High Lifetime Prevalence of Syphilis in Men Who Have Sex With Men and Transgender Women Versus Low Lifetime Prevalence in Female Sex Workers in Lima, Peru

Hung, Phoebe; Osias, Ethan; Konda, Kelika A.; Calvo, Gino; Reyes-Díaz, E. Michael; Vargas, Silver K.; Goldbeck, Cameron; Caceres, Carlos F.; Klausner, Jeffrey D.

doi:10.1097/olq.0000000000001200

Cited by 15 publications

(6 citation statements)

References 22 publications

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“…Of the 2593 included patients, 695 had a history of STIs, suggesting an overrepresentation of risk-taking behaviour in our sample. This finding is corroborated by studies conducted in the Netherlands and Peru, 38,39 in which patients visiting STI clinics were more likely to have a history of STIs than the general population. This should come as no surprise, as people who have a history of STIs and/or engage in risk-taking behaviour are generally more willing to undergo STI screening.…”

Section: Discussionsupporting

confidence: 58%

High prevalence of syphilis in women, minors and precarious patients: a cross‐sectional study in a Reunion Island sexually transmitted infection clinic, 2017–2020

Delfosse¹,

Bouscaren

Dupin

et al. 2021

Acad Dermatol Venereol

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Background Syphilis is a sexually transmitted infection (STI) with a global prevalence estimated at 0.5% in 2012.Syphilis has been on the rise among men who have sex with men (MSM) in high-income countries and remains at endemic levels in low-and middle-income countries. This trend, however, has not been observed in Reunion Island.Objectives To determine the prevalence, clinical characteristics and risk factors of syphilis in at-risk patients visiting the South Reunion STI clinic in Reunion Island.Methods This monocentric cross-sectional study included all patients who visited our STI clinic between 2017 and 2020. Syphilis serology was performed on all included patients, and data were collected using a standardized selfadministered questionnaire. ResultsOver the 3-year study period, 2593 patients were enrolled. The prevalence of syphilis was 7.52% (n = 195, 95% CI, 6.50-8.65%) in the overall study population, 11.76% (n = 18, 95% CI, 6.97-18.59%) in minors (aged under 18 years) and 36.36% (n = 16, 95% CI, 21-59%) in pregnant women. The risk factors identified in multivariate analysis were being female [adjusted Prevalence Ratio (aPR) 1.85, 95% CI, 1.10-3.11], being MSM (aPR 2.87, 95% CI, 1.71-4.80), being aged under 18 years (aPR 3.54, 95% CI, 1.90-6.57), living in precarious conditions [aPR 3.12, 95% CI, 2.11-4.62] and being born in Reunion Island (aPR 2.43, 95% CI, 1.42-4.13). The clinical presentation was heterogeneous (plaques and papules, chancre, atypical ulcerations, multiple ulcerations, condyloma lata, etc.).Conclusions These findings suggest a high prevalence of syphilis in at-risk patients visiting our STI clinic. Unlike the situation in other high-income countries, the people most at risk of syphilis in Reunion Island are local-born residents, minors, women and precarious patients. This is a source of concern, especially given the risk of resurgence of congenital syphilis on the island.

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Section: Discussionsupporting

confidence: 58%

High prevalence of syphilis in women, minors and precarious patients: a cross‐sectional study in a Reunion Island sexually transmitted infection clinic, 2017–2020

Delfosse¹,

Bouscaren

Dupin

et al. 2021

Acad Dermatol Venereol

View full text Add to dashboard Cite

show abstract

“…Therefore, this area deserves more investigation into possible confounders or moderators, such as access to care or other structural issues [6], that impact the relationship between these two variables. A more stable statistical model should be used to confirm this relationship, especially now when there has been a further increase of syphilis rates in Peru ´and globally [26].…”

Section: Discussionmentioning

confidence: 99%

Substance use and other correlates of HIV infection among transwomen and men who have sex with men in Perú: Implications for targeted HIV prevention strategies for transwomen

