Men with syphilis at high risk for HIV
HIV incidence among men diagnosed with syphilis is high, according to a recent study of New Yorkers.
“We found that men in New York City who have been diagnosed with [primary and secondary] syphilis are at high risk for HIV, with more than one in 30 diagnosed with HIV within a year of syphilis infection,” Preeti Pathela, DrPH, of the New York City Department of Health and Mental Hygiene, and colleagues wrote in Clinical Infectious Diseases.
Pathela and colleagues studied 2,805 males who were listed in New York City’s STD registry for syphilis from January 2000 through June 2010, and who were not previously identified in the city’s HIV/AIDS registry.
The men, aged 14 to 86 years, contracted HIV at an annual rate of 3.61% (95% CI, 3.27%-3.97%), according to the study. HIV incidence was similar for the major race/ethnicity groups. The risk of being diagnosed with HIV did not change considerably, although men aged 50 years and older with syphilis had a significantly lower annual HIV incidence rate (1.15%) than those aged 44 years or younger (2.85% to 5.42%). Those with secondary compared with primary syphilis also recorded higher annual rates of HIV (4.1% vs. 2.64%), as did men diagnosed with another bacterial STD after their syphilis diagnosis (7.89%).
The numbers were higher for men who have sex with men, as one in 20 (5.56%) included in the study was diagnosed with HIV within 1 year of contracting syphilis. The researchers excluded those who were diagnosed with HIV within 60 days of syphilis diagnosis to account for the possibility that the diseases were contracted simultaneously.
The researchers said the “epidemiologic link between syphilis and HIV” makes pre-exposure prophylaxis initiation imperative for men with syphilis who are HIV-negative.
“To prevent the spread of HIV, it is necessary to identify persons for prevention interventions such as pre-exposure prophylaxis — the daily use of oral emtricitabine/tenofovir to prevent HIV acquisition,” the researchers wrote. – by David Jwanier
Disclosure: The researchers report no relevant financial disclosures.