Article Text

Download PDFPDF

P172 High HIV incidence in MSM diagnosed with early syphilis: a role for PrEP?
  1. Nicolo Girometti,
  2. Angela Gutierrez,
  3. Nneka Nwokolo,
  4. Alan McOwan,
  5. Tara Suchak,
  6. Gary Whitlock
  1. 56 Dean Street, Chelsea & Westminster Hospital, London, UK


Background Understanding the risk factors for HIV acquisition allows targeted interventions to reduce HIV transmission such as PrEP.

Aims/Objectives To evaluate HIV incidence in HIV-negative MSM with early syphilis infection.

Methods A retrospective case-note review of MSM who were diagnosed with early syphilis between January and June 2014 at a London sexual health clinic.

Results 206 MSM were diagnosed with early syphilis: 110 HIV-negative; 96 HIV-positive. For 110 HIV-negative MSM, median age was 32 y, median number of sexual partners in last 3 months was 4. Reported drug use in the previous month was 38%; 19% had injected drugs. Syphilis stage was primary (31%), secondary (25%), early latent (45%).Up to February 2016, total follow-up was 144 person-years. 12 (11%) were newly diagnosed HIV-positive. HIV incidence was 8.3 (95% confidence interval, CI 4.2–14) per 100 person-years follow-up (HPYFU). Incidence of rectal STIs was: rectal chlamydia, 27 HPYFU (CI 19–36); rectal gonorrhoea, 33 HPYFU (CI 25–44); syphilis re-infection, 10 HPYFU (CI 5.7–17).

Conclusions The significant risk of HIV seroconversion following a diagnosis of early syphilis suggests that this group may particularly benefit from the use of pre-exposure prophylaxis. The high levels of subsequent rectal infections support the inclusion of regular STI screening in PrEP management guidelines.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.