Syphilis and HIV/Syphilis Co-infection Among Men Who Have Sex With Men (MSM) in Ecuador

Abstract

There is a reemergence of syphilis in the Latin American and Caribbean region. There is also very little information about HIV/Syphilis co-infection and its determinants. The aim of this study is to investigate knowledge, attitudes, and practices regarding sexually transmitted infections (STIs), in particular syphilis infection and HIV/Syphilis co-infection, as well as to estimate the prevalence of syphilis among men who have sex with men (MSM) in a city with one of the highest HIV prevalence rates in Ecuador. In this study, questionnaires were administered to 291 adult MSM. Questions included knowledge about STIs and their sexual practices. Blood samples were taken from participants to estimate the prevalence of syphilis and HIV/syphilis co-infection. In this population, the prevalence of HIV/syphilis co-infection was 4.8%, while the prevalence of syphilis as mono-infection was 6.5%. Participants who had syphilis mono-infection and HIV/syphilis co-infection were older. Men who had multiple partners and those who were forced to have sex had increased odds of syphilis and HIV/syphilis co-infection. A high prevalence of syphilis and self-reported STI was observed, which warrants targeted behavioral interventions. Co-infections are a cause for concern when treating a secondary infection in a person who is immunocompromised. These data suggest that specific knowledge, attitudes, and behaviors among MSM are associated with increased odds of STIs (including HIV/syphilis co-infections) in this region of Ecuador.

Compare HIV/syphilis infections between age groups and explore associated factors of HIV/syphilis co-infections among men who have sex with men in Shenzhen, China, from 2009 to 2017

“…This study suggested that MSM with more anal/oral sex partners and inconsistent condom use during anal sex had a higher risk of HIV/syphilis co-infection than those with fewer sex partners and consistent condom use, which was in accordance with findings in previous studies [14, 16, 54, 55]. More sex partners may indicate more opportunities to engage in unprotected sexual behaviors, so partner notifications should be further promoted in this population.…”

“…In the present study, the prevalence of HIV/syphilis co-infections (9.2%) among older MSM was much higher than several previous studies (2.6% in China and 4.8% in Ecuador) [10, 16], which suggests that integrated interventions and screening for both HIV and syphilis infections on older MSM could be considered. A possible reason of the higher prevalence of co-infections in our study was that many rural-to-urban migrants looked for economic opportunities in China, and this population was found to have limited education, lower income, and more vulnerable to STIs [44, 45].…”

“…Diaz et al suggested that the associated factors of HIV/syphilis co-infection among MSM in Spain were reporting exclusively anal intercourse, having STI diagnosis history, and having sex with casual or several types of partners [15]. Hernandez et al found that MSM with older age, having multiple partners, and those who were forced to have sex were more likely to have co-infection [16].…”

Epidemiología de la sífilis con enfoque territorial: caso del Hospital de La Serena, años 2015-2017

“…Está descrito que presentar una ITS aumenta el riesgo de adquirir otra 2,15 . En efecto, la proporción de personas que presentaron co-infección con VIH en nuestro estudio fue de cerca de 10% y 20%, otras ITS.…”

“…La evidencia muestra que presentar una ITS aumenta el riesgo de adquirir otras, entre ellas el Virus de Inmunodeficiencia Humana (VIH) 2,15 . La epidemia de VIH y los avances en su tratamiento han traído consigo cambios en la epidemiología de otras ITS, incluida la sífilis 3 .…”