RT Journal Article
SR Electronic
T1 Clinical factors associated with syphilis concordance in men in sexual partnerships: a cross-sectional couples study.
JF Sexually Transmitted Infections
JO Sex Transm Infect
FD BMJ Publishing Group Ltd
SP sextrans-2017-053297
DO 10.1136/sextrans-2017-053297
A1 Janet M Towns
A1 Sarah Huffam
A1 Eric P F Chow
A1 Ian Denham
A1 Lei Zhang
A1 Andrea Ryan
A1 Clare Elizabeth Bellhouse
A1 Melanie Bissessor
A1 Catriona S Bradshaw
A1 Tiffany Phillips
A1 Stephen Graves
A1 Christopher K Fairley
A1 Marcus Y Chen
YR 2017
UL http://sti.bmj.com/content/early/2017/11/29/sextrans-2017-053297.abstract
AB Background Syphilis infections continue to increase among men who have sex with men (MSM) in many countries, with rates often higher among HIV-positive MSM. There is limited understanding of the risk and determinants of syphilis transmission between men. We aimed to examine the concordance of early syphilis infection between male sexual partners and clinical factors associated with transmission.Methods Men attending Melbourne Sexual Health Centre with their male partners, where at least one was diagnosed with early syphilis, were identified from linkage of partner records between March 2011 and April 2016. Early latent syphilis was defined as a new asymptomatic syphilis presentation of less than 2 years’ duration. Associations between concordance and potential risk factors were examined using Fisher’s exact test.Results Among 43 couples (86 men) identified, there were 13 couples (26 men) where both were diagnosed with early syphilis, representing a concordance rate of 30.2% (95% CI 17.2% to 46.1%). Among the 13 concordant couples, 5 men had primary syphilis (4 penile, 1 anal), 11 secondary syphilis (8 generalised rash, 3 penile, 2 anal, 1 oral lesion) and 10 early latent infections. Concordance was higher among couples where at least one partner had secondary syphilis compared with couples where neither partner had secondary syphilis (53% (9/17) vs 15% (4/26), P=0.016). Furthermore, concordance was higher among couples where one was HIV positive compared with couples where both were HIV negative (62% (5/8) vs 23% (8/35), P=0.042).Conclusions There was an overall concordance rate of 30%. Higher concordance rates for early syphilis infection between male sexual partners were associated with HIV and secondary syphilis.