title: Endemic early syphilis among young newly diagnosed HIV-positive men in a southeastern U.S. state.
abstract: An epidemic of HIV infections among college students who are primarily men who have sex with men (MSM) have been reported from North Carolina, a state with one of the highest syphilis rates in the southeastern United States. We assessed the proportion of early syphilis coinfections among young HIV-infected individuals statewide and associated risk factors. From January 2002 to July 2006, chart abstractions were performed from North Carolina surveillance records for newly diagnosed HIV-positive men 18-30 years of age reported between 2000-2005, and a subset of women in the same age group. Bivariable and multivariable analyses were conducted to assess early syphilis risk factors among HIV-infected persons. During the 6-year period, there were 1460 HIV-positive men aged 18-30 years reported in North Carolina; 90 (6.2%) were coinfected with early syphilis without a significant change over time. Data were available for 551 HIV-positive women diagnosed from 2002-2005; only 6 (1.1%) were coinfected. Fifty-five percent of coinfected men were diagnosed with both infections on the same date of evaluation. Young HIV-infected men who are black (adjusted odds ratio [aOR] 2.3; 95% confidence interval [CI], 1.3, 4.1), MSM (aOR 3.8; 95% CI, 1.8, 7.8), or reported sex with both genders (aOR 5.1; 95% CI, 2.2, 11.5), or anonymous sex (aOR 2.1; 95% CI, 1.3, 3.3) were more likely to have early syphilis. Although male coinfections have not increased over time, early syphilis has become endemic among young HIV-positive men statewide, emphasizing the need to provide screening for both infections among high-risk individuals.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina 27599, USA. idrod@med.unc.edu
authors.forename: Arlene C
authors.initials: AC
authors.lastname: Seña
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Torrone
authors.forename: Peter A
authors.initials: PA
authors.lastname: Leone
authors.forename: Evelyn
authors.initials: E
authors.lastname: Foust
authors.forename: Lisa
authors.initials: L
authors.lastname: Hightow-Weidman
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D019353:Endemic Diseases; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D012307:Risk Factors; D015144:Southeastern United States / Q000453:epidemiology; D013587:Syphilis / Q000150:complications / Q000453:epidemiology; D055815:Young Adult