RESUMEN
BACKGROUND: Rectal Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among men who have sex with men (MSM) are escalating public health concerns. This study aimed to explore (1) the reliability of self-reported sexual positioning as an indicator for rectal CT and NG screening, and (2) factors associated with rectal CT and NG infections in Shenzhen, China. METHODS: A cross-sectional study was conducted in 2 settings in Shenzhen, China, from April 1, 2021, to March 31, 2022. Data on sociodemographic characteristics, sexual behaviors, and basic CT knowledge were collected. Urine and self-collected rectal swabs were collected for CT and NG testing. RESULTS: In total, 195 MSM participated in the study, and 5.1% tested positive for urogenital CT, 29.2% for rectal CT, 1.0% for urogenital NG, and 8.2% for rectal NG. Among those who reported exclusively insertive anal sex, 69.2% of CT infections and 85.7% of NG infections would have remained undetected with urine testing alone. Risk factors for rectal CT infection included engaging in both insertive and receptive anal sex, with a significant association found for coinfection with rectal NG. CONCLUSIONS: Self-reported sexual positioning was found to be an unreliable indicator for CT and NG screening, as a substantial proportion of infections would have remained undetected. The findings suggest that CT and NG screening in China should be offered to all MSM regardless of self-reported sexual positioning, and that the dual CT/NG testing is recommended.
Asunto(s)
Infecciones por Chlamydia , Chlamydia trachomatis , Gonorrea , Homosexualidad Masculina , Neisseria gonorrhoeae , Autoinforme , Conducta Sexual , Humanos , Masculino , Gonorrea/diagnóstico , Gonorrea/epidemiología , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/epidemiología , China/epidemiología , Estudios Transversales , Adulto , Neisseria gonorrhoeae/aislamiento & purificación , Chlamydia trachomatis/aislamiento & purificación , Tamizaje Masivo , Recto/microbiología , Adulto Joven , Factores de Riesgo , Enfermedades del Recto/microbiología , Enfermedades del Recto/diagnóstico , Enfermedades del Recto/epidemiología , Minorías Sexuales y de Género , Persona de Mediana Edad , Reproducibilidad de los ResultadosRESUMEN
Objective: This study aimed to perform a cluster analysis of symptoms linked with Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) and to identify which cluster of symptoms was associated with a higher risk of NG and CT. Study design: From 15 April to 16 May 2018, a cross-sectional study was conducted, and patients attending sexually transmitted infections (STI) related clinics were recruited from 22 medical institutions in six districts of Shenzhen city. Methods: A structured questionnaire was used to collect social-demographic information as well as STI symptoms, and urine samples were collected for nucleic acid detection. Cluster analysis and logistic regression were applied. Results: Among 8,207 participants, the prevalence of CT and NG infection was 9.04% (742/8,207) and 2.36% (194/8,207), respectively. Among male outpatients, four clusters with distinct symptomatic patterns were identified. Unmarried, having casual sexual partners in the past 6 months, cluster 2 (OR = 6.70, 95% CI = 3.36-13.35) and cluster 4 (OR = 24.53, 95% CI = 12.96-46.44) were risk factors associated with NG infection. Unmarried, cluster 2 (OR = 2.54, 95% CI = 1.83-3.53) and cluster 4 (OR = 3.31, 95% CI = 2.37-4.61) were risk factors associated with CT infection. Among female outpatients, five clusters with distinct symptomatic patterns were identified. Aged 24 years or below and cluster 3 (OR = 3.68, 95% CI = 1.61-8.39) were risk factors associated with NG infection. Aged 24 years or below, unmarried, having a high school/secondary technical school education, and having junior high school or below education were risk factors associated with CT infection. Conclusion: The cluster of symptoms integrated into risk assessment for CT and NG infections suggests a new strategy of symptomatic management. Healthcare providers in STI clinics and resource-limited places may use this strategy to identify more potential patients and deliver adequate, acceptable, and equitable STI care for outpatients with a high risk of STI.
