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Volume 47, Number 6, December 2015

Associated factors with syphilis among human immunodeficiency virus-infected men who have sex with men in Taiwan in the era of combination antiretroviral therapy 


Yi-Hsin Chang, Wen-Chun Liu, Sui-Yuan Chang, Bing-Ru Wu, Pei-Ying Wu, Mao-Song Tsai, Chien-Ching Hung, Chih-Yin Lew-Ting


Received: April 3, 2013    Revised: September 4, 2013    Accepted: November 4, 2013   

 

Corresponding author:

Corresponding author. Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of
Medicine, 7, Chung-Shan South Road, Taipei 100, Taiwan.
E-mail address: hcc0401@ntu.edu.tw (C.-C. Hung) 



 

Background and purpose: 

Little is known about the factors associated with syphilis among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) with access to combination antiretroviral therapy (cART) in Taiwan, where MSM has re-emerged as the leading risk group for HIV transmission. 



 

Methods:

From March to October 2011, MSM who regularly attended HIV clinics at a university hospital were invited to participate in the study. A structured questionnaire interview was conducted to collect information on sociodemographic characteristics, immunologic and virologic status, sexual partners and patterns of sexual behavior, and use of recreational drugs. 



 

Results:

During the study period, 310 HIV-infected MSM with a mean age of 35.5 years were enrolled, of which 82.3% (n = 255) were sexually active and 37.4% (n = 116) used recreational drugs in the past 6 months. Syphilis was self-reported in 46.5% (n = 144) of the participants after HIV infection was diagnosed and 37.5% (112/299) had serologic evidence of syphilis within 1 year before enrollment. Multivariate logistic regression analysis limited to those who were receiving cART showed that higher CD4 counts [adjusted odds ratio (AOR): 1.17; 95% confidence interval (CI): 1.02–1.34], lower educational achievement (AOR: 1.95; 95% CI: 1.05–3.63), serosorting (AOR: 3.32; 95% CI: 1.04–10.63), and use of recreational drugs (AOR: 2.55; 95% CI: 1.26–5.13) were associated with syphilis. 



 

Conclusion:

Improved immune status, lower educational achievement, serosorting, and use of recreational drugs were associated with syphilis among HIV-infected MSM who were receiving cART. These findings suggest that strengthening client-specific counseling is needed to reduce risks for syphilis among HIV-infected MSM in Taiwan. 



 

Key words:

Recreational drug, Risky sexual behavior, Serosorting, Sexually transmitted infection