Viewing the resurgence of early syphilis in light of increasing male homosexuality and childhood sexual abuse

Abstract

Back Ground and Objectives: A rising trend of syphilis has been documented worldwide recently. After decriminalization of homosexuality in India more and more males having sex with males (MSMs) have come out to seek medical advice. Aim: We evaluated sexual behavior of patients with syphilis attending our sexually transmitted infections (STIs) clinic focusing on the factors associated with the increasing MSM practices and rising trend of syphilis among MSM. Materials and Methods: This is a 10-year (2006–2015) descriptive study from among STI patients attending the dermatology outpatient department in a tertiary care center. Recognizing the rising homosexuality, from 2011 onward, we had given a questionnaire to assess their sexual behavior and sexual practices. Results: Analysis of data from 560 cases diagnosed as having STI revealed a rising trend of all STIs including syphilis from 2011 onward. The MSM cases reporting to our STI clinic showed a sustained rise from 2011 onward. The most common STI in MSM was syphilis that too early acquired. More than half of the MSM indulged in bisexual activities and the predominant mode was anoreceptive. Nearly 70% had unprotected contact and most had early sexual debut (<20 years). Thirty-six percent gave a history of childhood sexual abuse (CSA) by a close male acquaintance. Conclusions: After 2011, we have observed a resurgence of early acquired syphilis which coincided with an increase in promiscuous homosexuality. Many of the MSMs were bisexuals and homosexuality was an acquired behavior. An alarming increase in the incidence of CSA was observed in MSMs.

A scoping review of lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) people’s health in India

“…Thirty-seven percent (n = 65) of the articles focused on reporting STI/HIV prevalence estimates [ 30 – 47 ] and correlates of HIV-related risk behaviors [ 48 – 94 ] among MSM and TGW ( Fig 4 ). In the 18 studies [ 30 – 47 ] that reported HIV and STI prevalence estimates among MSM and TGW, nine [ 31 – 33 , 37 , 39 – 42 , 45 ] were conducted in clinical settings, six [ 30 , 34 , 35 , 38 , 43 , 46 ] in community settings, and three [ 36 , 44 , 47 ] in both clinical and community settings. Of these 18 studies, eight [ 30 , 34 , 35 , 37 , 40 , 43 , 45 , 46 ] reported HIV/STI prevalence and risk factors among MSM, three [ 36 , 39 , 44 ] human papillomavirus (HPV) prevalence among MSM living with HIV, and three [ 31 , 33 , 45 ] reported prevalence of perianal dermatoses, HPV and other STIs (such as syphilis, chlamydia and gonorrhea) among MSM.…”

“…In the 18 studies [ 30 – 47 ] that reported HIV and STI prevalence estimates among MSM and TGW, nine [ 31 – 33 , 37 , 39 – 42 , 45 ] were conducted in clinical settings, six [ 30 , 34 , 35 , 38 , 43 , 46 ] in community settings, and three [ 36 , 44 , 47 ] in both clinical and community settings. Of these 18 studies, eight [ 30 , 34 , 35 , 37 , 40 , 43 , 45 , 46 ] reported HIV/STI prevalence and risk factors among MSM, three [ 36 , 39 , 44 ] human papillomavirus (HPV) prevalence among MSM living with HIV, and three [ 31 , 33 , 45 ] reported prevalence of perianal dermatoses, HPV and other STIs (such as syphilis, chlamydia and gonorrhea) among MSM. Two studies [ 38 , 47 ] reported correlates of HIV incidence among MSM, with one study each reporting Hepatitis C prevalence among MSM living with HIV [ 42 ], and one study the prevalence of herpes [ 45 ].…”

“…Of these 18 studies, eight [ 30 , 34 , 35 , 37 , 40 , 43 , 45 , 46 ] reported HIV/STI prevalence and risk factors among MSM, three [ 36 , 39 , 44 ] human papillomavirus (HPV) prevalence among MSM living with HIV, and three [ 31 , 33 , 45 ] reported prevalence of perianal dermatoses, HPV and other STIs (such as syphilis, chlamydia and gonorrhea) among MSM. Two studies [ 38 , 47 ] reported correlates of HIV incidence among MSM, with one study each reporting Hepatitis C prevalence among MSM living with HIV [ 42 ], and one study the prevalence of herpes [ 45 ].…”

“…Overall, HIV prevalence among MSM ranged from 3.8% to 23.0% across different study sites. Among MSM, HPV/genital warts (23.0% to 95.0%), syphilis (0.8% to 11.9%), HSV/genital herpes (7.1 to 32.0%), and genital molluscum contagium (9.6%) were the most commonly reported STIs [ 30 , 31 , 33 , 34 , 36 , 37 , 39 , 40 , 42 , 45 ]. One study [ 42 ] reported Hepatitis-C prevalence among MSM as 1.3%.…”