Asunto(s)
Gonorrea , Enfermedades de Transmisión Sexual , Humanos , Femenino , Masculino , Chlamydia trachomatis , Neisseria gonorrhoeae , Gonorrea/epidemiología , Estudios Transversales , Enfermedades de Transmisión Sexual/epidemiología , Análisis por Conglomerados , China/epidemiologíaRESUMEN
Background: Rectal Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among men who have sex with men (MSM) have become an increasingly important concern. The study aimed to explore (1) the acceptability of rectal self-sampling for chlamydia and gonorrhea testing among MSM in non-clinical venues in Shenzhen city, China; (2) factors associated with the acceptability of rectal self-sampling; and (3) factors associated with rectal CT and NG infections, respectively. Methods: This cross-sectional study was conducted in two non-clinical settings in Shenzhen, China, from April 2021 to October 2021. Mixed-effects logistic regression analysis was performed to explore the factors associated with acceptance of rectal self-collection for CT and NG testing. Results: Of the 306 MSM who were offered to perform rectal self-sampling, 133 (43.46%) accepted, and 96.24% (128/133) of them successfully provided a valid rectal sample. The prevalence of urogenital CT and NG infections among 303 MSM was 4.29 and 0.66%, respectively. The prevalence of rectal CT and NG infections among 128 participants was 31.25 and 9.38%, respectively. Participants having been diagnosed with HIV infection showed a higher acceptance of rectal self-collection for CT and NG testing. Conclusion: This study reported that rectal self-sampling in non-clinical venues for CT and NG testing among MSM was barely acceptable and feasible in China. Most CT and NG infections would have been missed if urethral screening was offered alone, which implies that the CT and NG screening should be scaled up in the above setting. Integrating free CT tests into regular STI interventions for MSM could also be considered.
Asunto(s)
Chlamydia , Gonorrea , Infecciones por VIH , Minorías Sexuales y de Género , Masculino , Humanos , Estudios Transversales , Homosexualidad Masculina , Gonorrea/diagnóstico , Gonorrea/epidemiología , China/epidemiologíaRESUMEN
Objective: Chlamydia trachomatis (CT) infection is one of the most common sexually transmitted infections (STIs) worldwide. This study aimed to provide prevalence and associated factors data among patients seeking clinic-based STI services for estimating the disease burden of CT. Study design and method: A cross-sectional survey was conducted among patients attending clinics for STI services. Patients' social-demographic and behavioral information was collected and CT infection was determined by nucleic acid amplification test (NAAT) with self-collected urine specimens. Associated factors were identified using logistic regression. Results: Among the 8,324 participants, the overall prevalence was 9.0% with 10.7% for males and 8.3% for females respectively. Multivariate analysis showed that aged < 24 [adjusted odds ratio (aOR) = 1.27, 95% confidence interval (CI) = 1.01-1.59], being unmarried (aOR = 1.64, 95%CI = 1.35-2.00), having junior high school or below education level (aOR = 1.47, 95%CI = 1.13-1.91), having no access to health insurance (aOR = 1.27, 95%CI = 1.07-1.51), and being positive for Neisseria gonorrhoeae (NG, aOR = 4.49, 95%CI = 3.25-6.21) were significantly associated with CT infection. Conclusion: We found that CT infection is prevalent among patients seeking clinic-based STI services in Southern China. Targeted interventions could be implemented for patients with a higher risk of CT infection including those aged < 24, being unmarried, having junior high school or below education level, having no access to health insurance, and being positive for NG. In addition, routine CT screening could be considered a public health strategy by the government.
Asunto(s)
Infecciones por Chlamydia , Enfermedades de Transmisión Sexual , Femenino , Masculino , Humanos , Estudios Transversales , Infecciones por Chlamydia/epidemiología , Enfermedades de Transmisión Sexual/epidemiología , Pacientes , Seguro de SaludRESUMEN
BACKGROUND: Chlamydia trachomatis (CT) infection could lead to seriously adverse outcomes if left untreated. This study aimed to determine CT-related knowledge, opinion to testing, and practices of providers among different sexually transmitted infections (STI) related departments in hospitals in Shenzhen city, China, and also to explore the differences in these responses. MATERIALS AND METHODS: From 1st April 2018 to 15th April 2018, a cross-sectional study was conducted in Shenzhen and 64 of 66 hospitals agreed to participate in this study. In the hospital sites, all the providers from the department of obstetrics and gynecology, department of dermatology and venereology, department of urology, and anorectal surgical department were recruited. A structured paper-based questionnaire was used to obtain data on CT-related information. RESULTS: A total of 355 providers from 64 hospitals participated in the current study. Compared to providers from the department of dermatology and venereology, those from the department of obstetrics and gynecology (OR = 0.31, 95% CI 0.16-0.62), department of urology (OR = 0.32, 95% CI 0.16-0.65), and anorectal surgical department (OR = 0.25, 95% CI 0.09-0.71) were less likely to identify that "Be in a long-term mutually monogamous relationship with a partner who has been tested and has negative STI test results." is an appropriate way for a sexually active person to reduce risk of getting CT. Also, those from the department of obstetrics and gynecology (OR = 0.45, 95% CI 0.23-0.87) were less likely to identify that "Use latex condoms the right way every time you have sex" is another appropriate way. A high proportion of providers agreed that all sexually active patients attending to their department should be screened regularly (77.1%), and they are willing to offer opportunistic CT screening (96.0%). Only 11.4% of respondents correctly identified that the appropriate time frame of the CT retesting is three months. CONCLUSIONS: Providers among STI-related departments in hospitals showed a very high willingness to offer opportunistic CT screening. However, this study showed important gaps in providers' knowledge and practices in China, targeted training in CT-related knowledge and practice is urgently needed.