Cyrus

Lama²,

Sánchez³

et al. 2023

PLOS Glob Public Health

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Characterization of HIV risk factors among transwomen and men who have sex with men (MSM) should be assessed separately and independently. However, due to several constraints, these populations continue to be conflated in clinical research and data. There are limited datasets globally powered to make such comparisons. The study aimed to use one of the largest surveys of transwomen and MSM in Latin America to determine differences in HIV risk and related correlates between the two populations. Secondary data analysis was completed using a cross-sectional biobehavioral survey of 4413 MSM and 714 transwomen living in Perú. Chi Square analysis of selected HIV correlates was conducted to examine differences between transwomen and MSM. Additionally, stratified binary logistic regression was used to split data for further comparative analyses of correlates associated with transwomen and MSM separately. HIV prevalence among transwomen was two-fold greater than among MSM (14.9% vs. 7.0%, p<0.001). Transwomen had a higher prevalence of most HIV risk factors assessed, including presence of alcohol dependence (16.4% vs. 19.0%; p < .001) and drug use in the past 3 months (17.0% vs. 14.9%). MSM were more likely to use marijuana (68.0% vs. 50.0%, p < .001), and transwomen were more likely to engage in inhaled cocaine use (70.0% vs. 51.1%, p < .001). The regression exposed differences in correlates driving sub-epidemics in transwomen vs. MSM, with a trend of substance use increasing HIV risk for transwomen only. Transwomen were more likely to be HIV-infected and had different risk factors from MSM. Targeted prevention strategies are needed for transwomen that are at highest risk. Additionally, further research is needed to determine if these observations in Perú regarding substance use patterns and the role of substance use in HIV risk relate to other trans populations globally.

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“…25 Therefore, this area deserves more investigation into possible confounders or moderators, such as access to care or other structural issues 26 , that impact the relationship between these two variables. A more stable statistical model should be used to confirm this relationship, especially now when there has been a further increase of syphilis rates in Perú and globally 27 .…”

Section: Discussionmentioning

confidence: 99%

Substance Use and other Correlates of HIV infection among transwomen and men who have sex with men in Perú: Implications for Targeted HIV Prevention Strategies for Transwomen

Cyrus

Lama

Sánchez

et al. 2022

Preprint

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Introduction: Characterization of HIV risk factors among transwomen and men who have sex with men (MSM) should be assessed separately and independently. However, due to several constraints, these populations continue to be conflated in clinical research and data. There are limited datasets globally powered to make such comparisons. The study aimed to use one of the largest surveys of transwomen and MSM in Latin America to determine differences in HIV risk and related correlates between the two populations. Methods: Secondary data analysis was completed using a cross-sectional biobehavioral survey of 4413 MSM and 714 transwomen living in Per. Chi Square analysis of selected HIV correlates was conducted to examine differences between transwomen and MSM. Additionally, stratified binary logistic regression was used to split data for further comparative analyses of correlates associated with transwomen and MSM separately. Results: HIV prevalence among transwomen was two-fold greater than among MSM (14.9% vs. 7.0%, p<0.001). Transwomen had a higher prevalence of most HIV risk factors assessed, including presence of alcohol dependence (16.4% vs. 19.0%; p<.001) and drug use in the past 3 months (17.0% vs. 14.9%). MSM were more likely to use marijuana (68.0% vs. 50.0%, p<.001), and transwomen were more likely to engage in inhaled cocaine use (70.0% vs. 51.1%, p<.001). The regression exposed differences in correlates driving sub-epidemics in transwomen vs. MSM, with a trend of substance use increasing HIV risk for transwomen only. Conclusions: Transwomen were more likely to be HIV-infected and had different risk factors from MSM. Targeted prevention strategies are needed for transwomen that are at highest risk. Additionally, further research is needed to determine if these observations in Peru regarding substance use patterns and the role of substance use in HIV risk relate to other trans populations globally.

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High Lifetime Prevalence of Syphilis in Men Who Have Sex With Men and Transgender Women Versus Low Lifetime Prevalence in Female Sex Workers in Lima, Peru

Abstract: A study of men who have sex with men, transwomen, and female sex workers in Lima, Peru found that lifetime prevalence of syphilis was substantially lower in female sex workers compared with other groups.

Cited by 15 publications

References 22 publications

High prevalence of syphilis in women, minors and precarious patients: a cross‐sectional study in a Reunion Island sexually transmitted infection clinic, 2017–2020

High prevalence of syphilis in women, minors and precarious patients: a cross‐sectional study in a Reunion Island sexually transmitted infection clinic, 2017–2020

Substance use and other correlates of HIV infection among transwomen and men who have sex with men in Perú: Implications for targeted HIV prevention strategies for transwomen

Substance Use and other Correlates of HIV infection among transwomen and men who have sex with men in Perú: Implications for Targeted HIV Prevention Strategies for Transwomen

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