Sexually transmitted diseases 2018 03 29() doi 10.1097/OLQ.0000000000000841
Southern Non-Hispanic Black persons are disproportionately represented in the HIV epidemic. Those previously diagnosed with syphilis are at significant risk to become HIV infected within 36 months. Effective prevention strategies such as PrEP should be offered to those at highest risk to maximize prevention efforts.
HIV negative persons diagnosed with P&S syphilis during 1998 – 2014 were matched with incident HIV cases diagnosed during 1998 – 2016 in Shelby County Tennessee. Person-year HIV incidence rate, Kaplan – Meier survival estimates, and Cox proportional regression model analyses were performed to explore predicting risk factors and quantifying risk factors associated with HIV-free survival timeframes.
Among 2,032 HIV negative Non-Hispanic Black Shelby County residents diagnosed with P&S syphilis, 139 (6.8%) were subsequently diagnosed with HIV infection. Men who have sex with men (MSM) experienced the highest incidence of HIV diagnosis rate (4.98 per 100 person-years, 95%CI: 4.76 – 5.2). Being male, MSM, <30 years old, or co-infected with gonorrhea increased risk of HIV acquisition 2.32, 11.80, 1.67 and 2.44 times respectively compared to females, heterosexual men, being 30+ years old, or patients not infected with other Sexually transmitted infections (STIs). CONCLUSIONS
Among our population diagnosed with P&S syphilis, 1 in 6 MSM and 1 in 16 persons co-infected with gonorrhea were subsequently diagnosed with HIV during 36 months of follow-up. These findings have implications for HIV screening and recruitment as priority PrEP candidates.