PT  - JOURNAL ARTICLE
AU  - Kirsten Salado-Rasmussen
AU  - Terese Lea Katzenstein
AU  - Jan Gerstoft
AU  - Susan Alice Cowan
AU  - Troels Bygum Knudsen
AU  - Lars Mathiesen
AU  - Steen Hoffmann
AU  - Niels Obel
TI  - Risk of HIV or second syphilis infection in Danish men with newly acquired syphilis in the period 2000–2010
AID  - 10.1136/sextrans-2012-050580
DP  - 2013 Aug 01
TA  - Sexually Transmitted Infections
PG  - 372--376
VI  - 89
IP  - 5
4099  - http://sti.bmj.com/content/89/5/372.short
4100  - http://sti.bmj.com/content/89/5/372.full
SO  - Sex Transm Infect2013 Aug 01; 89
AB  - Objectives Risk of subsequent diagnosis of HIV in persons diagnosed with newly acquired syphilis, and syphilis in HIV-infected persons, are of interest as these infections are markers of unsafe sex. Methods From a nationwide register, all Danish men aged >16 years diagnosed with syphilis in the period 2000–2010 (n=1217) were identified, and subsequently data on HIV status was extracted from the Danish HIV Cohort Study. We used Kaplan–Meier analysis to estimate the 5-year risk of HIV and second syphilis infection, and Cox regression to determine incidence rate ratios (IRR). Results The 5-year risk of HIV diagnosis was 9.8% (95% CI 7.0% to 12.6%). Those with a second diagnosis of syphilis had a higher risk of being diagnosed with HIV (IRR=3.1, 95% CI 1.2 to 8.0). The 5-year risk for a second diagnosis of syphilis was 14.8% (95% CI 12.1% to 17.4%) and HIV-infected persons had a higher risk of a second syphilis diagnosis (IRR=4.0, 95% CI 2.8 to 5.9). Sixty-five percent of the persons were men having sex with men (MSM). Thirty-four percent of the HIV-infected persons had viral load >1000 copies/ml at time of syphilis diagnosis. Conclusions The substantial risks of syphilis and HIV infection in men diagnosed with one of these sexually transmitted diseases indicate a high frequency of unsafe sex in the Danish MSM population. As one-third of the HIV-infected persons diagnosed with syphilis had high viral loads, our data support initiation of antiretroviral therapy in all HIV-infected MSM to reduce HIV transmission.