1 / 28

Novel STD Prevention Services for Men who have Sex with Men 针对与同性发生性行为的男性 (MSM) 的新型性病预防服务

Novel STD Prevention Services for Men who have Sex with Men 针对与同性发生性行为的男性 (MSM) 的新型性病预防服务. Jeffrey D. Klausner, MD, MPH Director, STD Prevention Services San Francisco Department of Public Health 旧金山公共卫生部 性传播疾病预防服务办公室主任 Jeffrey D. Klausner 医学博士兼公共卫生硕士

tamara-rodriquez
Download Presentation

Novel STD Prevention Services for Men who have Sex with Men 针对与同性发生性行为的男性 (MSM) 的新型性病预防服务

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Novel STD Prevention Services for Men who have Sex with Men针对与同性发生性行为的男性 (MSM) 的新型性病预防服务 Jeffrey D. Klausner, MD, MPH Director, STD Prevention Services San Francisco Department of Public Health 旧金山公共卫生部 性传播疾病预防服务办公室主任 Jeffrey D. Klausner 医学博士兼公共卫生硕士 Associate Clinical Professor of Medicine Divisions of AIDS and Infectious DiseasesUniversity of California San Francisco 加州旧金山大学 艾滋病和传染病学院 临床医学副教授

  2. Increases in male rectal gonorrhea, San Francisco男性直肠淋病患者增长率（旧金山） CDC MMWR 1999;48(3):45-55

  3. Gonorrhea in MSM, San Francisco, 1999-2008 1999-2008 年间旧金山 MSM 淋病患者增长率 SFDPH, STD Section, 2008 2008，SFDPH，STD 部分

  4. Early Syphilis 1998–2007 1998–2007 年间早期梅毒病例数

  5. Public Health Response公共健康应对措施 • Enhanced surveillance 监管力度增强 • More clinical & lab services 临床与化验服务增多 • Health provider education 健康提供者教育 • Community health promotion 社区健康程度提高 • Address select risk factors 解决首要风险因素 • Public Health Evaluation 公共健康评估

  6. Strong association (OR = 8.7, P<.05) between meeting partner on the Internet and syphilis 和互联网上认识的性伴侣约会与感染梅毒之间的密切联系 (OR = 8.7, P<.05) JAMA 2000; 284:447-450

  7. Percent of Syphilis Cases Reporting Meeting Partners by Venue, California在聚会场所与性伴侣约会感染梅毒的病例比例（加州） Internet 互联网 Bars/Clubs 酒吧/俱乐部 Bathhouses/Sex Clubs 洗浴中心/色情俱乐部 Private/Circuit Parties 私人/盛大舞会 7/2006 Provisional Data - CA DHS STD Control Branch 7/2006 临时数据 - 加利福尼亚 DHS STD 控制分支机构

  8. STD Control Strategy性病控制战略 • Screen 检查 • Treat 治疗 • Treat partners 治疗性伴侣 • Screen 检查

  9. Most rectal chlamydial infections in MSM are asymptomaticMSM 中多数直肠衣原体感染者无症状 14% Symptomatic 有症状 Asymptomatic 无症状 86% N= 316 Kent et al. CID 2005 Kent 等，CID 2005

  10. STD Screening性病检查 • STDs are asymptomatic 性病无症状 • Promote screening 加大检查力度 • Use accurate screening tests 采用精确的检查检验方法 • Make screening easy 使检查简单易行

  11. Screen with nucleic acid tests采用核酸检验方法进行检查

  12. Pharyngeal Gonorrhea Positivity San Francisco, 2005 (n=9,727) 2005 年旧金山咽部淋病呈阳性的患者比例(n=9,727) Overall prevalence 7.8% 总患病率为 7.8%

  13. Rectal Gonorrhea PositivitySan Francisco, 2005 (n=6,968)2005 年旧金山直肠淋病呈阳性的患者比例 (n=6,968) Overall prevalence 7.0% 总患病率为 7.0%

