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Risk Factors Associated with Incident Syphilis in a Cohort of High-Risk Men in Peru

Park, Hayoung ; Konda, Kelika A ; Roberts, Chelsea P ; Maguiña, Jorge L ; Leon, Segundo R ; Clark, Jesse L ; Coates, Thomas J ; Caceres, Carlos F ; Klausner, Jeffrey D De Socio, Giuseppe Vittorio

PloS one, 2016-09, Vol.11 (9), p.e0162156-e0162156 [Periódico revisado por pares]

United States: Public Library of Science

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Título:
Risk Factors Associated with Incident Syphilis in a Cohort of High-Risk Men in Peru
Autor: Park, Hayoung ; Konda, Kelika A ; Roberts, Chelsea P ; Maguiña, Jorge L ; Leon, Segundo R ; Clark, Jesse L ; Coates, Thomas J ; Caceres, Carlos F ; Klausner, Jeffrey D
De Socio, Giuseppe Vittorio
Assuntos: Acquired immune deficiency syndrome ; Adult ; Age ; AIDS ; Antibiotics ; Biology and Life Sciences ; Bivariate analysis ; Cohort Studies ; Disease transmission ; Epidemiology ; Health aspects ; Health risks ; HIV ; HIV infection ; HIV infections ; HIV testing ; HIV tests ; Human immunodeficiency virus ; Humans ; Incidence ; Infections ; Infrared radiation ; Longitudinal Studies ; Male ; Mathematical models ; Medicine and Health Sciences ; Men ; Models, Statistical ; People and places ; Peru - epidemiology ; Quartiles ; Risk analysis ; Risk Factors ; Risk groups ; Risk taking ; Sex ; Sexually transmitted diseases ; STD ; Surveys ; Syphilis ; Syphilis - epidemiology ; Womens health ; Young Adult
É parte de: PloS one, 2016-09, Vol.11 (9), p.e0162156-e0162156
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
Conceptualization: JLC KAK JDK JLM. Data curation: JLM HP KAK SRL. Formal analysis: HP KAK JLM. Funding acquisition: JDK TJC JLC. Investigation: TJC CFC SRL. Methodology: JLC JDK KAK. Project administration: TJC CFC. Resources: KAK TJC TDK JLC. Software: JDK. Supervision: KAK JDK CFC TJC. Validation: KAK JLM. Visualization: HP KAK JDK. Writing – original draft: HP KAK JDK. Writing – review & editing: HP CPR JLC.
Competing Interests: The authors have declared that no competing interests exist.
Descrição: Syphilis is concentrated among high-risk groups, but the epidemiology of syphilis reinfection is poorly understood. We characterized factors associated with syphilis incidence, including reinfection, in a high-risk cohort in Peru. Participants in the NIMH CPOL trial were assessed at baseline and 2 annual visits with HIV/STI testing and behavioral surveys. Participants diagnosed with syphilis also attended 4- and 9-month visits. All participants underwent syphilis testing with RPR screening and TPPA confirmation. Antibiotic treatment was provided according to CDC guidelines. Reinfection was defined as a 4-fold titer increase or recurrence of seroreactivity after successful treatment with subsequent negative RPR titers. The longitudinal analysis used a Possion generalized estimating equations model with backward selection of variables in the final model (criteria P <0.02). Of 2,709 participants, 191 (7.05%) were RPR-reactive (median 1:8, range 1:1-1:1024) with TPPA confirmation. There were 119 total cases of incident syphilis, which included both reinfection and first-time incident cases. In the bivariate analysis, the oldest 2 quartiles of age (incidence ratio (IR) 3.84; P <0.001 and IR 8.15; P <0.001) and being MSM/TW (IR 6.48; P <0.001) were associated with higher risk of incident syphilis infection. Of the sexual risk behaviors, older age of sexual debut (IR 12.53; P <0.001), not being in a stable partnership (IR 1.56, P = 0.035), higher number of sex partners (IR 3.01; P <0.001), unprotected sex in the past 3 months (IR 0.56; P = 0.003), HIV infection at baseline (IR 3.98; P <0.001) and incident HIV infection during the study period (IR 6.26; P = 0.003) were all associated with incident syphilis. In the multivariable analysis, older age group (adjusted incidence ratio (aIR) 6.18; P <0.001), men reporting having sex with a man (aIR 4.63; P <0.001), and incident HIV infection (aIR 4.48; P = 0.008) were significantly associated. We report a high rate of syphilis reinfection among high-risk men who have evidence of previous syphilis infection. Our findings highlight the close relationship between HIV incidence with both incident syphilis and syphilis reinfection. Further studies on syphilis reinfection are needed to understand patterns of syphilis reinfection and new strategies beyond periodic testing of high-risk individuals based on HIV status are needed.
Editor: United States: Public Library of Science
Idioma: Inglês

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Risk Factors Associated with Incident Syphilis in a Cohort of High-Risk Men in Peru

Park, Hayoung ; Konda, Kelika A ; Roberts, Chelsea P ; Maguiña, Jorge L ; Leon, Segundo R ; Clark, Jesse L ; Coates, Thomas J ; Caceres, Carlos F ; Klausner, Jeffrey D De Socio, Giuseppe Vittorio

United States: Public Library of Science

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