Risk factors for early syphilis among gay and bisexual men seen in an STD clinic: San Francisco, 2002-2003.
BACKGROUND
Substantial increases in syphilis among gay and bisexual men have been reported in San Francisco.


OBJECTIVE
To identify risk factors for early syphilis infection among gay and bisexual men attending the San Francisco municipal STD clinic (City Clinic).


METHODS
Cross-sectional, self-administered, behavioral survey of gay and bisexual men attending City Clinic between November 2002 and March 2003 linked with electronic medical record data.


RESULTS
Among 1318 gay and bisexual men surveyed, 53 (4.0%) were diagnosed with early syphilis. The final multivariate model included nonwhite race (OR = 2.1 [1.1-4.4]), HIV-infection (OR = 3.9 [2.0-7.7]), using both methamphetamine and sildenafil (Viagra(R)) (OR = 6.2 [2.6-14.9]), using methamphetamine without sildenafil (OR = 3.2 [1.3-7.6]), using sildenafil without methamphetamines (OR = 0.9 [0.3-2.9]), stronger gay community affiliation (OR = 2.3 [1.2-4.6]), and having recent Internet partners (OR = 2.1 [1.0-4.3]).


CONCLUSIONS
Syphilis prevention efforts should address methamphetamine and sildenafil use among gay and bisexual men and require strong and substantive involvement with the gay community to address syphilis in San Francisco.
Wong
William
W
STD/HIV Prevention and Care Programs, Chicago Department of Public Health, IL 60616, USA. wong_will@cdph.org
Chaw
Janice K
JK
Kent
Charlotte K
CK
Klausner
Jeffrey D
JD
D000328:Adult; D001727:Bisexuality; D003430:Cross-Sectional Studies; D006306:Health Surveys; D018451:Homosexuality, Male; D006782:Hospitals, Special; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D008694:Methamphetamine; D010879:Piperazines; D011687:Purines; D012307:Risk Factors; D012495:San Francisco / Q000453:epidemiology; D000068677:Sildenafil Citrate; D013450:Sulfones; D013587:Syphilis / Q000453:epidemiology*
D010879:Piperazines; D011687:Purines; D013450:Sulfones; D008694:Methamphetamine; D000068677:Sildenafil Citrate