背景:最近的报告表明,澳大利亚女性性工作者(FSW)中淋病和衣原体的增加,随着口交使用避孕套的减少。
方法:我们通过分析来自医学和病理记录的数据,确定了2005年至2019年在我们诊所就诊的FSWs中淋病和衣原体的患病率和阳性趋势。我们通过使用仅每个日历年的首次测试结果的替代患病率定义进行了敏感性分析。
结果:淋病的患病率(所有部位:咽部,生殖器,直肠)从2005年的1/130(0.8%)增加到2012年的14/166(8.4%),到2019年的31/257(12.1%);比率(RR)1.19,95CI1.14-1.24,ptrend<0.001。咽部淋病(RR1.11,95%CI1.05-1.17,ptrend=0.001)和生殖器淋病(RR1.17,95%CI1.08-1.26,ptrend<0.001)呈上升趋势。衣原体(所有地点)的患病率从2005年的4/130(3.1%)增加到2012年的8/166(4.8%),到2019年的20/257(7.8%);RR1.05,95CI1.01-1.09,ptrend=0.006。这种上升主要反映了咽部衣原体(RR1.16,95CI1.04-1.29,ptrend=0.004)。定性相似的趋势,具有相似的显著结果,在敏感性分析中发现淋球菌和衣原体感染,表明结果对测试频率潜在变化的鲁棒性。淋病和衣原体与在中国出生的FSW显着相关。衣原体与18-25岁年龄组显著相关。在2015-2019年期间,89例淋球菌感染的妇女中,56(62.9%)仅咽部;在93例衣原体感染中,32例(34.4%)是仅咽部感染。
结论:FSW需要筛查咽部和生殖器感染。需要加强和可持续的健康促进。
BACKGROUND: Recent reports indicate increasing gonorrhoea and chlamydia among female sex workers (FSWs) in Australia, with decreasing condom use for oral sex.
METHODS: We determined trends in prevalence and positivity of gonorrhoea and chlamydia among FSWs attending our clinic from 2005 to 2019, by analysing data from medical and pathology records. We conducted a sensitivity analysis by using an alternative prevalence definition of first test result only per calendar year.
RESULTS: Prevalence of gonorrhoea (all sites: pharynx, genital, rectal) increased from 1/130 (0.8%) in 2005 to 14/166 (8.4%) in 2012, to 31/257 (12.1%) in 2019; rate ratio (RR) 1.19, 95%CI 1.14-1.24, ptrend < 0.001. There were rising trends for
pharyngeal (RR 1.11, 95% CI 1.05-1.17, ptrend = 0.001) and genital gonorrhoea (RR 1.17, 95% CI 1.08-1.26, ptrend < 0.001). Prevalence of chlamydia (all sites) increased from 4/130 (3.1%) in 2005 to 8/166 (4.8%) in 2012, to 20/257 (7.8%) in 2019; RR 1.05, 95%CI 1.01-1.09, ptrend = 0.006. This rise reflected predominately
pharyngeal chlamydia (RR 1.16, 95%CI 1.04-1.29, ptrend = 0.004). Qualitatively similar trends with similar significant results, were seen for gonococcal and chlamydial infections in the sensitivity analyses, indicating robustness of results to potential changes in testing frequency. Gonorrhoea and chlamydia were significantly associated with FSWs born in China. Chlamydia was significantly associated with age group 18-25. In the 2015-2019 period, of 89 women with gonococcal infections, 56 (62.9%) were
pharyngeal-only; of 93 with chlamydial infections, 32 (34.4%) were
pharyngeal-only infections.
CONCLUSIONS: FSWs require screening for
pharyngeal as well as genital infections. Enhanced and sustainable health promotion is required.