Syphilis infection, sexual practices and bisexual behaviour among men who have sex with men and transgender women: a cross-sectional study

Fernandes, Fernanda Rodas Pires; Zanini, Paola; Rezende, Grazielli Rocha de; Castro, Ludiele Souza; Bandeira, Larissa Melo; Puga, Marco Antonio Moreira; Tanaka, Tayana Serpa Ortiz; Bertolacci-Rocha, L. G.; Teles, Sheila Araújo; Motta-Castro, Ana Rita Coimbra

doi:10.1136/sextrans-2014-051589

Cited by 43 publications

(29 citation statements)

References 25 publications

(22 reference statements)

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“…The prevalence of suspected STD infections (24.4%) found in our study was much higher than reported among MSM in Guangzhou (23.2% in 2012 and 17.0% in 2013) [25] and central Brazil (4.3%) [26], but lower than among MSM in the Jiangsu province of China (34.1%) [27] and El Salvador (49.8%) [28] and among female sex workers (FSWs) in Shanxi province (53.6%) [29] of China (the comparisons of prevalence of suspected STD infection were all made under the same definition). The HIV prevalence among suspected STD-infected MSM was 16.7%, which was also higher than Chinese MSM in general (6.5%) [30] and Chinese FSWs (0.2%) [31], as reported in two recently published meta-analyses.…”

Section: Discussioncontrasting

confidence: 63%

Treatment-seeking behaviour and barriers to service access for sexually transmitted diseases among men who have sex with men in China: a multicentre cross-sectional survey

Yan

et al. 2017

Infect Dis Poverty

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BackgroundDelayed or inappropriate treatment for sexually transmitted diseases (STDs) increases the risk of HIV acquisition and may cause other harmful outcomes. However, studies on STD treatment-seeking behaviour and correlated factors in men who have sex with men (MSM) are scarce.This information is crucial for the promotion of STD treatment-seeking behaviour and reduction of HIV transmission among Chinese MSM.MethodsDuring 2012–2013, a multicentre cross-sectional study was conducted in 7 Chinese cities. Participants completed an interview-questionnaire and gave venous blood samples, which were then tested for antibodies to HIV, syphilis, and herpes simplex virus-2 (HSV-2). MSM who tested positive for syphilis/HSV-2 or had obvious STD-related symptoms within the last 12 months were defined as suspected STD-infected MSM.ResultsOf the 4 496 eligible MSM who completed this survey, 24.4% (1 096/4 496) were categorized as suspected STD-infected MSM. 35.7% (391/1 096) of these MSM with suspected STD infections sought STD treatment in clinics within the last 12 months. Among MSM who did not attend STD clinics for treatment, the prevalence of syphilis and HSV-2 was significantly higher; the HIV prevalence and incidence within this subpopulation reached as high as 14.5% and 12.2/100 person-years, respectively. Multivariate logistic regression analysis indicated that having 7–12 years of education (vs. ≤6 years; aOR, 2.5; 95%CI, 1.0–6.1), ≥13 years of education (vs. ≤6 years: aOR, 2.8; 95%CI, 1.2–7.0), monthly income >500 USD (vs. ≤500 USD: aOR, 1.5; 95%CI, 1.1–2.1), obvious STD-related symptoms within last 12 months (aOR, 5.3; 95%CI, 3.7–7.5), being HIV infected (aOR, 1.7; 95%CI, 1.1–2.6), currently syphilis infected (aOR, 0.6; 95%CI, 0.4–0.9) and HSV-2 infected (aOR, 0.6; 95%CI, 0.5–0.9) were independent correlates with seeking STD treatment in clinics among Chinese MSM.ConclusionsThe high prevalence of STD infection coupled with a low proportion of individuals who exhibit appropriate treatment-seeking behaviour create a high risk of a growing HIV epidemic among Chinese MSM. Models that prioritize better screening for and education about STDs should be urgently implemented, especially among low-income MSM.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-016-0219-5) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 63%

Treatment-seeking behaviour and barriers to service access for sexually transmitted diseases among men who have sex with men in China: a multicentre cross-sectional survey

Yan

et al. 2017

Infect Dis Poverty

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“…Syphilis is a systemic disease caused by the spirochaete Treponema pallidum and is one of the oldest and most well-known diseases, for which curative treatment is available and efficient. Several studies have recently reported its resurgence, particularly in specific populations, especially in communities of men who have sex with men (MSM) in many parts of the world 6-8,12,23 .…”