Asunto(s)
Infecciones por Chlamydia , Enfermedades de Transmisión Sexual , Infecciones por Chlamydia/diagnóstico , Chlamydia trachomatis , Estudios Transversales , Femenino , Hospitales , Humanos , Embarazo , Prevalencia , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/prevención & controlRESUMEN
BACKGROUND: Chlamydia trachomatis (CT) is a common sexually transmitted infection (STI) with significant morbidity. The study aimed to explore the willingness to undergo routine CT screening and its associated factors among hospital-based patients in Shenzhen. METHODS: We used data from the Shenzhen Gonorrhea and Chlamydia Intervention Programme. Participants were recruited with a stratified purposeful sampling design from 1 April 2018 to 16 May 2018. A structured questionnaire was used to obtain data on baseline characteristics and CT-related participant information. RESULTS: Of the 16,546 participants, 64.79% were women, with a mean age of 31.85 ± 7.31 of all participants. Of the participants, 88.78% were willing to undergo routine CT screening. According to multivariate logistic regression analyses, willingness to undergo routine CT screening was associated with the following (P < 0.05): being a woman (AOR = 1.53, 95% CI = 1.34-1.75), one year or more residency in Shenzhen (AOR = 1.64, 95% CI = 1.37-1.95), any secondary education (AOR = 2.46, 95% CI = 1.92-3.15), monthly income ≥ RMB 10,000 (AOR = 1.24, 95% CI = 1.01-1.51), having forgotten CT diagnosis history (AOR = 1.42, 95% CI = 1.12-1.79), without current STI-related symptoms (AOR = 1.24, 95% CI = 1.10-1.41), and having correct understanding of the sequelae of CT infection (AOR = 1.68, 95% CI = 1.39-2.03). CONCLUSION: This study reported high willingness to undergo routine CT screening among hospital-based patients in Shenzhen, and provided evidence for the promotion and the implementation of strategies and recommendations on routine CT screening in China.
Asunto(s)
Infecciones por Chlamydia/diagnóstico , Chlamydia trachomatis , Tamizaje Masivo/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Adulto , China , Estudios Transversales , Femenino , Hospitales , Humanos , Masculino , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Genital Chlamydia trachomatis (CT) is one of the most common sexually transmitted infections (STI) worldwide. We explored the factors associated with willingness to participate in partner notification (PN) among women attending reproductive health and STI clinics in Shenzhen, China. An anonymous questionnaire was used to collect the sociodemographic characteristics, STI histories, and willingness to participate in routine CT screening and partner notification. In total, 87.31% (n = 10,780) of participants were willing to notify their sex partner(s) if they were diagnosed with a CT infection. Willingness to complete PN was significantly associated with: being married, residing in Shenzhen ≥1 year, having completed junior college or higher, not currently reporting STI-related symptoms, willing to have routine CT screening, and having a correct understanding of the health sequelae of CT infection. Nearly all women surveyed at reproductive health and STI clinics in Shenzhen reported willingness to complete PN. Promoting PN in these settings could help detect a large number of additional CT cases. Our findings provide evidence and implications for public health interventions on PN and suggest that targeted interventions are urgently needed for particular subpopulations including those not currently married, with shorter residency, lower education, and less awareness about the dangers of CT infection.
