Among human immunodeficiency virus (HIV)-infected individuals,
syphilis is an important
sexually transmitted infection (
STI), and repeat
infections are common. Identifying risk factors for delineating the trends in repeat
syphilis are essential for
STI and HIV prevention.This study is to investigate the dynamic of the
syphilis epidemic among HIV-infected patients and to identify the risk factors associated with repeat
syphilis.A population-based cohort design was used to analyze claim data between January 2000 and December 2010 using the Taiwan National Health Insurance Research Database. The Poisson regression test was used to identify risk factors for repeat
syphilis.Of 13,239 HIV-infected patients, annual
syphilis screen tests have been performed in 4,907 (37.1%) of these patients.
Syphilis has been diagnosed in 956 (19.5%) patients, and 524 (10.7%) had repeat
syphilis. The annual trend in repeat
syphilis showed a significant increase in the study period (β = 0.23, P < .001). Younger age (adjusted incidence rate ratio [aIRR] 1.43; 95% CI 1.11-1.86), male gender (aIRR 11.14, 95% CI 4.16-29.79), a history of
STIs (aIRR 1.39, 95% CI 1.21-1.59) were independently associated with repeat
syphilis. The retention in HIV care and adherence to antiretroviral
therapy ≥85% ([aIRR] 0.77, 95% CI 0.61-0.98; P < .001) were associated with a reduced risk of repeat
syphilis.The incidence of repeat
syphilis increased during 11 years of follow-up. The screening of
syphilis for early diagnosis and retention in HIV care with medication adherence should be encouraged to minimize the risk of repeat
syphilis in the targeted population.