Eric P F Chow1,2, Denton Callander3,4, Christopher K Fairley1,2, Lei Zhang1,2, Basil Donovan3,5, Rebecca Guy3, David A Lewis6,7, Margaret Hellard8,9, Phillip Read3,10, Alison Ward11, Marcus Y Chen1,2. 1. Melbourne Sexual Health Centre, Alfred Health. 2. Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria. 3. The Kirby Institute. 4. Centre for Social Research in Health, UNSW Sydney. 5. Sydney Sexual Health Centre, Sydney Hospital. 6. Western Sydney Sexual Health Centre, Parramatta. 7. Marie Bashir Institute for Infectious Diseases and Biosecurity & Sydney Medical School-Westmead, University of Sydney, New South Wales. 8. Burnet Institute. 9. Infectious Disease Unit, Alfred Hospital, Melbourne, Victoria. 10. Kirketon Road Centre, Kings Cross, Sydney, New South Wales. 11. Clinic 275, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Abstract
BACKGROUND: Syphilis rates have increased markedly among men who have sex with men (MSM) internationally. We examined trends in syphilis testing and detection of early syphilis among MSM in Australia. METHODS: Serial cross-sectional analyses on syphilis testing and diagnoses among MSM attending a national sentinel network of 46 clinics in Australia between 2007 and 2014. RESULTS: 359313 clinic visits were included. The proportion of MSM serologically tested for syphilis annually increased in HIV-negative (48% to 91%; Ptrend < .0001) and HIV-positive MSM (42% to 77%; Ptrend < .0001). The mean number of tests per man per year increased from 1.3 to 1.6 in HIV-negative MSM (Ptrend < .0001) and from 1.6 to 2.3 in HIV-positive MSM (Ptrend < .0001). 2799 and 1032 syphilis cases were detected in HIV-negative and HIV-positive MSM, respectively. Among HIV-negative MSM, the proportion of infections that were early latent increased from 27% to 44% (Ptrend < .0001), while the proportion that were secondary decreased from 24% to 19% (Ptrend = .030). Among HIV-positive MSM, early latent infections increased from 23% to 45% (Ptrend < .0001), while secondary infections decreased from 45% to 26% (Ptrend = .0003). Among HIV-positive MSM, decreasing secondary syphilis correlated with increasing testing coverage (r = -0.87; P = .005) or frequency (r = -0.93; P = .001). CONCLUSIONS: Increases in syphilis screening were associated with increased detection of asymptomatic infectious syphilis and relative falls in secondary syphilis for both HIV-positive and HIV-negative MSM nationally, suggesting interruption of syphilis progression.
BACKGROUND: Syphilis rates have increased markedly among men who have sex with men (MSM) internationally. We examined trends in syphilis testing and detection of early syphilis among MSM in Australia. METHODS: Serial cross-sectional analyses on syphilis testing and diagnoses among MSM attending a national sentinel network of 46 clinics in Australia between 2007 and 2014. RESULTS: 359313 clinic visits were included. The proportion of MSM serologically tested for syphilis annually increased in HIV-negative (48% to 91%; Ptrend < .0001) and HIV-positive MSM (42% to 77%; Ptrend < .0001). The mean number of tests per man per year increased from 1.3 to 1.6 in HIV-negative MSM (Ptrend < .0001) and from 1.6 to 2.3 in HIV-positive MSM (Ptrend < .0001). 2799 and 1032 syphilis cases were detected in HIV-negative and HIV-positive MSM, respectively. Among HIV-negative MSM, the proportion of infections that were early latent increased from 27% to 44% (Ptrend < .0001), while the proportion that were secondary decreased from 24% to 19% (Ptrend = .030). Among HIV-positive MSM, early latent infections increased from 23% to 45% (Ptrend < .0001), while secondary infections decreased from 45% to 26% (Ptrend = .0003). Among HIV-positive MSM, decreasing secondary syphilis correlated with increasing testing coverage (r = -0.87; P = .005) or frequency (r = -0.93; P = .001). CONCLUSIONS: Increases in syphilis screening were associated with increased detection of asymptomatic infectious syphilis and relative falls in secondary syphilis for both HIV-positive and HIV-negative MSM nationally, suggesting interruption of syphilis progression.
Authors: Alex de Voux; Kyle T Bernstein; Heather Bradley; Robert D Kirkcaldy; Yunfeng Tie; R Luke Shouse Journal: Clin Infect Dis Date: 2019-03-05 Impact factor: 9.079
Authors: Jason J Ong; Hongyun Fu; Stephen Pan; M Kumi Smith; Dan Wu; Chongyi Wei; Bolin Cao; Wei Ma; Ligang Yang; Weiming Tang; Joseph D Tucker Journal: Sex Transm Dis Date: 2018-06 Impact factor: 2.830
Authors: Christina M Marra; Clare L Maxwell; Sharon K Sahi; Lauren C Tantalo; Shelia B Dunaway; Sheila A Lukehart Journal: Clin Infect Dis Date: 2020-08-22 Impact factor: 9.079
Authors: Christina M Marra; Clare L Maxwell; Sharon K Sahi; Lauren C Tantalo; Shelia B Dunaway; Sheila A Lukehart Journal: Clin Infect Dis Date: 2022-03-01 Impact factor: 9.079