title: Men who have sex with men, infectious syphilis and HIV coinfection in inner Sydney: results of enhanced surveillance.
abstract: Background The resurgence of infectious syphilis in men who have sex with men (MSM) has been documented worldwide; however, HIV coinfection and syphilis reinfections in MSM in inner Sydney have not been published.
  
  
  METHODS
  For all laboratory syphilis notifications assessed as a newly notified case or reinfection, a questionnaire was sent to the requesting physician seeking demographic data and disease classification. Sex of partner and HIV status were collected for all infectious syphilis notifications in men received from 1 April 2006 to March 2011.
  
  
  RESULTS
  From April 2001 to March 2011, 3664 new notifications were received, 2278 (62%) were classified as infectious syphilis. Infectious syphilis notifications increased 12-fold from 25 to 303 in the first and last year respectively, and almost all notifications were in men (2220, 97.5%). During April 2006 to March 2011, 1562 infectious syphilis notifications in males were received and 765 (49%) of these men were HIV-positive and 1351 (86%) reported a male sex partner. Reinfections increased over time from 17 (9%) to 56 (19%) in the last year of the study and were significantly more likely to be in HIV-positive individuals (χ(2)=140.92, degrees of freedom= 1, P=<0.001).
  
  
  CONCLUSIONS
  Inner Sydney is experiencing an epidemic of infectious syphilis in MSM and about half of these cases are in HIV-positive patients. Reinfections are increasing and occur predominantly in HIV-positive men. Accurate surveillance information is needed to inform effective prevention programs, and community and clinician education needs to continue until a sustained reduction is achieved.
authors: Public Health Unit, South Eastern Sydney Local Health District, Locked Bag 88, Randwick, NSW 2031, Australia.
authors: Susan J
authors: SJ
authors: Botham
authors: Kelly-Anne
authors: KA
authors: Ressler
authors: Patrick
authors: P
authors: Maywood
authors: Kirsty G
authors: KG
authors: Hope
authors: Chris P
authors: CP
authors: Bourne
authors: Stephen J
authors: SJ
authors: Conaty
authors: Mark J
authors: MJ
authors: Ferson
authors: Darren J
authors: DJ
authors: Mayne
mesh_terms: D060085:Coinfection; D015658:HIV Infections / Q000453:epidemiology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D012747:Sexual Partners; D013587:Syphilis / Q000453:epidemiology