Incidence of syphilis among HIV-infected men in Singapore, 2006-2017: temporal trends and associated risk factors.
Sex Transm Infect
; 96(4): 293-299, 2020 06.
Article
em En
| MEDLINE
| ID: mdl-31371448
ABSTRACT
OBJECTIVE:
There have been recent reports globally on substantial increase in syphilis diagnoses particularly among high-risk men. The aim of this study was to assess temporal trends of incident syphilis and associated risk factors among HIV-infected men in Singapore.METHODS:
We conducted retrospective cohort analysis using the clinical database maintained by the Clinical HIV Programme at the National Centre for Infectious Diseases, Singapore. HIV-infected men with a negative syphilis result at baseline who had undergone at least one subsequent test in 2006-2017 were included. Factors associated with incident syphilis were investigated using Cox proportional hazards regression analyses.RESULTS:
A total of 1069 HIV-infected men were tested for syphilis at least once following their negative baseline test during the 12-year period, and they contributed 4284 person-years of follow-up (PYFU). There were 266 cases of incident syphilis, giving an overall incidence of 6.21 per 100 PYFU (95% CI 5.49-7.00). The incidence of syphilis per 100 PYFU increased from 1.21 (95% CI 0.33 to 3.10) in 2010 to 26.04 (95% CI 19.97 to 33.40) in 2017. In the multivariable model, risk factors for syphilis seroconversion were age 15-24 years at HIV diagnosis (adjusted HR (aHR) 1.64, 95% CI 1.05 to 2.56) versus ≥45 years, being Chinese (aHR 1.82, 95% CI 1.01 to 3.29) versus Indian and other minority ethnic groups, men having sex with men (MSM) (aHR 3.29, 95% CI 2.22 to 4.87) versus heterosexuals, and HIV diagnosis in later periods of 2009-2011 (aHR 1.96, 95% CI 1.41 to 2.74), 2012-2014 (aHR 3.96, 95% CI 2.68 to 5.83) and 2015-2017 (aHR 7.94, 95% CI 4.52 to 13.95) versus 2006-2008.CONCLUSION:
The annual incidence rate of syphilis in HIV-infected men was on the rise, and it was consistently higher among MSM than in heterosexual men. The findings supported regular screening for syphilis and enhanced behavioural interventions in Singapore.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Sífilis
/
Infecções por HIV
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article