age was 25 years; 155 (82%) were unmarried, 156 (83%) were currently using contraception, and 41 (22%) reported having an STD treated in the preceding 12 months. Although none volunteered abnormal urogenital symptoms, 74 (39%) had at least one elicited by direct questioning. 119 women (63%) had at least one genital infection: N gonorrhoeae (eight; 4%), C trachomatis (14; 8%), T vaginalis (26; 14%), C albicans (56; 30%), active syphilis (15; 8%), HIV (44; 24%), and bacterial vaginosis (29; 15%). 49 women (26%) had multiple infections. Most infections (71; 60%) were asymptomatic. Symptomatic women failed to recognise and report their symptoms, and routine services failed to detect the infections. CONCLUSION: Prevalence of genital tract infection is high among these women, most infections are asymptomatic, and symptomatic infections are frequently not recognised. Women attending family planning clinics in such settings should be screened for syphilis and offered testing for HIV infection. Strategies to detect and treat other genital infections need to be developed.     

Should screening of genital infections be part of antenatal care in areas of high HIV prevalence? A prospective cohort study from Kigali,Rwanda, 1992-1993. The Pregnancy and HIV (EGE) Group.

OBJECTIVE--To study the prevalence and incidence of genital infections and their association with HIV-1 infection among pregnant women in Kigali, Rwanda. SUBJECTS AND METHODS--HIV+ and HIV- pregnant women were followed prospectively during the last three months of pregnancy. At enrolment, syphilis test (RPR) on blood sample, Chlamydiae trachomatis ELISA test on cervical smear, laboratory gonococcal culture, trichomonas and candida direct examination, CD4 lymphocyte count were performed. At each monthly follow-up clinic visit until delivery, genital infections were screened in the presence of clinical signs and symptoms. RESULTS--The HIV seroprevalence rate was 34.4% (N = 1233), 384 HIV+ women and 381 HIV- women of same parity and age were enrolled. Prevalence of genital infections at enrolment was generally higher in HIV+ women than in HIV- women: syphilis, 6.3% versus 3.7% (p = 0.13); Neisseria gonorrhoea, 7.0% versus 2.4% (p = 0.005); Trichomonas vaginalis, 20.2% versus 10.9% (p = 0.0007); Chlamydia trachomatis, 3.4% versus 5.5% (p = 0.21); Candida vaginalis, 22.3% versus 20.1% (p = 0.49). Until delivery, the relative risk of acquiring genital infections was also higher in HIV+ women than in HIV- women: 1.0 for syphilis (95% CI: 0.5-2.2), 3.7 for Neisseria gonorrhoea (1.0-13.3), 2.6 for Trichomonas vaginalis (1.5-4.6) and 1.6 for Candida vaginalis (1.1-2.4). CONCLUSION--In the context of high HIV-1 seroprevalence among pregnant women, prenatal care should include at least once screening for genital infections by clinical examination with speculum and a syphilis testing in Africa.     

High prevalence of sexually transmitted diseases in a rural area in Mozambique.

OBJECTIVE--To assess the extent of the sexually transmitted diseases (STDs) problem in a rural area of Mozambique. METHODS--A cross sectional study among pregnant women and patients presenting with genital complaints. Laboratory confirmation was done for gonorrhoea, chlamydial infection, active syphilis, trichomoniasis and HIV infection. SETTING--A primary health care setting in Vilanculos, Inhambane province, Mozambique. RESULTS--Evidence of one or more of the above STDs was found in 51% of 201 pregnant women, 56% of 85 women and 62% of 77 men with genital complaints. Neisseria gonorrhoea or Chlamydia trachomatis were found in 16% of pregnant women, 23% of female patients and 28% of male patients; genital ulcer disease was present in 6%, 28% and 36%, of respectively pregnant women, female and male patients. The prevalence of active syphilis was about the same in the three groups of study subjects, that is 15%. HIV infection was found in 4% of the male patients; no HIV infection could be detected in the female groups. CONCLUSION--STDs were a major health problem in this rural area in Mozambique. Though HIV infection was still low, the high prevalence of STDs indicates that the potential is there for an explosive spread of the HIV/AIDS epidemic.     

