背景:与其他患有慢性健康状况的年轻人相似,围产期HIV感染(PHU)的青少年可能会影响性发育。
目的:本文旨在比较HIV感染的性别里程碑与未感染HIV的同龄人,通过系统评价(SR)和探索性研究。
方法:我们在4个电子数据库中进行了系统搜索(Medline,Embase,WebofScience,和Scopus),根据系统评价和荟萃分析(PRISMA)指南的首选报告项目。所有数据库中的最后一次搜索是在2021年5月进行的。我们纳入了报告任何主要结局的定量数据的研究,并将HIV与未感染HIV的对照组进行了比较。主要结果定义为性里程碑的发生和/或首次出现年龄(坠入爱河,在一段浪漫的关系中,手淫,接吻,非生殖器爱抚(感觉或抚摸,触摸),生殖器爱抚(指法,手工),给予或接受口交,和穿透性(阴道或肛门)。我们排除了病例报告,审计,指导方针,社论,摘要,研究报告了行为感染的HIV患者,不包括未感染HIV的对照组的研究以及无法翻译成英语或荷兰语的研究。我们使用医疗保健研究和质量机构(AHRQ)清单进行质量评估。我们对数据进行了定性合成。在探索性研究中,我们比较了年龄相匹配的HIV和未感染HIV的对照的性里程碑,性别,种族和教育水平,使用经过验证的问卷的问题子集。
结果:我们在SR中纳入了18项研究,描述了估计1,963名参与者的结果。17项研究比较了未感染HIV和未感染HIV的对照中性交的发生和/或首次发生年龄,4项研究报告了其他任何性里程碑。大多数研究发现,与对照组相比,PHIVl的性交发生率(16项研究中的12项)或首次出现年龄(8项研究中的6项)没有差异。报告任何其他里程碑的4项研究中的两项发现,在未感染HIV的对照和未感染HIV的对照之间没有显着差异。在探索性研究中,我们纳入了10名艾滋病毒感染者和16名未感染艾滋病毒的人,匹配的控件。PMiv倾向于报告性里程碑的首次出现年龄比对照组晚(不重要)。
UNASSIGNED:SR仅包括少量研究,很少有关于非穿透里程碑的研究报告。这项探索性研究通过包括非穿透性里程碑并将HIV与未感染HIV进行比较,良好匹配的控制。然而,样本量很小。
结论:PHU似乎从事性活动,并以与未感染HIV的同龄人相似的速度实现性里程碑,在经过良好治疗的HIV中,有以后开始的趋势。该审查已在PROSPERO数据库(CRD42021252103)中注册,并由AIDSfonds资助。AIDSfonds在本研究的研究设计或解释中没有作用。特哈尔AM,FietenA,VandenHofM,etal.围产期感染HIV的年轻人的性发育:系统回顾和探索性研究。SexMed2022;10:100578。
BACKGROUND: Similar to other young people with a chronic health condition, perinatally HIV-infected (PHIV) adolescents may have an impacted sexual development.
OBJECTIVE: This paper aims to compare sexual milestones of PHIV to HIV uninfected peers, through a systematic
review (SR) and explorative study.
METHODS: We performed a systematic search in 4 electronic databases (Medline, Embase, Web of Science, and Scopus), according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Last search in all databases was performed in May 2021. We included studies that reported on quantitative data of any of the main outcomes and compared PHIV to HIV uninfected control groups. Main outcomes were defined as the occurrence and/or debut age of sexual milestones (falling in love, having been in a romantic relationship, masturbation, kissing, non-genital caressing (feeling or petting, touching), genital caressing (fingering, handjob), giving or receiving oral sex, and penetrative sex (vaginal or anal). We excluded case reports, audits, guidelines, editorials, abstracts, studies that reported on behaviorally infected HIV patients, studies that did not include an HIV uninfected control group and studies that could not be translated to English or Dutch. We used the Agency for Health Care Research and Quality (AHRQ) Checklist for quality assessment. We performed qualitative synthesis of the data. In the explorative study, we compared sexual milestones of PHIV and HIV uninfected controls matched for age, sex, ethnicity and educational level, using a subset of questions of a validated questionnaire.
RESULTS: We included eighteen studies in the SR, describing outcomes of an estimated 1,963 participants. Seventeen studies compared the occurrence and/or debut age of intercourse in PHIV and HIV uninfected controls and 4 studies reported on any of the other sexual milestones. The majority of studies found no difference in occurrence (12 of 16 studies) or debut age (6 of 8 studies) of intercourse in PHIV compared to controls. Two of 4 studies reporting on any of the other milestones found no significant differences between PHIV and HIV uninfected controls. In the explorative study, we included ten PHIV participants and 16 HIV uninfected, matched controls. PHIV tended to report a later debut age of sexual milestones than controls (not significant).
UNASSIGNED: The SR includes only a small number of studies and few studies report on non-penetrative milestones. The explorative study adds to this
review by including non-penetrative milestones and comparing PHIV to HIV-uninfected, well-matched controls. However, the sample size was small.
CONCLUSIONS: PHIV seem to engage in sexual activities and achieve sexual milestones at a similar rate as their HIV uninfected peers, with a tendency of a later start in well treated PHIV. The
review was registered in the PROSPERO database (CRD42021252103) and funded by AIDSfonds. AIDSfonds had no role in the study design or interpretations of this study. ter Haar AM, Fieten A, Van den Hof M, et al. Sexual Development in Perinatally HIV-Infected Young People: A Systematic
Review and Explorative Study. Sex Med 2022;10:100578.