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Risk factors for repeat syphilis in men who have sex with men, San Francisco

Warren Phipps1, Charlotte K Kent, Robert Kohn

  • 1Department of Medicine, University of Washington, Virology Research Center, 600 Broadway, Suite 400, Seattle, WA 98122, USA. wphipps@u.washington.edu

Sexually Transmitted Diseases
|June 27, 2009
PubMed
Abstract

Insights

Men who have sex with men (MSM) with HIV are at higher risk for repeat syphilis infections. Increased screening and interventions for this group can help reduce overall syphilis rates.

Area of Science:

  • Public Health
  • Epidemiology
  • Infectious Diseases

Background:

  • Syphilis incidence has risen significantly in the U.S. since 2000.
  • Men who have sex with men (MSM) are the primary demographic affected.
  • HIV-infected MSM experience disproportionately higher rates of syphilis.

Purpose of the Study:

  • To determine the rate of repeat syphilis infection among MSM in San Francisco.
  • To identify risk factors for syphilis reinfection in MSM.
  • To inform enhanced syphilis prevention strategies.

Main Methods:

  • Retrospective cohort study of primary, secondary, and early latent syphilis cases among MSM in San Francisco (2001-2002).
  • Data evaluated through end of 2003 to identify reinfections within 1 year of prior infection and treatment.

Main Results:

  • 6.7% of cases experienced repeat syphilis infection within one year.
  • HIV infection was significantly associated with increased risk of repeat syphilis infection (OR = 4.7).
  • No significant differences observed in age, race, partner numbers, substance use, or meeting venues.

Conclusions:

  • HIV-infected MSM diagnosed with syphilis are a key at-risk group for reinfection.
  • Targeted screening and risk reduction for HIV-infected MSM in care are recommended.
  • Interventions can help reduce the overall incidence of syphilis among MSM.

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