Epidemic Lymphogranuloma venereum during epidemics of crack cocaine use and HIV infection in the Bahamas

BACKGROUND: Since the early 1980s, the Bahamas has experienced sequential epidemics of freebase/crack cocaine use, genital ulcer-inguinal adenopathy disease (GUD), and heterosexual HIV infection. GOAL: To prospectively define the etiology of GUD in patients at the Princess Margaret Hospital during outbreaks of crack cocaine use, GUD, and HIV infection in the Bahamas. STUDY DESIGN: In Nassau, 47 consecutive patients with GUD underwent serologic testing for syphilis and for infections with HIV, herpes simplex virus type 2 (HSV-2), and Chlamydia trachomatis. Genital ulcer specimens were tested by culture and/or polymerase chain reaction (PCR) assay for Haemophilus ducreyi; by PCR and/or antigen assay for HSV; and by PCR for C trachomatis. Lymph node aspirates were tested by PCR for C trachomatis and H ducreyi. RESULTS: Twenty patients (43%) had HIV infection; eight had lymphogranuloma venereum (LGV), confirmed by PCR detection of C trachomatis sequences consistent with the L2 serovar; and nine others had possible LGV, on the basis of serum microimmunofluorescent C trachomatis antibody titers > or =256. Inguinal lymphadenopathy or bubo was present in 15 of 17 patients, who thus met the laboratory criteria for definite or possible LGV, and in 7 of 30 who did not meet such laboratory criteria (P < 0.001). Thirteen patients had confirmed genital herpes, seven had confirmed chancroid, and four had probable or possible primary syphilis. CONCLUSIONS: The epidemics in the Bahamas of crack use, heterosexual HIV infection, and GUD apparently included epidemic transmission of LGV.     

Improvement of clinical algorithms for the diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis by the use of Gram-stained smears among female sex workers in Accra, Ghana

BACKGROUND: Screening for cervical infection is difficult in developing countries. Screening strategies must be improved for high-risk women, such as female sex workers. GOAL: To evaluate the sensitivity and specificity of screening algorithms for cervical infection pathogens among female sex workers in Accra, Ghana. STUDY DESIGN: A cross-sectional study among female sex workers was conducted. Each woman underwent an interview and a clinical examination. Biologic samples were obtained for the diagnosis of HIV, syphilis, bacterial vaginosis, yeast infection, Trichomonas vaginalis, Neisseria gonorrhoeae, and Chlamydia trachomatis infection. Signs and symptoms associated with cervicitis agents were identified. Algorithms for the diagnosis of cervical infection were tested by computer simulations. RESULTS: The following prevalences were observed: HIV, 76.6%; N. gonorrhoeae, 33.7%; C. trachomatis, 10.1%; candidiasis, 24.4%; T. vaginalis, 31.4%; bacterial vaginosis, 2.3%; serologic syphilis, 4.6%; and genital ulcers on clinical examination, 10.6%. The best performance of algorithms were reached when using a combination of clinical signs and a search for gram-negative diplococci on cervical smears (sensitivity, 64.4%; specificity, 80.0%). CONCLUSIONS: In the algorithms, examination of Gram-stained genital smears in female sex workers without clinical signs of cervicitis improved sensitivity without altering specificity for the diagnosis of cervical infection.     

梅毒、淋病和生殖道沙眼衣原体感染诊疗指南（2020年）

梅毒、淋病和生殖道沙眼衣原体感染是我国目前重点防治的性传播疾病。梅毒的临床表现复杂,按照其发病时间、临床表现及传染方式,可分为一期梅毒、二期梅毒、三期梅毒、神经梅毒、隐性梅毒及先天梅毒等。淋病和生殖道沙眼衣原体感染主要侵犯泌尿生殖道,其临床表现从无症状到伴发各种并发症,差别较大。这3种性病的诊断应依据流行病学史、临床表现及实验室检查结果综合判断后确定。应尽早、规范并按推荐方案进行治疗。治疗后应进行必要的随访。淋病的病原体耐药已经成为临床关注的问题。     

HIV and STIs in clients and female sex workers in mining regions of Gejiu City, China

OBJECTIVE: To investigate HIV/sexually transmitted infections (STIs) among female sex workers (FSWs) and clients in a mining region of China. GOAL: To estimate HIV/STI prevalence and to identify HIV risk factors among FSWs and miner clients. STUDY DESIGN: A cross-sectional study of 96 FSWs and 339 miner clients. RESULTS: In FSWs, prevalence of HIV was 8.3%, herpes simplex virus-2 70.8%, syphilis 12.5%, Neisseria gonorrhoeae 36.8%, Chlamydia trachomatis 46.3%, Trichomonas vaginalis 22.1%, and 90.6% were infected with any STI. Illegal drug use was associated with HIV [adjusted odds ratio (OR) = 45.1, 95% confidence interval, 6.4-317.9] in FSWs, and 45.8% reported no condom use with the last client. In miner clients, HIV prevalence was 1.8%, herpes simplex virus-2 14.9%, syphilis 2.4%, N. gonorrhoeae 2.1%, C. trachomatis 6.5%, and 23.2% were infected with any STI. Never using condoms with FSWs and regular partners were reported in 61.2% and 84.1%, respectively. Independent risk factors for HIV in miner clients were illegal drug use (OR 190.2), symptoms of urethral discharge or frequent urination (OR 32.9), early sexual debut (OR 7.1), and visiting 4 or more FSWs in the last 12 months (OR 11.5). CONCLUSIONS: HIV/STI prevalence is high among FSWs and moderate among clients in mining regions of Gejiu City. Drug use is the most important factor placing FSWs and miner clients at risk for HIV in Gejiu City; risky sexual characteristics such as early sexual debut, frequent visits to FSWs, and STI symptoms are also important factors for miner clients. FSWs and miner clients may constitute bridging groups for HIV to low-risk populations.     

