The high risk of an HIV diagnosis following a diagnosis of syphilis: a population-level analysis of New York City men.

Abstract

BACKGROUND:

Epidemiologic studies have shown that syphilis is associated with risk for human immunodeficiency virus (HIV) infection. We used population-level syphilis and HIV data to quantify HIV incidence among men following primary or secondary (P&S) syphilis diagnoses and identify the highest-risk subgroups for intensified prevention, such as pre-exposure prophylaxis with antiretroviral medications.

METHODS:

Male cases reported to the New York City HIV/AIDS and Sexually Transmitted Disease (STD) surveillance registries were matched using a deterministic algorithm. We measured HIV incidence following P&S syphilis diagnosed between 2000 and June 2010 and identified risk factors for HIV infection using Cox proportional hazards models.

RESULTS:

Of 2805 men with syphilis contributing 11 714 person-years of follow-up, 423 (15.1%) acquired HIV; annual incidence was 3.61% (95% confidence interval [CI], 3.27%, 3.97%). HIV incidence was high among: men who have sex with men (MSM) (5.56%, 95% CI, 5.02%-6.13%); males with secondary compared with primary syphilis (4.10% vs 2.64%, P < .0001); and males diagnosed with another bacterial STD after syphilis (7.89%, 95% CI, 6.62%-9.24%).

CONCLUSIONS:

HIV incidence among men diagnosed with syphilis is high; one in 20 MSM were diagnosed with HIV within a year. Our data have implications for syphilis and HIV screening and may be useful for further targeting HIV-negative populations for pre-exposure prophylaxis.

• Authors: Preeti Pathela, Sarah L Braunstein, Susan Blank, Colin Shepard, Julia A Schillinger
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 61 Issue 2 Pg. 281-7 (Jul 15 2015) ISSN: 1537-6591 [Electronic] United States
• PMID: 25870333 (Publication Type: Journal Article)
• Copyright: © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: [email protected].

Topics

• Adolescent
• Adult
• Follow-Up Studies
• HIV Infections (complications, diagnosis, epidemiology, prevention & control)
• Homosexuality, Male
• Humans
• Incidence
• Male
• Middle Aged
• New York City (epidemiology)
• Population Surveillance
• Risk Factors
• Syphilis (complications, diagnosis, epidemiology, microbiology)
• Young Adult