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Rates of Primary and Secondary Syphilis Among White and Black non-Hispanic Men Who Have Sex with Men, US States, 2014.

Rates of Primary and Secondary Syphilis Among White and Black non-Hispanic Men Who Have Sex with Men, US States, 2014.
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Grey JA, Bernstein KT, Sullivan PS, Kidd SE, Gift TL, Hall EW, Hankin-Wei A, Weinstock HS, Rosenberg ES,


Grey JA, Bernstein KT, Sullivan PS, Kidd SE, Gift TL, Hall EW, Hankin-Wei A, Weinstock HS, Rosenberg ES, (click to view)

Grey JA, Bernstein KT, Sullivan PS, Kidd SE, Gift TL, Hall EW, Hankin-Wei A, Weinstock HS, Rosenberg ES,

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Journal of acquired immune deficiency syndromes (1999) 2017 07 26() doi 10.1097/QAI.0000000000001508

Abstract
BACKGROUND
Men who have sex with men (MSM) in the United States experience an approximately 100-fold greater rate of primary and secondary (P&S) syphilis diagnoses compared to men who have sex with women only. As in the general population, racial/ethnic disparities in P&S syphilis diagnosis rates may exist among MSM, but MSM-specific P&S syphilis rates by race/ethnicity are unavailable. We enhanced a published modeling approach to estimate area-level MSM populations by race/ethnicity and provide the first estimates of P&S syphilis among black and white non-Hispanic MSM.

METHODS
We used data from the American Community Survey (ACS), published findings from the National Health and Nutrition Examination Survey (NHANES), and national syphilis surveillance data to estimate state-level rates of P&S syphilis diagnoses among MSM, overall and for black and white non-Hispanic MSM. We also used variability around ACS and NHANES estimates to calculate 95% confidence intervals for each rate.

RESULTS
Among 11,359 cases of P&S syphilis among MSM with known race/ethnicity in 2014, 72.5% were among white (40.3%) or black (32.2%) MSM. The national rate of P&S syphilis diagnosis was 168.4/100,000 for white MSM and 583.9/100,000 for black MSM. Regional rates for black MSM ranged from 602.0/100,000 (South) to 521.5/100,000 (Midwest) and were consistently higher than those for white MSM.

CONCLUSIONS
Although white MSM accounted for the majority of P&S syphilis diagnoses in 2014, when evaluating diagnoses based on rate per 100,000, black MSM had consistently and markedly higher rates than white MSM, with the highest-impacted states located in the US South.

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