Prevalence of HIV and syphilis and their co-infection among men having sex with men in Asia: A systematic review and meta-analysis.

Background: Studies found that the group of men who have sex with men (MSM) is at a very high level of risk of HIV and sexually transmitted infections (STIs) in Asian regions due to multiple reasons. Although the prevalence of HIV among general people in Asia is considered low, the prevalence of HIV and Syphilis among MSM in this region was found very high and usually, it goes unnoticed. This study aimed to inspect the prevalence of and trends in HIV, Syphilis, and their co-infection among MSM in Asia. Methods: A systematic search was performed on January 5, 2021, in PubMed, Web of Science, and Google Scholar databases. To evaluate the heterogeneity, Q-tests, and I 2 were used. To explore the publication bias, Eggers' test and funnel plot were used. The random-effect model and subgroup analysis were performed due to the significant heterogeneity. Results: A total of 2872 articles were identified, and 66 articles were included in the final analysis. The overall prevalence of HIV and Syphilis among MSM was estimated considering 69 estimates from 66 studies whereas 19 estimates of co-infection were found in 17 studies. The pooled HIV prevalence was 8.48% (CI: 7.01-9.95) and the pooled Syphilis prevalence was 9.86% (CI: 8.30-11.41) with significant heterogeneity and publication bias. The pooled prevalence of HIV and Syphilis co-infection was 2.99% (CI: 1.70-4.27) with significant heterogeneity and no publication bias. The HIV, Syphilis, and HIV-Syphilis co-infection prevalence estimates exhibited an upward trend during 2002-2017. Conclusions: HIV, Syphilis, and their co-infection are quite prevalent among MSM in the Asia-Pacific region. Integrated and intensified intervention strategies, HIV testing, and improved access to antiretroviral treatment as well as increased awareness are needed to reduce HIV, Syphilis, and their co-infection among the discussed vulnerable group.

The Intersection of HIV and Syphilis: Update on the Key Considerations in Testing and Management.

PURPOSE OF REVIEW: To highlight recent trends in the epidemiology of HIV and syphilis, the impact of the COVID epidemic, our approach to care of co-infected patients, and our views on important next steps in advancing the field. RECENT FINDINGS: HIV and syphilis co-infection has been on the rise in recent years although since the COVID pandemic there is a decrease in new diagnoses-it remains unclear if this represents a true decline or inadequate testing or under-reporting. Standard HIV care should include regular syphilis serology .Treatment and serological follow-up of syphilis in HIV positive and negative patients can be conducted similarly. Challenges remain in the diagnosis and management of neurosyphilis. New models for testing and prevention will be crucial next steps in controlling co-infection. The intersection of HIV and syphilis infections continues to pose new and unique challenges in diagnosis, treatment, and prevention.

Elimination of the Perinatal Transmission of HIV and Syphilis in Puerto Rico and Sustained Success since 2007: Convergence of Science, Women-Centered Care, and Policy.

OBJECTIVE: There have been significant successes in the fight against HIV/AIDS due to the access to rapid HIV testing, interventions to reduce the mother-to-child transmission (MTCT) risk, potent and effective antiviral medications, and other biomedical prevention strategies. The purpose of this work is to demonstrate that Puerto Rico eliminated Mother-to-Child Transmission of HIV (MTCT) following the 2017 World Health Organization (WHO) criteria for validating the elimination of MTCT and Syphilis. METHODS: Existing epidemiological data from Puerto Rico was used to document the elimination of MTCT and Syphilis. Data to calculate the indicators was obtained from the various divisions of the Puerto Rico Department of Health, including vital statistics, surveillance data, and programmatic outcomes. RESULTS: Puerto Rico eliminated MTCT and syphilis, according to the WHO indicators, earlier than other countries. We can trace the outcomes to 1994 using the incidence rate of perinatally-acquired HIV of <50/100,000; to 2007 using HIV perinatal transmission rates for non-breastfeeding countries (<2%), to 2008 using 90% of women receiving ART at delivery, and to 2005 using the incidence rate of congenital syphilis of <50/100,000. CONCLUSION: Not only have we eliminated the MTCT of HIV and syphilis, but the efforts have been sustained since 2000. The elimination of transmission of infectious diseases requires the intersection of scientific feasibility, coordinated interventions, and political will, successfully attained in Puerto Rico.

Do the same socio-demographic variables predict testing uptake and sero-status? HIV and syphilis among an observational sample of Chinese men who have sex with men in Shanghai, China.

