Sexually transmitted infections among patients attending a sexual assault centre: a cohort study from Oslo, Norway.

Autor:	Skjælaaen K; Department of General Practice, University of Oslo, Oslo, Norway.; Oslo Sexual Assault Centre, City of Oslo Health Agency, Oslo, Norway., Nesvold H; Oslo Sexual Assault Centre, City of Oslo Health Agency, Oslo, Norway., Brekke M; Department of General Practice, University of Oslo, Oslo, Norway., Sare M; Department of Microbiology, Oslo University Hospital, Oslo, Norway., Landaas ET; Department of Microbiology, Oslo University Hospital, Oslo, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Mdala I; Department of General Practice, University of Oslo, Oslo, Norway., Olsen AO; Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway.; Department of Infection Control and Vaccine, Norwegian Institute of Public Health, Oslo, Norway., Vallersnes OM; Department of General Practice, University of Oslo, Oslo, Norway o.m.vallersnes@medisin.uio.no.; Oslo Accident and Emergency Outpatient Clinic, City of Oslo Health Agency, Oslo, Norway.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2022 Dec 01; Vol. 12 (12), pp. e064934. Date of Electronic Publication: 2022 Dec 01.
DOI:	10.1136/bmjopen-2022-064934
Abstrakt:	Objectives: We estimate the prevalence of sexually transmitted infection (STI) among patients after sexual assault, assess the possible value of azithromycin prophylaxis, and identify risk factors for assault-related STI and for not presenting at follow-up. Design: Prospective observational cohort study. Setting: Sexual assault centre in Oslo, Norway. Participants: 645 patients, 602 (93.3%) women and 43 (6.7%) men, attending the centre from May 2017 to July 2019. Outcome Measures: Microbiological testing at the primary examination and at follow-up consultations after 2, 5 and 12 weeks. Estimated relative risk for assault-related STI and for not presenting at follow-up. Results: At primary examination, the prevalence of genital chlamydia was 8.4%, Mycoplasma genitalium 6.4% and gonorrhoea 0.6%. In addition, the prevalence of bacterial STI diagnosed at follow-up and possibly from the assault was 3.0% in total: 2.5% for M. genitalium, 1.4% for genital chlamydia and 0.2% for gonorrhoea. This prevalence did not change when azithromycin was no longer recommended from January 2018. There were no new cases of hepatitis B, hepatitis C, HIV or syphilis. We found no specific risk factors for assault-related STI. Patients with previous contact with child welfare service less often presented to follow-up (relative risk (RR) 2.0 (95% CI 1.1 to 3.5)), as did patients with a history of sex work (RR 3.6 (1.2 to 11.0)) or substance abuse (RR 1.7 (1.1 to 2.7)). Conclusions: Most bacterial STIs were diagnosed at the primary examination, hence not influenced by prophylaxis. There was no increase in bacterial STI diagnosed at follow-up when azithromycin prophylaxis was not routinely recommended, supporting a strategy of starting treatment only when infection is diagnosed or when the patient is considered at high risk. Sex work, substance abuse and previous contact with child welfare services were associated with not presenting to follow-up. Trial Registration Number: ClinicalTrials.gov Registry (NCT03132389). Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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