Section: Introductionmentioning

confidence: 99%

Factors associated with reinfection of syphilis in reference centers for sexually transmitted infections

2017

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OBJECTIVEWe aim to analyze trend of syphilis and factors associated with recurrent episodes of syphilis among adults and adolescents attended in a STI/AIDS reference centers in Campinas, state of São Paulo, 2004 to 2012.METHODSMedical records, pharmacy data, and notification database were accessed to analyze trends of syphilis and sociodemographic, epidemiological and clinical variables associated with reinfection of syphilis. After univariate analysis, a hierarchical logistic regression model was adjusted to analyze variables associated with more than one episode of syphilis (dependent variable). First step (sex, age, and years of schooling) were tested and in the second, epidemiological and clinical variables.RESULTSA total of 1,009 episodes of syphilis were identified among 860 adolescents and adults, 117 individuals (13.6%) presented with more than one episode of syphilis. Factors associated with more than one episode of syphilis were sex (male) (OR = 4.28; 95%CI 1.31–14.0), age (OR = 1.02; 95%CI 1.00–1.04), homosexual/bisexual orientation (OR = 2.29; 95%CI 1.22–4.32), HIV coinfection (OR = 3.54; 95%CI 2.22–5.63), and absence of STI symptoms at the time of syphilis diagnostic (OR = 1.70; 95%CI 1.03–2.80).CONCLUSIONSThe number of cases of syphilis and proportion in relation to STI increased in recent years in a specific population attended in a STI/AIDS reference centers in Campinas. Association with HIV, homosexual/bisexual orientation and the silent clinical characteristic of cases confirm the necessity to implement more aggressive strategies to prevent the occurrence of syphilis and other STI in specific populations with higher disease risk.

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“…2,4 Despite the existence of inexpensive and effective antimicrobial therapy, syphilis has increased significantly in vulnerable groups, including men who have sex with men (MSM), transgender women (TW), commercial sex workers (CSWs), and prisoners. [5][6][7][8] Prison populations are considered to be at high risk for STIs, including syphilis, due to risk behaviors such as intravenous drug use, homosexual contact with unprotected sexual practices, and multiple sexual partners. 8,9 Although syphilis control strategies are well established, some studies have shown significantly increasing rates of T. pallidum infection among prisoners.…”

Section: Introductionmentioning

confidence: 99%

High Prevalence of Treponema pallidum Infection in Brazilian Prisoners

Correa

Croda

Castro

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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The number of new syphilis cases in Brazil has risen alarmingly in recent years. However, there is limited data regarding syphilis prevalence in the Brazilian prison population. To facilitate the development of effective interventions, a cross-sectional study was undertaken to determine the prevalence of infection, active syphilis, and associated risk factors among Brazilian prisoners. We administered a questionnaire to a population-based sample of prisoners from 12 prisons in Central-West Brazil and collected sera for syphilis testing, from January to December 2013. Univariable and multivariable regression analyses were performed to assess associations with active syphilis. We recruited 3,363 prisoners (men: 84.6%; women: 15.4%). The overall lifetime and active syphilis prevalences were 10.5% (9.4% among men; 17% among women, < 0.001) and 3.8% (2% among men; 9% among women, < 0.001), respectively. The variables associated with active syphilis in men prisoners were homosexual preference, history of sexually transmitted infections, and human immunodeficiency virus status. Among women, the factors were sex with intravenous drug users, genital ulcer disease, and previous incarceration. Despite the high prevalence of active syphilis, 88.5% reported unawareness of their serological status and 67% reported unprotected sexual practices. Women had the highest rates of infection, including them in a high-risk group for the development of syphilis during pregnancy. Thus, implementing screening programs to enable continuous measures of control and prevention of infection in the prison environment, mainly in women institutions, is important to prevent severe forms of this disease and congenital infections.

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Syphilis infection, sexual practices and bisexual behaviour among men who have sex with men and transgender women: a cross-sectional study

Cited by 43 publications

References 25 publications

Treatment-seeking behaviour and barriers to service access for sexually transmitted diseases among men who have sex with men in China: a multicentre cross-sectional survey

Treatment-seeking behaviour and barriers to service access for sexually transmitted diseases among men who have sex with men in China: a multicentre cross-sectional survey

Factors associated with reinfection of syphilis in reference centers for sexually transmitted infections

High Prevalence of Treponema pallidum Infection in Brazilian Prisoners

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