title: A case-control study of syphilis among men who have sex with men in New York City: association With HIV infection.
abstract: OBJECTIVE
  The objective of this study was to determine factors associated with syphilis among men who report sex with other men in New York City. DESIGN, SETTING AND STUDY SUBJECTS: We conducted a case-control study among 88 men who reported sex with men in the previous year, 18 to 55 years old and diagnosed with primary or secondary syphilis during 2001; and 176 control subjects frequently matched by age and type of health provider.
  
  
  RESULTS
  HIV prevalence among syphilis cases was 48% compared with 15% among control subjects (P <0.001). Variables associated with syphilis in a multivariate model were HIV infection (odds ratio [OR], 7.3; 95% confidence interval [CI], 3.5-15.4), income >$30,000 per year (OR, 2.7; CI, 1.4-5.2), and barebacking (OR, 2.6; CI, 1.4-4.8). The median time since HIV diagnosis for HIV-positive was 6 years for cases and 7 years for control subjects (P = 0.70). Among HIV-infected participants, syphilis cases were more likely than control subjects to report being on antiretroviral therapy (69% vs. 44%, P = 0.05) and to report having undetectable viral load (58% vs. 24%, P = 0.02).
  
  
  CONCLUSIONS
  HIV infection was strongly associated with syphilis in this study. High-risk behavior reported by both cases and control subjects indicates the potential for increased HIV transmission.
authors.affiliation: Division of STD Prevention, NCHSTP, Centers for Disease Control and Prevention, Mail stop E-04, 1600 Clifton Road, Atlanta, GA 30333, USA. gpbz@cdc.gov
authors.forename: Gabriela
authors.initials: G
authors.lastname: Paz-Bailey
authors.forename: Andrea
authors.initials: A
authors.lastname: Meyers
authors.forename: Susan
authors.initials: S
authors.lastname: Blank
authors.forename: James
authors.initials: J
authors.lastname: Brown
authors.forename: Steve
authors.initials: S
authors.lastname: Rubin
authors.forename: Jim
authors.initials: J
authors.lastname: Braxton
authors.forename: Akbar
authors.initials: A
authors.lastname: Zaidi
authors.forename: Josh
authors.initials: J
authors.lastname: Schafzin
authors.forename: Susan
authors.initials: S
authors.lastname: Weigl
authors.forename: Laurie E
authors.initials: LE
authors.lastname: Markowitz
mesh_terms: D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D016022:Case-Control Studies; D015658:HIV Infections / Q000453:epidemiology / Q000209:etiology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000453:epidemiology* / Q000209:etiology*; D019562:Viral Load