| Popis: |
Partner notification strategies have increased the number of MSM attending sexually transmitted infection (STI) clinics as sexual contacts of syphilis. Current guidelines suggest testing and consideration of presumptive antimicrobial treatment. Syphilis treatment with benzathine penicillin; requires clinic resources, is painful and is associated with complications: it is important we consider strategies to rationalise presumptive antimicrobial use in MSM and promote antimicrobial stewardship. We aimed to determine if there are any factors associated with having syphilis among MSM attending as sexual contacts of syphilis. We examined the clinical records of MSM attending as sexual contacts of syphilis from January through December 2019. Of the 6613 MSM who attended for STI testing, 142/6613 (2.1%) presented as sexual contacts of syphilis. The median age was 40 years (IQR = 31–51), 43/142 (30%) were HIV positive, 38/142 (27%) had been diagnosed and treated for syphilis in the past and 11/142 (8%) presented with symptoms (possible lesions of primary or secondary syphilis). Thirteen (9%, 95%CI=4.4–13.9) tested positive for syphilis on the day of presentation and all were treated presumptively. MSM who were symptomatic (genital ulcer or body rash), HIV sero-positive or had a history of previous syphilis were significantly more likely to test positive for syphilis (OR=51.88, 95%CI-3.01–893.14, p=0.007). Factors associated with acquiring syphilis amongst MSM presenting as sexual contacts of syphilis were; being HIV sero-positive, having a previous history of syphilis, or presenting with symptoms (possible lesions of primary or secondary syphilis). |
