title: Repeat syphilis among men who have sex with men in California, 2002-2006: implications for syphilis elimination efforts.
abstract: OBJECTIVE
  We examined rates of and risk factors for repeat syphilis infection among men who have sex with men (MSM) in California.
  
  
  METHODS
  We analyzed 2002 to 2006 California syphilis surveillance system data.
  
  
  RESULTS
  During the study period, a mean of 5.9% (range: 4.9%-7.1% per year) of MSM had a repeat primary or secondary (PS) syphilis infection within 2 years of an initial infection. There was no significant increase in the annual proportion of MSM with a repeat syphilis infection (P = .42). In a multivariable model, factors associated with repeat syphilis infection were HIV infection (odds ratio [OR] = 1.65; 95% confidence interval [CI] = 1.14, 2.37), Black race (OR = 1.84; 95% CI = 1.12, 3.04), and 10 or more recent sex partners (OR = 1.99; 95% CI = 1.12, 3.50).
  
  
  CONCLUSIONS
  Approximately 6% of MSM in California have a repeat PS syphilis infection within 2 years of an initial infection. HIV infection, Black race, and having multiple sex partners are associated with increased odds of repeat infection. Syphilis elimination efforts should include messages about the risk for repeat infection and the importance of follow-up testing. Public health attention to individuals repeatedly infected with syphilis may help reduce local disease burdens.
authors.affiliation: Center for AIDS Prevention Studies, San Francisco, CA, USA. stephanie.cohen@sfdph.org
authors.forename: Stephanie E
authors.initials: SE
authors.lastname: Cohen
authors.forename: Rilene A
authors.initials: RA
authors.lastname: Chew Ng
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Katz
authors.forename: Kyle T
authors.initials: KT
authors.lastname: Bernstein
authors.forename: Michael C
authors.initials: MC
authors.lastname: Samuel
authors.forename: Peter R
authors.initials: PR
authors.lastname: Kerndt
authors.forename: Gail
authors.initials: G
authors.lastname: Bolan
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D044469:Racial Groups / Q000706:statistics & numerical data; D012189:Retrospective Studies; D055502:Secondary Prevention; D012747:Sexual Partners; D013587:Syphilis / Q000453:epidemiology* / Q000517:prevention & control; D013997:Time Factors
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