Disclosures: The authors report no relevant financial disclosures.
July 19, 2021
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Almost 8% of MSM globally have syphilis, study finds

Disclosures: The authors report no relevant financial disclosures.
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The global prevalence of syphilis among men who have sex with men is close to 8%, according to the results of a study published recently in The Lancet Global Health.

“Every 5 years or so, WHO generates new global estimates of curable sexually transmitted infections among women and men in the general population. I was a co-author of the most recent global estimates for 2016 — which were published in 2019 — and, at the time, there were no globally pooled estimates of syphilis prevalence among MSM,” Matthew Chico, PhD, MPH, an associate professor of public health at the London School of Hygiene & Tropical Medicine, told Healio.

Tsuboi M, et al. Lancet Global Health. 2021;doi:10.1016/S2214-109X(21)00221-7.

Tsuboi M, et al. Lancet Global Health. 2021;doi:10.1016/S2214-109X(21)00221-7.

In preparation for the next cycle of global estimates of curable STIs, Chico and colleagues conducted a systematic review and meta-analysis to get a better measure of the prevalence of syphilis among MSM. They searched MEDLINE, Embase, LILACS, AIM and Integrated Bio-Behavioral Surveillance (IBBS) reports for studies conducted between Jan. 1, 2000, and Feb. 1, 2020, with syphilis point prevalence data measured by biological assay among MSM. They used random-effects models to generate pooled prevalence estimates across eight global regions.

Overall, the researchers identified 275 eligible studies that included a total of 606,232 participants and 345 prevalence data points in 77 countries.

They estimated that the global pooled syphilis prevalence among MSM from 2000 to 2020 was 7.5% (95% CI, 7%-8%), ranging from 1.9% (95% CI, 1%-3.1%) in Australia and New Zealand to 10.6% (95 CI, 8.5%-12.9%) in Latin America and the Caribbean.

The global rate is “alarmingly high” and 15 times higher than men in the general population, Chico said. He said cases are particularly high in regions where HIV prevalence among MSM is 5% or greater, and are increasing in lower middle, upper middle and high-income countries.

“Syphilis screening and treatment is vitally important,” Chico said. “To reduce syphilis incidence 90% globally from 2018 to 2030, as per the WHO Global Health Sector strategy adopted by countries of the world, will require interventions that target MSM.”