Prevalence of syphilis among people living with HIV who attend a large urban antiretroviral therapy clinic in Panama: a cross-sectional epidemiological study.

Autor:	Gabster A; Instituto Conmemorativo Gorgas de Estudios de la Salud, Ave. Justo Arosemena y Calle 36, Panamá, Panamá 507-527-4952, Panama.; National Research System, National Secretariat of Science, Technology and Innovation, Panama City, Panama.; Center of Population Sciences for Health Equity, Faculty of Nursing, Florida State University, Tallahassee, FL, USA.; Instituto de Investigaciones Científicas y Servicios de Alta Tecnología, Panama City, Panama., Fernández Díaz F; Hospital Santo Tomás, Panama City, Panama., Zaldívar Y; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá, Panama., Hernández M; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá, Panama., Pascale JM; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá, Panama.; Facultad de Medicina, Universidad de Panamá, Transismica, Panama City, Panama., Orillac A; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá, Panama., Moreno-Wynter S; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá, Panama., Xavier Hall CD; Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, USA.; College of Social Work, Florida State University, Tallahassee, FL, USA., Jhangimal M; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá, Panama., Yu-Pon A; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá, Panama., Rodríguez-Vargas C; Hospital Santo Tomás, Panama City, Panama., Arjona-Miranda D; Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá, Panama., Fuentes B; Facultad de Medicina, Universidad Interamericana de Panamá, Panama City, Panama., Henestroza G; Division of Infectious Diseases, University of Alabama, Birmingham, AB, USA., Araúz AB; Hospital Santo Tomás, Panama City, Panama.; National Research System, National Secretariat of Science, Technology and Innovation, Panama City, Panama.; Facultad de Medicina, Universidad de Panamá, Transismica, Panama City, Panama.
Jazyk:	angličtina
Zdroj:	Therapeutic advances in infectious disease [Ther Adv Infect Dis] 2024 May 30; Vol. 11, pp. 20499361241256290. Date of Electronic Publication: 2024 May 30 (Print Publication: 2024).
DOI:	10.1177/20499361241256290
Abstrakt:	Background: Syphilis is a serious global public health challenge. Despite prior progress in syphilis control, incidence has been increasing in recent years. Syphilis is a common coinfection among people living with HIV (PLHIV). In Panama, few data describe syphilis prevalence among PLHIV. We describe syphilis antibody and high-titer (⩾1:8) active syphilis prevalence and associated factors among individuals who attended an antiretroviral clinic. Methods: A cross-sectional study was undertaken during February-March 2022 and September-October 2022 for adults (⩾18 year) assigned male and female at birth, respectively. Participants provided peripheral blood samples and self-administered a questionnaire. Samples were screened using immunochromatography; antibody-positive samples were tested using rapid plasma regain to 1:512 dilutions. Logistic regression was used to identify factors associated with syphilis antibody and high-titer active syphilis. Results: In all, 378 participants gave blood samples; 377 individuals participated in the questionnaire (216 self-reported male sex [males], 158 female [females], and three intersex individuals). Median age was 36 years (interquartile range: 28-45 years). Overall, syphilis antibody prevalence was 32.3% (122/378) (males, 50.7% [108/2013]; females, 5.7% [9/158]; intersex individuals, 100.0% (3/3)], p  < 0.01. High-titer active syphilis was found among 24.6% ( n  = 30) of samples with positive antibody test (males 27.8% [ n  = 30], females 0.0% [0/9], intersex individuals 0.0% [0/3]). Antibody positivity was associated in the multivariable model with males (50.7%, AOR = 24.6, 95%CI: 1.57-384.53). High-titer active syphilis was associated with younger participant age (18-30 years, 13.2%, OR = 4.82, 95%CI: 1.17-19.83); 31-40 years, 7.8%, OR = 4.24, 95%CI: 1.04-17.21 versus 3.2% >40 years), homosexual identity (16.0% OR = 34.2, 95%CI: 4.50-259.27 versus 0.6% among heterosexual identity); in the multivariable model, associated with sexual identity (bisexual 19.1%, AOR = 10.89, 95%CI: 1.00-119.06) compared to heterosexual identity (0.6%) and weakly associated with concurrency (⩾1 ongoing sexual relationships, 15.9%, AOR = 3.09, 95%CI: 0.94-10.14). Conclusion: This study found very high prevalence of syphilis antibodies and high-titer syphilis among PLHIV in Panama. Those most affected are males, younger in age, those who practice concurrent sexual relationships, and those who reported homosexual and bisexual identity. Targeted interventions should include repetitive testing and treatment, especially among individuals who may be at increased infection risk. (© The Author(s), 2024.)
Databáze:	MEDLINE
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