HIV and syphilis are pronounced among men who have sex with men (MSM) in China and often occur as co-infections, while testing remains low. Few studies examine common predictors across these outcomes. This observational venue-based sample of 546 MSM in Shanghai, China used a common set of psychosocial predictors to construct logistic models for the outcomes (HIV non-testing, syphilis non-testing, HIV sero-status, and syphilis sero-status). Fifty-seven (10.7%) participants tested positive for HIV, 126 (23.5%) for syphilis, and 33% of HIV-positive participants had a co-infection. Non-sex working MSM had consistently higher odds of HIV and syphilis non-testing (OR= 2.2, 95% CI 1.4-3.5, p < 0.001; OR = 2.4, 95, 95% CI 1.5-3.8, p < 0.001, respectively) compared to 'money boy' sex workers. Participants with a 0 score on HIV knowledge had 4.1 times (95% CI 1.4-12.5, p = 0.01) the odds of reporting HIV non-testing, 6.0 (95% CI 1.96-18.5, p < 0.01) times the odds of reporting non-testing for syphilis, and 8.44 times (95% CI 1.19-59.7, p = 0.03) the odds of testing positive for HIV, compared to a score of 8. The results highlighted the importance of integrating HIV/syphilis education and promoting testing for both HIV and syphilis among all sub-groups of MSM in China.

Coinfecção HIV/sífilis na gestação e transmissão vertical do HIV: um estudo a partir de dados da vigilância epidemiológica / HIV and syphilis coinfection in pregnancy and vertical HIV transmission: a study based on epidemiological surveillance data

RESUMO Objetivo Estimar a taxa de coinfecção do HIV/sífilis nas gestantes de Porto Alegre, estado do Rio Grande do Sul, e sua associação com a transmissão vertical do HIV e variáveis socioeconômicas. Método Neste estudo transversal retrospectivo analítico, foram utilizados dados do sistema de vigilância epidemiológica de gestantes portadoras do HIV e crianças expostas e dados da sífilis na gestação e da sífilis congênita no período de 2010 a 2013. Resultados A população do estudo incluiu 1 500 gestantes positivas para HIV com partos no período de 2010 a 2013. Dessas, 155 (10,3%) também eram infectadas por sífilis, correspondendo a uma taxa de coinfecção HIV/sífilis de 10,2% (± 1,5%). Foi encontrada menor escolaridade no grupo de gestantes coinfectadas, bem como maior prevalência de mulheres negras e maior exposição ao HIV relacionada ao uso de drogas pelo parceiro e pela gestante. Gestantes com coinfecção HIV/sífilis tiveram diagnóstico do HIV em momentos mais tardios, como no parto, além de maior prevalência de não realização de pré-natal (44%). Na análise bruta foi identificada associação da transmissão vertical do HIV com a presença de coinfecção HIV/sífilis (razão de prevalência = 2,1; IC95%: 1,21 a 3,74; P = 0,01), a qual se manteve na análise ajustada. Conclusão Um perfil de maior vulnerabilidade foi evidenciado no grupo de gestantes coinfectadas por HIV/sífilis, enfatizando a importância de melhorar o acesso a atendimento qualificado à saúde para impacto positivo do tratamento na redução da sífilis congênita e na eliminação da transmissão vertical do HIV.

ABSTRACT Objective To estimate the rate of HIV and syphilis coinfection among pregnant women living in Porto Alegre, Brazil, as well as the association of coinfection with vertical HIV transmission and socioeconomic variables. Method This analytical retrospective cross-sectional study employed data from the regular epidemiological surveillance system for the period from 2010 to 2013. Data were obtained regarding pregnant women with HIV and exposed children, syphilis in pregnancy, and congenital syphilis. Results The study population included 1 500 HIV-positive women with deliveries from 2010 to 2013. Of these, 155 (10.3%) were also infected with syphilis, corresponding to an HIV and syphilis coinfection rate of 10.2% (± 1.5%). The coinfected group had lower education levels, higher prevalence of black women, and greater HIV exposure related to drug use by the woman or a partner. Coinfected women had more delayed HIV diagnosis (for example, during childbirth) and greater prevalence of lacking prenatal care (44%). Crude analysis showed an association between vertical HIV transmission and HIV and syphilis co-infection (PR = 2.1; 95%CI: 1.21-3.74; P = 0.01) that persisted in the adjusted analysis. Conclusion A profile of increased vulnerability was identified among pregnant women with HIV and syphilis coinfection. A positive impact of the treatment to reduce congenital syphilis and eliminate vertical transmission of HIV depends on enhanced access to qualified health care.

