Analysis of risk factors for late presentation in a cohort of HIV-infected patients in Dresden: positive serology for syphilis in MSM is a determinant for earlier HIV diagnosis

Abstract

A positive syphilis screening test seems to be a determinant for lower risk of late presentation to HIV care and diagnosis in MSM. The presence and awareness of sexually transmitted infections (STIs) such as syphilis may lead to earlier utilisation of HIV health care and, thus, promote earlier HIV diagnosis. HIV prevention strategies should focus more on STIs and not only on HIV.

Characteristics and coinfection with syphilis in newly HIV‐infected patients at the University Hospital Dresden 1987–2012

“…Since current data indicates that STI predominantly circulate among HIV infected men with increased risk behavior, international and German recommendations have been developed promoting intensified STI screening in this particular patient population. In this context, diagnosis of an STI may thus contribute to the early diagnosis of an HIV infection: in our patient group, HIV positive MSM with a positive syphilis serology showed a lower risk for late presentation of HIV . This has also been the case in a Korean study in MSM with a positive VDRL test as marker for active syphilis .…”

“…The percentage of late presenters, i.e. primary HIV diagnosis with a CD4 count of <350/μl by definition , in a previous analysis of our patient group largely matched national figures at 50 % . According to current guidelines, CD4 counts <350/μl in asymptomatic patients constitute an indication for antiretroviral therapy (ART).…”

Clinical and epidemiological features of HIV/AIDS infection among migrants at first access to healthcare services as compared to Italian patients in Italy: a retrospective multicentre study, 2000–2010

“…As mentioned above, and in accordance with previous reports [27][28][29][30], our findings confirm that migrants are much more likely to receive care at advanced stage, with about 55 and 35 % of them, respectively, classified as late presenters and very late presenters. In our study, patients belonging to these categories showed a more advanced age and a risky heterosexual behaviour, suggesting a lower risk awareness both in Italian and migrant population [31]. Moreover, among the latter, illegal status plays an important role in enhancing delay in access, which strongly highlights the need to facilitate early access to health services as much as possible, also for public health implications.…”

Demographic, risk factors and motivations among blood donors with reactive serologic tests for syphilis in São Paulo, Brazil

“…The presence and awareness of syphilis may lead to earlier utilisation of health care (Spornraft-Ragaller et al ., 2013), thereby preventing other STIs, including HIV. Earlier utilisation of health care benefits not only donors but also their partners, children and society (de Almeida Neto et al ., 2009).…”