Researchers identify patients who may benefit from more frequent syphilis testing
Researchers identified patients with HIV who they said may benefit from more frequent syphilis testing.
They include younger cisgender men who have sex with men and transgender women who have sex with men and who also inject drugs, “particularly among those who identify as Hispanic,” the researchers reported in Clinical Infectious Diseases.
“Syphilis diagnoses have been increasing rapidly in the United States, and people living with HIV are more likely to experience a new or recurrent syphilis diagnosis compared to people without HIV,” Timothy W. Menza, MD, PhD, medical director for the Oregon Health Authority’s HIV/STD/tuberculosis section, told Healio. “We conducted this study to further define optimal prioritization of syphilis testing and prevention interventions among people living with HIV.”
Menza and colleagues reviewed records of people with HIV who were in care between Jan. 1, 2014, and Nov. 16, 2018, from four sites in the Centers for AIDS Research Network of Integrated Clinical Systems cohort (n = 8,455). According to the study, they calculated rates of syphilis testing and incident syphilis and demographic and clinical predictors of testing and diagnosis.
In total, the 8,455 participants contributed 29,568 person-years of follow-up. Overall, the rate of syphilis testing was 118 tests per 100 person-years (95% CI, 117-119), whereas the rate of incident syphilis was 4.7 cases per 100 person-years (95% CI, 4.5-5).
According to Menza, they observed the highest rate of incident syphilis among younger men who have sex with men (MSM) and transgender women who have sex with men and inject drugs, particularly among those who identify as Hispanic. He added that incident syphilis was also more common during follow-up intervals in which participants had a detectable viral load, a rectal infection and new positive hepatitis C test.
“[These groups] are more likely to experience a syphilis diagnosis and should, thus, be prioritized for syphilis testing and behavioral, like eHealth interventions, and biomedical interventions, like doxycycline for sexually transmitted infections pre- or post-exposure prophylaxis, for sexually transmitted infection prevention,” Menza said.