The high risk of an HIV diagnosis following a diagnosis of syphilis: a population-level analysis of New York City men.

Pathela, Preeti; Braunstein, Sarah L.; Blank, Susan; Shepard, Colin; Schillinger, Julia A.

doi:10.1093/cid/civ289

Cited by 118HIV/AIDS Research and InterventionsSyphilis Diagnosis and TreatmentHIV, Drug Use, Sexual Risk

The high risk of an HIV diagnosis following a diagnosis of syphilis: a population-level analysis of New York City men.

Pathela, Preeti, Braunstein, Sarah L., Blank, Susan, Shepard, Colin, Schillinger, Julia A.·2015·Clinical Infectious Diseases

DOI 10.1093/cid/civ289

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Abstract

BACKGROUND: Epidemiologic studies have shown that syphilis is associated with risk for human immunodeficiency virus (HIV) infection. We used population-level syphilis and HIV data to quantify HIV incidence among men following primary or secondary (P&S) syphilis diagnoses and identify the highest-risk subgroups for intensified prevention, such as pre-exposure prophylaxis with antiretroviral medications. METHODS: Male cases reported to the New York City HIV/AIDS and Sexually Transmitted Disease (STD) surveillance registries were matched using a deterministic algorithm. We measured HIV incidence following P&S syphilis diagnosed between 2000 and June 2010 and identified risk factors for HIV infection using Cox proportional hazards models. RESULTS: Of 2805 men with syphilis contributing 11 714 person-years of follow-up, 423 (15.1%) acquired HIV; annual incidence was 3.61% (95% confidence interval [CI], 3.27%, 3.97%). HIV incidence was high among: men who have sex with men (MSM) (5.56%, 95% CI, 5.02%-6.13%); males with secondary compared with primary syphilis (4.10% vs 2.64%, P < .0001); and males diagnosed with another bacterial STD after syphilis (7.89%, 95% CI, 6.62%-9.24%). CONCLUSIONS: HIV incidence among men diagnosed with syphilis is high; one in 20 MSM were diagnosed with HIV within a year. Our data have implications for syphilis and HIV screening and may be useful for further targeting HIV-negative populations for pre-exposure prophylaxis.

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Studies have documented the risk for HIV acquisition among MSM within 1 year after infection with rectal gonorrhea or chlamydia (one in 15 men), primary or secondary syphilis (one in 18), and among men with no rectal STI or syphilis infection (one in 53).
“Studies have documented the risk for HIV acquisition among MSM within 1 year after infection with rectal gonorrhea or chlamydia (one in 15 men), primary or secondary syphilis (one in 18), and among men with no rectal STI or syphilis infection (one in 53) (81–83).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [83]
STI diagnoses often can serve as risk markers for HIV acquisition.
“Because STI diagnoses often can serve as risk markers for HIV acquisition (83), public health services might include follow-up of MSM with an STI to offer HIV PrEP.”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [83]

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Authors: Pathela, P., Braunstein, S. L., Blank, S., Shepard, C., & Schillinger, J. A.
Affiliations: New York City Department of Health and Mental Hygiene (US)
Centers for Disease Control and Prevention (US)
Corresponding author: Pathela, Preeti
ORCID: Pathela, Preeti
Braunstein, Sarah L.
Blank, Susan
Venue: Clinical Infectious Diseases
Publisher: Oxford University Press (OUP)
Published: 2015-04-13
Volume: 61
Issue: 2
Pages: 281-287
ISSN: 1058-4838 (ISSN-L)
1537-6591
DOI: 10.1093/cid/civ289
OpenAlex: W2105614190
Cited by: 118
References: 22
Citations by year: 2026: 2 · 2025: 4 · 2024: 9 · 2023: 6 · 2022: 14 · 2021: 11 · 2020: 16 · 2019: 18 · 2018: 11 · 2017: 11 · 2016: 13 · 2015: 3
FWCI: 9.84
Type: journal article
Language: en
Open access: closed
Locations: Clinical Infectious Diseases (publishedVersion)
PubMed (publishedVersion)
HighWire Press Open Archive (submittedVersion)
Topics: Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords: HIV incidence, syphilis, primary and secondary syphilis, men who have sex with men, HIV screening, pre-exposure prophylaxis, sexually transmitted infections, HIV risk factors, New York City
MeSH terms: Adolescent, Adult, Follow-Up Studies, Humans, Male, Middle Aged, New York City, Population Surveillance, Risk Factors, Syphilis, HIV Infections, Incidence, Homosexuality, Male, Young Adult

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The high risk of an HIV diagnosis following a diagnosis of syphilis: a population-level analysis of New York City men.

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