Asunto(s)
Participación del Paciente/psicología , Participación del Paciente/estadística & datos numéricos , Salud Reproductiva/estadística & datos numéricos , Enfermedades de Transmisión Sexual/terapia , Telemedicina/métodos , Telemedicina/estadística & datos numéricos , Adolescente , Adulto , China , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto JovenRESUMEN
The aim of this study is to assess the HIV/syphilis epidemic among men who have sex with men (MSM) aged <50 years and ≥50 years in Shenzhen, and explore the associated factors of HIV/syphilis co-infections among MSM in Shenzhen, in order to help prevention and intervention programs determine their target sub-group. A serial cross-sectional study was conducted on MSM in Shenzhen city, China from 2009 to 2017. A questionnaire was used to collect demographic characteristics, history of HIV testing, history of blood donation and sexual behaviors. 5 ml of venous blood were collected for syphilis and HIV tests. The overall prevalence of HIV, syphilis, HIV/syphilis co-infection was 9.40%, 18.97%, and 4.91%, respectively. The prevalence of HIV (15.26%), syphilis (27.71%), HIV/syphilis co-infection (9.24%) in aged ≥50 years MSM was significantly higher than aged <50 years MSM (9.15%, 18.59% and 4.72%, respectively). The following factors were found to be significantly associated with HIV/syphilis co-infections (P<0.05): age≥50 years (OR = 1.78, 95% CI = 1.10-2.87), high school or lower (OR = 1.49, 95% CI = 1.10-2.01), monthly income ≤436.2 USD (OR = 1.74, 95% CI = 1.25-2.42), monthly income 436.4-727.2 USD (OR = 1.46, 95% CI = 1.05-2.03), ≥2 anal sex partners in the past 6 months (OR = 1.59, 95% CI = 1.02-2.49), ≥2 oral sex partners in the past 6 months (OR = 1.60, 95% CI = 1.08-2.36), inconsistent condom use during anal sex in the past 6 months (OR = 1.50, 95% CI = 1.11-2.03). We found that aged <50 years and ≥50 years MSM in Shenzhen had a high prevalence of HIV/syphilis infection in a period from 2009 to 2017. Age-specific sexually transmitted diseases education, prevention, and intervention programs for aged ≥50 years MSM should be implemented urgently and integrated interventions of both HIV and syphilis infections on MSM are needed in the future.
Asunto(s)
Coinfección , Infecciones por VIH/epidemiología , Homosexualidad Masculina , Sífilis/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , China/epidemiología , Estudios Transversales , Femenino , Infecciones por VIH/historia , Infecciones por VIH/transmisión , Historia del Siglo XXI , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Vigilancia en Salud Pública , Factores de Riesgo , Parejas Sexuales , Enfermedades de Transmisión Sexual/epidemiología , Sífilis/historia , Sífilis/transmisión , Adulto JovenRESUMEN
OBJECTIVES: Few studies reported the clustering of cardiovascular disease (CVD) biological risk factors among older adults. The objective of this study was to characterise the clustering of CVD biological risk factors among adults aged 65 or older in Shenzhen city, China. DESIGN: Cross-sectional study. SETTING: General communities in Shenzhen, Guangdong, China. PARTICIPANTS: A representative sample of 5635 participants aged 65 or older participated in the survey with a response rate of 93.6%. MAIN OUTCOME MEASURES: Individual CVD biological risk factors (overweight/obesity, central obesity, hypertension, dyslipidaemia and diabetes) and their clustering. RESULTS: The prevalence of overweight, obesity, central obesity, hypertension, dyslipidaemia and diabetes in this study was 37.4%, 10.8%, 37.0%, 51.9%, 40.2% and 18.0%, respectively. The mean count of CVD biological risk factors per participant was 1.95. The 86.0% of the participants presented at least one CVD biological risk factor and 33.8% of the participants presented clustering of CVD biological risk factors, that is, presenting three or more CVD biological risk factors, as defined in this study. Multivariable logistic regression analysis showed that gender, age, and drinking and smoking status were significantly associated with clustering of CVD biological risk factors (P<0.05). Women, the older and alcohol drinkers were more likely to have clustering of CVD biological risk factors. CONCLUSIONS: The prevalence of CVD biological risk factors is fairly high in the older adults with a tendency of clustering in Shenzhen. The findings highlight the need for integrated management of CVD biological risk factors among older adults.