Syphilis Predicts HIV Incidence Among Men and Transgender Women Who Have Sex With Men in a Preexposure Prophylaxis Trial

Abstract

Syphilis infection was associated with HIV incidence in an HIV-prevention trial that randomized participants to once-daily emtricitabine/tenofovir (FTC/TDF) vs placebo. FTC/TDF had no effect on the association between incident syphilis and HIV acquisition; syphilis infection did not decrease FTC/TDF efficacy.

The Effect of High Rates of Bacterial Sexually Transmitted Infections on HIV Incidence in a Cohort of Black and White Men Who Have Sex with Men in Atlanta, Georgia

“…The iPrEx trial did show an association between syphilis and HIV acquisition among MSM, and we may have seen a similar effect with additional follow-up time in our study. 33 Our study enrolled only black and white MSM, was limited to one geographic urban area in the Southeast, and may not be generalizable to all U.S. MSM. Finally, it is important to note that we have not estimated the PAF associated with the increased risk of HIV transmission from HIV-positive partners with STI in this study.…”

2016 United Kingdom national guideline on the sexual health care of men who have sex with men

“…HIV incidence varied by the rate of incident syphilis, when controlled for known predictors of HIV in the iPrEx study of HIV PrEP (230). In a study of 301 MSM diagnosed with bacterial STI in a London clinic recalled at 3 months for retesting, of whom 206 attended (231); 29 MSM per 100 person-years of follow up were diagnosed with a new STI and there were 5 new cases of HIV infection.…”

Laboratory Evaluation of a Dual Rapid Immunodiagnostic Test for HIV and Syphilis Infection

“…Additionally, syphilis infection, like other genital ulcer diseases, may facilitate HIV acquisition and transmission (8)(9)(10). In coinfected patients, syphilis can increase transmission of HIV by increasing viral shedding at the site of genital ulcers (11,12) and increasing the HIV load (13,14).…”