Sexually transmitted infections among at-risk women in Ecuador: implications for global prevalence and testing practices for STIs detected only at the anorectum in female sex workers.

Autor:	Llangarí-Arizo LM; Escuela de Medicina, Universidad Internacional del Ecuador, Quito, Ecuador., Broad CE; Institute for Infection and Immunity, St George's University of London, London, UK., Zhou L; Institute for Infection and Immunity, St George's University of London, London, UK., Martin Mateo M; Escuela de Medicina, Universidad Internacional del Ecuador, Quito, Ecuador.; Autonomous University of Barcelona, Barcelona, Spain.; Red Internacional Grups de Recerca d'América i África Llatines-GRAAL, Barcelona, Spain., Moreno CI; Escuela de Medicina, Universidad Internacional del Ecuador, Quito, Ecuador., Moreno Cevallos M; Escuela de Medicina, Universidad Internacional del Ecuador, Quito, Ecuador., Cooper PJ; Escuela de Medicina, Universidad Internacional del Ecuador, Quito, Ecuador.; Institute for Infection and Immunity, St George's University of London, London, UK., Romero-Sandoval N; Escuela de Medicina, Universidad Internacional del Ecuador, Quito, Ecuador.; Red Internacional Grups de Recerca d'América i África Llatines-GRAAL, Barcelona, Spain., Sadiq ST; Institute for Infection and Immunity, St George's University of London, London, UK ssadiq@sgul.ac.uk.
Jazyk:	angličtina
Zdroj:	Sexually transmitted infections [Sex Transm Infect] 2024 Nov 18; Vol. 100 (8), pp. 504-511. Date of Electronic Publication: 2024 Nov 18.
DOI:	10.1136/sextrans-2023-056075
Abstrakt:	Objectives: Anorectal sexually transmitted infections (STIs) such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), present treatment challenges, potentially increase antibiotic resistance selection and if undetected may facilitate onward transmission. However, there are limited global prevalence data for anorectal STIs. We conducted a cross-sectional study to assess the prevalence and risk factors of non-viral genital and extragenital STIs in female sex workers (FSW) and female non-sex workers (NSW) in Ecuador. Methods: 250 adult street and brothel FSWs and 250 NSWs, recruited from settlements in north-west Ecuador provided oropharyngeal and vulvo-vaginal swabs (VVS) as well as socio-demographic data. FSWs also provided anorectal swabs. PCR was used to detect CT, NG, Mycoplasma genitalium (MG) from all swabs and additionally Trichomonas vaginalis (TV) from VVS. Risk factors were analysed using logistic regression. Results: Prevalence of FSW vaginal, anorectal and oropharyngeal infection was 32.0% (95% CI 26.5% to 38.0%), 19.7% (95% CI 15.1% to 25.2%) and 3.2% (95% CI 1.6% to 6.2%), respectively, with most vaginal infections being TV (23.4%; 95% CI 18.5% to 29.2%). Overall FSW STI prevalence, at any anatomical site was 39.7% (95% CI 33.8% to 46.1%), with 12.1% (95% CI 8.5% to 16.9%) of infections detected only at the anorectum. Of all the CT and/or NG infections, 64.4% (95% CI 50.4% to 78.4%) were detected only at the anorectum. STI prevalence in NSWs in the vagina and oropharynx were 5.6% (95% CI 3.4% to 9.2%) and 0.8% (95% CI 0.2% to 2.9%), respectively, with most vaginal infections being MG (3.2%; 95% CI 1.6% to 6.2%). In multivariable analysis, risk factors among brothel-based FSWs for having an anorectal STI were vaginal CT, NG or MG (p<0.001), vaginal TV (p=0.029) and being 'in a relationship' (p=0.038). Conclusions: High prevalence of CT and NG detected only at the anorectum in these FSWs indicate the possibility of missing significant infections if providing only genital testing and calls for greater research into the potential impact on global STI estimates if extragenital infections among at-risk women are not identified. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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