Low viral suppression and high HIV diagnosis rate among men who have sex with men with syphilis--Baltimore, Maryland.

BACKGROUND: The burden of syphilis and HIV among gay, bisexual, and other men who have sex with men (MSM) in Baltimore, Maryland, is substantial. Syphilis and HIV surveillance data were analyzed to characterize MSM with syphilis, including those with repeat infection and HIV coinfection, to strengthen prevention efforts. METHODS: MSM 15 years or older from Baltimore City or County diagnosed as having early syphilis in 2010 to 2011 were included. Those previously treated for syphilis in 2007 to 2011 were considered to have repeat syphilis infection. HIV surveillance data were used to identify HIV coinfection and assess viral suppression. For MSM not diagnosed as having HIV at or before their syphilis diagnosis, annual HIV diagnosis rates were estimated, using Baltimore City data. RESULTS: Of 460 MSM with early syphilis in 2010 or 2011, 92 (20%) had repeat infection; 55% of MSM with a single diagnosis and 86% with repeat infection were HIV coinfected. Among MSM diagnosed as having HIV, viral suppression was low (25%, or 46% of those with a viral load reported). Among Baltimore City MSM without a prior HIV diagnosis, estimated annual HIV diagnosis rates were high (5% for those with 1 syphilis diagnosis, 23% for those with repeat infection). CONCLUSIONS: Baltimore-area MSM with syphilis, particularly those with repeat infection, represent a unique population for whom coinfection with HIV is high. Increasing frequency of syphilis and HIV testing among Baltimore area MSM with a syphilis diagnosis and prioritizing HIV-infected MSM with syphilis in efforts to achieve viral suppression may improve outcomes locally for both infections.

Development and validation of the attitudes toward same-sex marriage scale.

This research details the development of a new instrument designed to measure attitudes toward same-sex marriage. Participants were 615 heterosexual women and men, drawn from both student and nonstudent adult populations. Four studies were conducted for the purpose of developing the scale and to establish its psychometric properties. The resulting Attitudes Toward Same-Sex Marriage Scale (ATSM) consists of 17 items, has a one-dimensional factor structure, and exhibits a high degree of reliability. Additional analyses established the construct validity of the ATSM where ATSM scores were highly correlated with scores on the Attitudes Toward Lesbians and Gay Men Scale (Herek, 1988). ATSM scores followed predicted correlational patterns with select demographics, including educational attainment, religiosity, and political conservatism. The usefulness of this new measure in survey research is discussed.