Risk Factors and Incidence of Syphilis in Human Immunodeficiency Virus (HIV)–Infected Persons: The HIV Outpatient Study, 1999–2015
| Autor: | Richard M. Novak, Hiv Outpatient Study (Hops) Investigators, Douglas J. Ward, Abdelhamid Ghanem, Rachel Hart, Kate Buchacz, Carl Armon |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) medicine.medical_specialty Adolescent Sexual Behavior HIV Infections Men who have sex with men Sexual and Gender Minorities Young Adult 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Outpatients medicine Humans Prospective Studies Syphilis 030212 general & internal medicine Homosexuality Male Young adult Heterosexuality Prospective cohort study business.industry Incidence Incidence (epidemiology) Hazard ratio Middle Aged medicine.disease 030112 virology United States Confidence interval Infectious Diseases Cohort Female business |
| Zdroj: | Clinical Infectious Diseases. 67:1750-1759 |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1093/cid/ciy348 |
| Popis: | Background Since 2000, the incidence of syphilis has been increasing, especially among gay, bisexual, and other men who have sex with men (MSM) in the United States. We assessed temporal trends and associated risk factors for newly diagnosed syphilis infections among human immunodeficiency virus (HIV)-infected patients during a 16-year period. Methods We analyzed data from the HIV Outpatient Study (HOPS) cohort participants at 10 US HIV clinics during 1999-2015. New syphilis cases were defined based on laboratory parameters and clinical diagnoses. We performed Cox proportional hazards regression analyses of sociodemographic, clinical, and behavioral risk factors for new syphilis infections. Results We studied 6888 HIV-infected participants; 641 had 1 or more new syphilis diagnoses during a median follow-up of 5.2 years. Most participants were male (78%), aged 31-50 years, and 57% were MSM. The overall incidence was 1.8 (95% confidence interval [CI], 1.6-1.9) per 100 person-years (PY) and it increased from 0.4 (95% CI, .2-.8) to 2.2 (95% CI, 1.4-3.5) per 100 PY during 1999-2015. In multivariable analyses adjusting for calendar year, risk factors for syphilis included age 18-30 years (hazard ratio [HR], 1.3 [95% CI, 1.1-1.6]) vs 31-40 years, being MSM (HR, 3.1 [95% CI, 2.4-4.1]) vs heterosexual male, and being non-Hispanic black (HR, 1.6 [95% CI, 1.4-1.9]) vs non-Hispanic white. Conclusions The increases in the syphilis incidence rate through 2015 reflect ongoing sexual risk and highlight the need for enhanced prevention interventions among HIV-infected patients in care. |
| Databáze: | OpenAIRE |
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