  14. Rectal Chlamydia Positivity in San Francisco, 2005 (n=6,861)2005 年旧金山直肠衣原体呈阳性的患者比例 (n=6,861) Overall prevalence 8.4% 总患病率为 8.4%

  15. Patient access to services, education患者获取服务、教育的渠道 Klausner, STD, 1999; Klausner et al, AIDS Care 2004 Klausner，STD，1999；Klausner 等， AIDS 护理2004

  16. Gay Men’s Prevention Center男性同性恋疾病预防中心

  17. Online STD testing性病网上检验Levine et al, STD, 2005 Levine 等， STD，2005 6.4% reactive syphils tests 6.4% 反应性梅毒检验 = New case = 新病例

  18. Rapid treatment快速治疗 • Single-dose oral therapy 单剂量口服药疗法 • Field-delivered therapy 现场实施疗法 • Internet-based prescriptions 基于互联网的处方 • Monitor time to treatment 监督治疗时间

  19. Partner treatment性伴侣治疗 Partner treatment in MSM, 1998-2008 1998-2008 年 MSM 性伴侣治疗人数

  20. Partner notification性伴侣通知 • Patient referral 患者转介 • Peer-based, confidential or anonymous 同伴转介，以保密或匿名方式 • Provider-referral 提供者转介 • Health department, voluntary and anonymous 卫生部门，以自愿或匿名方式

  21. Internet partner notification guidelines互联网性伴侣通知指南 • Messages sent from Internet service provider less likely to be discarded; use same e-mail provider as case. Health departments may need multiple e-mail accounts. 互联网服务提供者发送的邮件丢失的可能性很小；使用与病例相同的电子邮件帐户提供者。卫生部门可能需要多个电子邮件帐户。 • Include reference to “Serious health matter” in message header; include verifiable information 在邮件标题注明“待严肃对待的健康问题”；包含有据可查的信息 • No group messages; use same principles of confidentiality as with postal service or telephone 不群发邮件；邮局服务或电话服务采用相同的保密原则 • Upon e-mail response, collect information to develop more personal contact 收到回复的电子邮件后，收集信息，以获取更多个人联系方式

  22. InSpot.org: Peer-to-peer Online Partner Notification and Treatment InSpot.org：同伴对同伴网上性伴侣通知和治疗 Woodruff, Plos Med, 2008

  23. Repeat screening复查 • Repeat testing of any gonorrhea, chlamydia or syphilis case at 3 months 3 个月时对任何淋病、衣原体疾病或梅毒病例进行复查 • Repeat screening at 3-6 months in those MSM with multiple partners 3 到 6 个月时对那些有多个性伴侣的 MSM 进行复查

  24. Conclusion结论 • A culturally-competent and community-informed response is critical in effective STD prevention, treatment and control services 具备文化能力，有相关知识的社区的应对措施对于有效的性病预防、治疗和控制服务至为关键 • Use technology—Internet, molecular, cellular—to increase access for screening and treatment 使用科技 — 互联网、分子、细胞，增加检查和治疗的渠道

  25. SFDPH City Clinic SFDPH 市诊所 www.SFCityClinic.org State of CA 加州 www.stdcheckup.org CDC STD Treatment Guidelines 2006 2006 年 CDC 性病治疗 指南 www.cdc.gov/std Sources for more STD information更多性病信息来源 www.amazon.com

  26. Acknowledgments致谢 • SFDPH STD Prevention and Control Services SFDPH 性病预防和控制服务 • Kyle Bernstein, PhD Kyle Bernstein 博士 • SF Partners in STD/HIV Prevention 性病/艾滋病预防 SF 合作伙伴 • CDC—Wendy Wolf, Frank Strona CDC—Wendy Wolf, Frank Strona • Dayne Collins Dayne Collins • SFDPH Laboratory—Dr. Mark Pandori and Sally Liska SFDPH 实验室— Mark Pandori 博士和 Sally Liska 博士 • Funding from City and County of San Francisco, CDC, State of California, NIH NIH，加州，CDC，旧金山市和旧金山县赞助 ISIS, Inc.

More Related