Prevalence and associated factors of sexually transmitted infections among methamphetamine users in Eastern China: a cross-sectional study

Abstract

Background The reported incidence of sexually transmitted infections (STIs) in China has been increasing over the last decades, especially among drug users, which has become one of the main burdens of public health in China. This study was conducted to estimate the prevalence and associated factors of STIs among non-injecting methamphetamine (MA) users in Eastern China. Methods A cross-sectional survey was conducted among 632 MA users in Eastern China in 2017. Demographic characteristics, sexual behaviors, behaviors of MA use and sexual health knowledge were collected through questionnaire. First pass urine specimens were collected and detected for deoxyribonucleic acid (DNA) of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) with Nucleic Acid Amplification Technology (NAAT), while blood specimens were collected and detected for antibodies of Human immunodeficiency virus (HIV), Herpes simplex virus type-2 (HSV-2), and syphilis with enzyme-linked immune sorbent assay (ELISA). Results Among the 632 MA users, 464 (73.42%) were males, 60.92% were < 35 years of age, 546 (86.39%) were Shandong residents. 317 (50.16%, 95% CI 46.26–54.06%) participants were tested positive for at least one kind of STIs, including 242 (38.29%, 95% CI 34.50–42.08%) for HSV-2, 107 (16.93%, 95% CI 14.01–19.85%) for active syphilis, 46 (7.28%, 95% CI 5.25–9.31%) for treated syphilis, 40 (6.33%, 95% CI 4.43–8.23%) for CT, 6 (0.95%, 95% CI 0.19–1.71%) for HIV, and 3 (0.47%, 95% CI 0.06–1.00%) for NG infection. 99 (15.66%, 95% CI 12.83–18.49%) participants were co-infected with two kinds of STIs, including 91 (14.40%, 95% CI 11.66–17.14%) participants were co-infected with HSV-2 and syphilis. 14 (2.22%, 95% CI 1.07–3.37%) participants were co-infected with three kinds of STIs, and 4 HIV positive participants were co-infected with both syphilis and HSV-2. In the multiple logistic regression analysis, the results showed that females (adjusted OR [AOR] = 7.30, 95% CI 4.34–12.30) and individuals ≥ 35 years of age (AOR = 2.97, 95% CI 2.04–4.32) were more likely to test positive for STIs among MA users, whereas participants who acquired sexual health knowledge primarily from the Internet (AOR = 0.57, 95% CI 0.40–0.82) and those whose regular partners did not use drugs (AOR = 0.59, 95% CI 0.37–0.94) were less likely. Conclusions This study found that the prevalence of HSV-2 and syphilis are alarming high among non-injecting MA users in Shandong Province in Eastern China. The prevention and control intervention of STIs among MA users in Shandong were needed, especially on females and MA users ≥ 35 years of age.

Advancing Syphilis Research: Exploring New Frontiers in Immunology and Pharmacological Interventions

“…Substance use can be linked to high-risk sexual behaviors, contributing to the spread of syphilis. For instance, studies conducted in 2021 showed that 60% of methamphetamine users reported engaging in unprotected sexual practices in a recent period [36][37][38].…”

Update on the Epidemiological Features and Clinical Implications of Human Papillomavirus Infection (HPV) and Human Immunodeficiency Virus (HIV) Coinfection

“…Treponema pallidum , Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and HPV are the most common sexually transmitted pathogens in the United States, and their incidence rate increased by 30% to 60% from 2015 to 2019 [ 127 ]. Coinfection of HIV, HPV, and other STIs such as NG or Mycoplasma genitalium (MG) is common [ 128 ], and the risk of contracting an STI is increased according to the number of sexual partners [ 129 ], condomless receptive anal intercourse [ 130 ] and drug consumption [ 131 ].…”

Epidemiological Overview of Urogenital Gonorrhea in Mexico (2003–2020)

“…Conversely, it has been recognized that the decrease in the use of contraceptive methods, little fear of contracting an STI (including HIV), change in sexual behavior, lack of timely medical care, and the isolation of N. gonorrhoeae strains resistant to antibiotics are causes that favor the increase in cases of UG [10]. Lastly, cross-sectional surveys in developed countries have identified other risk factors in the acquisition of STIs, e.g., the use of drugs such as noninjectable methamphetamines [11].…”