Epidemic syphilis among homosexually active men in Sydney
Epidemic syphilis among homosexually active men in Sydney
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DOI：
10.5694/j.1326-5377.2005.tb06989.x
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发表时间：
2005-08-15
影响因子：
11.4
通讯作者：
Grulich, AE
中科院分区：
文献类型：
--
作者：
Jin, FY;Prestage, GP;Grulich, AE
目的：描述新南威尔士州传染性梅毒报告的趋势，最近报告患有早期梅毒的同性恋活跃男性的特征，以及悉尼hiv阴性同性恋活跃男性队列中梅毒的血清阳性率和发病率以及相关危险因素。设计、环境和参与者：1998 - 2003年新南威尔士州传染性梅毒监测数据的二次分析；2002年12月至2004年1月内悉尼57例确诊为早期梅毒的男同性恋者；以及2001年6月至2003年12月在悉尼招募的1333名hiv阴性的同性恋活跃男性进行梅毒的前瞻性队列研究。主要结果测量指标：新南威尔士州和内悉尼地区传染性梅毒的通报率；病例系列中男性梅毒患者的行为和临床特征在队列研究中，梅毒发病率和与性行为相关的风险比（hr）。结果：内悉尼地区的传染性梅毒通报病例增加了10倍以上（从1999年的6例增加到2003年的162例），而且增加仅限于男性。在病例系列中的57名早期梅毒男性中，54%为艾滋病毒阳性，32%报告无梅毒症状。这57名男性性生活非常活跃，而且很可能报告使用娱乐性药物。在队列研究中，1292名男性（97%的参与者）同意进行梅毒检测；梅毒发病率为0.78 / 100人-年，危险因素包括报告与hiv阳性伴侣无保护肛交（HR, 5.31; 95% Cl, 2.00-184.93）和插入性口交（HR, 4.55; 95% Cl, 1.14-18.18）。结论：悉尼同性恋活跃男性中梅毒再次出现，hiv阳性男性比例过高。这一人群需要经常进行筛查，以遏制梅毒和艾滋病毒的传播。
Objectives: To describe trends in the notification of infectious syphilis in New South Wales, the characteristics of homosexually active men recently notified with early syphilis, and the seroprevalence and incidence of syphilis, as well as associated risk factors, in a Sydney cohort of HIV-negative homosexually active men.Design, setting and participants: Secondary analysis of New South Wales infectious syphilis surveillance data from 1998 to 2003; a case series of 57 homosexually active men diagnosed with early syphilis in inner Sydney from December 2002 to January 2004; and a prospective cohort study of syphilis among 1333 HIV-negative homosexually active men in Sydney recruited from June 2001 to December 2003.Main outcome measures: Rates of notification of infectious syphilis in New South Wales and in areas of inner Sydney; behavioural and clinical features of men with syphilis in the case series; and incidence of syphilis and hazard ratios (HRs) associated with sexual behaviours in the cohort study.Results: Infectious syphilis notifications in inner Sydney rose more than 10-fold (from 6 in 1999 to 162 in 2003), and the increase was confined to men. Of 57 men with early syphilis in the case series, 54% were HIV-positive and 32% reported no symptoms of syphilis. These 57 men were highly sexually active and likely to report recreational drug use. In the cohort study, 1292 men (97% of participants) consented to syphilis testing; the incidence of syphilis was 0.78 per 100 person-years, and risk factors included reporting unprotected anal intercourse with HIV-positive partners (HR, 5.31; 95% Cl, 2.00-184.93) and insertive oral sex (HR, 4.55; 95% Cl, 1.14-18.18).Conclusion: Syphilis has been re-established among homosexually active men in Sydney, and HIV-positive men are over-represented. Frequent screening is needed in this population to curb the transmission of both syphilis and HIV.