A case-control study of syphilis among men who have sex with men in New York City: association With HIV infection.
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.
Paz-Bailey
Gabriela
G
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
Meyers
Andrea
A
Blank
Susan
S
Brown
James
J
Rubin
Steve
S
Braxton
Jim
J
Zaidi
Akbar
A
Schafzin
Josh
J
Weigl
Susan
S
Markowitz
Laurie E
LE
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