2011—2020年广东省肇庆市生殖道沙眼衣原体感染的流行病学特征

 

目的了解广东省肇庆市生殖道沙眼衣原体感染的流行特征及趋势,为制定有效的防治策略提供依据。方法 通过“中国疾病预防控制信息系统”,收集广东省肇庆市2011—2020年报告的生殖道沙眼衣原体感染病例资料,进行流行病学分析。结果生殖道沙眼衣原体感染报告发病率呈上升趋势(  X² =730.95,P＜0.01),由2011年的16.16/10万上升至2020年的25.17/10万,年均升幅5.28%。生殖道沙眼衣原体感染疫情分布特点为集中在工业和流动人口相对较多的中部地区(高至62.48/10万),逐渐向西北部偏远县区(低至11.54/10万)下降的特点。女性从2011年的16.68/10万上升至2020年的40.21/10万,年均升幅10.27%,男性从2011年的15.66/10万下降至2020年的10.89/10万,年均降幅为3.96%。女性报告发病率高于男性,近几年发病率数倍于男性,男女性别比例从2011年的0.98 ∶ 1下降到2020年的0.29 ∶ 1,差异有统计学意义(X²=328.53,P<0.01)。高发年龄段为20～39岁,年均升幅最高为10～19岁(20.99%)。职业以家务及待业最多。结论2011—2020年间广东省肇庆市生殖道沙眼衣原体感染发病率总体呈上升趋势,男性、青少年、家务及待业人群是重点管理对象,应加大以上重点人群的筛查力度。

     

Sexually transmitted infections among brothel-based sex workers in bangladesh: high prevalence of asymptomatic infection

OBJECTIVE AND GOAL: The goal of this study was to study the prevalence of sexually transmitted infections (STIs)/reproductive tract infections (RTIs) among brothel-based sex workers (SWs) in Bangladesh. STUDY: A cross-sectional study was conducted among SWs in 4 randomly selected brothels. A sociodemographic and behavioral survey and pelvic examination was conducted. Specimens including endocervical swab, high vaginal swab, and blood were collected and were examined for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, bacterial vaginosis candidiasis, and syphilis. RESULTS: A total of 439 SWs were enrolled and 49.6% had genital symptoms. Among all SWs, 17.5% were positive for N. gonorrhoeae; 15.5% for C. trachomatis; 7.5% for T. vaginalis, and 6.6% had active syphilis. A total of 67.4% SWs were positive for at least 1 cervical and/or vaginal infection. CONCLUSION: The prevalence of STIs/RTIs among SWs in brothels in Bangladesh is high. An intervention strategy addressing both symptomatic and asymptomatic infections and periodic screening of SWs for RTIs/STIs is essential for successful HIV and STIs prevention programs.     

广东省江门市1286例女性性工作者性传播疾病调查分析

目的:调查广东省江门市女性性工作者人群中4种性传播疾病的发病情况,为本市制定预防控制对策提供一定的科学依据.方法:2009年7月至2011年3月,开展酒店、桑拿、发廊、站桩点等场所的外展活动,使用中国性病控制中心编制的国家科技重大专项课题FSW基线调查问卷对FSWs进行问卷调查,并同时做血清学梅毒、艾滋病检测及宫颈分泌物淋病、生殖道沙眼衣原体检测.结果:1 286例FSWs中4种性病总阳性231例,阳性率17.96%;特异性梅毒血清学(ELISA法)阳性率9.25%;非特异性梅毒血清学(TRUST)阳性率5.52%;艾滋病血清学(ELISA法)初筛阳性5例,WB法确证阳性4例,阳性率0.31%;淋球菌阳性率1.94%;生殖道沙眼衣原体阳性率6.45%.结论:近年来,FSWs已成为江门市的性病高危人群,应定期对其监测并积极进行干预、治疗.