摘要
Background:Male sex workers are at high-risk for acquisition of sexually transmitted infections(STIs),including human immunodeficiency virus(HIV).We quantified incidence rates of STIs and identified their time-varying predictors among male sex workers in Mexico City.Methods:From January 2012 to May 2014,male sex workers recruited from the largest HIV clinic and community sites in Mexico City were tested for chlamydia,gonorrhea,syphilis,hepatitis,and HIV at baseline,6-months,and 12-months.Incide nee rates with 95%bootstrapped confide nee limits were calculated.We examined potential timevarying predictors using generalized estimating equations for a population averaged model.Results:Among 227 male sex workers,median age was 24 and baseline HIV prevalence was 32%.Incidence rates(per 100 person-years)were as follows:HIV[5.23;95%confidence interval(CI):2.15-10.31],chlamydia(5.15;95%CI:2.58-9.34),gonorrhea(3.93;95%CI:1.88-7.83),syphilis(13.04;95%CI:8.24-19.94),hepatitis B(2.11;95%CI:0.53-4.89),hepatitis C(0.95;95%CI:0.00-3.16),any STI except HIV(30.99;95%CI:21.73-40.26),and any STI including HIV(50.08;95%CI:37.6062.55).In the multivariable-adjusted model,incident STI(excluding HIV)were lower among those who reported consistently using condoms during anal and vaginal intercourse(odds ratio=0.03,95%CI:0.00-0.68)compared to those who reported inconsistently using condoms during anal and vaginal intercourse.Conclusions:Incidence of STIs is high among male sex workers in Mexico City.Consistent condom use is an important protective factor for STIs,and should be an important comp on ent of interventions to prevent incide nt infect i ons.
基金
US National Institutes of Health(R21-HD065525"Conditional economic incentives to reduce HIV risk:A pilot in Mexico"and R34-MH114664"PrEP Seguro:Antiretrovial-Based HIV Prevention Among Men at High Risk in Mexico",PI:Galarraga)
Additional support was provided to A.Zullo by the Agency for Healthcare Research and Quality(K12-HS022998)
B.Marshall is supported by the National Institute on Drug Abuse(DP2-DA040236)
by a Henry Merrit Wriston Fellowship from Brown University
M.Lurie is supported in part by US NIH National Institute of Child Health and Development grant(R24-HD077976)
1R01 MH 106600-01 from the National Institute of Mental Health.This research was facilitated by the Providence/Boston Center for AIDS Research(P30AI042853)
it also benefited from support to the Population Studies and Training Center(PSTC)at Brown University,which receives core support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development(P2C-HD041020).