Using electronic readers to monitor progress toward elimination of mother-to-child transmission of HIV and syphilis: An opinion piece.

Electronic readers and smartphones have the potential to standardize the interpretation of rapid diagnostic tests (RDTs) and provide timely surveillance program data. RDTs are widely used for HIV and are being increasingly used for syphilis screening in pregnant women. Following the WHO initiative for the validation of elimination of mother-to-child transmission of HIV and syphilis, there is a need for more extensive testing and data monitoring. However, access to timely and accurate data can be challenging once testing is decentralized as data quality at remote sites is often difficult to verify. Electronic RDT readers can help to ensure quality and allow automated data transmission, creating an opportunity for real-time surveillance to inform control strategies and assess intervention impact. Furthermore, by linking the data to existing supply chain management software, stockouts can be minimized. The present opinion piece looks at the opportunities and challenges of using these tools within national elimination programs.

Vulnerabilidade e fatores associados a HIV e sífilis em homens que fazem sexo com homens, Belo Horizonte, MG / Vulnerability and factors associated with HIV and syphilis among men who have sex with men, Belo Horizonte, MG

Introdução: a epidemia do HIV no Brasil caracteriza-se como concentrada em populações-chave, incluindo homens que fazem sexo com homens (HSH). No entanto, são pouco conhecidos os indicadores de monitoramento e avaliação da epidemia em nível estadual ou municipal destas populações. Objetivo: descrever comportamentos de risco e prevalências de HIV e sífilis em população de HSH em Belo Horizonte, MG.Métodos: estudo de corte transversal parte de estudo multicêntrico nacional entre HSH adultos. A amostra foi recrutada pela técnica Respondent Driven Sampling (RDS). Foram realizadas entrevistas semiestruturadas e exames para HIV e sífilis. Resultados: foram recrutados 274 HSH em Belo Horizonte. Os participantes eram principalmente indivíduos jovens, com alta escolaridade, de classes sociais A/B, que se autorreferiram gay ou homossexual e tinham alta proporção do uso irregular de preservativos. As prevalências ponderadas da infecção pelo HIV e de sífilis foram, respectivamente, 10,3 e 13,9%. Idade, cor, contar para a mãe ou pai sobre a orientação sexual, testagem prévia para o HIV ou sífilis, diagnóstico prévio de sífilis ou de outras DSTs foram estatisticamente associados a ambas as infecções (p<0,05). Estado civil, família ser indiferente ou desaprovar a opção sexual, ter melhor conhecimento sobre HIV/Aids, mas não saber avaliar sua percepção de risco estiveram estatisticamente associados somente ao HIV e classe social somente com sífilis. Conclusão: os resultados revelam a gravidade da epidemia do HIV na população de HSH residentes em Belo Horizonte. Políticas públicas no nível municipal e estadual devem ser implementadas e/ou revistas com urgência...

Introduction: The HIV epidemic in Brazil is characterized as concentrated on key populations, incluiding men Who have sex with men (MSM). However, monitoring and evaluation indicators are not well known at Municipal or State levels. Objective: To describe risk behaviors and HIV and syphilis prevalences among MSM in Belo Horizonte, MG. Methods: Crosssectional study part of a national multicenter study among adult MSM in Brazil. The sample was recruited using Respondent Driven Sampling (RDS) technique. Semistructure interviews and serological exams for HIV and syphilis were conducted. Resultads: A total of 274 MSM were recruited in Belo Horizonte. Participants were mostly young, with high education, social classes A/B, self-reported as gay or homosexual and with high proportion of irregular use of condoms. Weighted prevalence of HIV infection and syphilis were, respectively, 10.3% and 13.9%. Age, color, sharing with their mother or father their sexual orientation, prior HIV and syphilis testing, and previous diagnosis of syphilis or other STDs were statistically associated with both infections (p<0.05). Marital status, family disapproval or indifference of their sexual orientation, better HIV/Aids knowledge, not knowing their chances of acquiring HIV were statistically associated only with HIV and social class only with syphilis. Conclusion: These results indicate the severity of the HIV epidemic amongthe MSM population in Belo Horizonte. Public policies at the municipal and state levels must be implemented and/or revised urgently...