Syphilis and HIV Seroconversion Among a 12-Month Prospective Cohort of Men Who Have Sex With Men in Shenyang, China

Abstract

Background Cross-sectional studies have found a high prevalence of syphilis and HIV infection among men who have sex with men (MSM) in China. Methods A total of 218 HIV-negative MSM participated in this prospective cohort study. Interviewer-administered questionnaires were completed, and blood samples were obtained for HIV and syphilis testing, both upon enrollment and at 12-month follow-up. Results Of enrolled participants, 56% (122) were retained for the full 12-month follow-up period. The cohort had an HIV incidence density of 5.4 (95% CI: 2.0–11.3)/100 person-year (PY) and a syphilis incidence density of 38.5(95% CI: 27.7–50.2)/100 PY. Having syphilis (odds ratio [OR]: 11.4, 95% CI: 1.2–104.7) and more than 5 male sexual partners within the past 12 months (OR: 6.5, 95% CI: 1.1–39.8) were independent risk factors for HIV seroconversion (each P < 0.05). Being married (OR: 3.5, 95% CI: 1.4–8.2) and having more than 5 male sexual partners within the past 12 months (OR: 4.7, 95% CI: 2.0–6.2) were risk factors for syphilis seroconversion, while age ≥30 (OR 2.1, 95% CI 0.7–9.5) and having recently engaged in unprotected receptive anal sex (OR: 2.4, 95% CI: 0.7–13.1) were marginally associated with syphilis seroconversion. Conclusion The high incidence rates of HIV and syphilis in the Shenyang MSM community are significant cause for concern. The seroconversion rate for syphilis, in particular, indicates the high prevalence of high-risk sexual behaviors and the potential for increased HIV transmission. Appropriate interventions that address MSM-specific issues, including stigma, pressures from traditional society, and bisexual behavior, need to be tailored to inform and empower MSM in order to prevent HIV and syphilis in this community.

Prevalence and Determinants of Herpes Simplex Virus Type 2 (HSV-2)/Syphilis Co-Infection and HSV-2 Mono-Infection among Human Immunodeficiency Virus Positive Men Who Have Sex with Men: a Cross-Sectional Study in Northeast China

“…Incidence conveys information about the risk of contracting the disease, whereas prevalence indicates the distribution of the disease. Previous studies revealed both high HIV incidence and high HIV prevalence among MSM in Shenyang (12)(13)(14). Currently, HIV, syphilis, and gonorrhea are notifiable by law in China; however, genital herpes caused mainly by HSV-2, is not.…”

Correlates of Incident Infections for HIV, Syphilis, and Hepatitis B Virus in A Cohort of Men Who Have Sex with Men in Beijing

“…23,29 Whereas previous research provides only cross-sectional data on the incidence rates of HIV, syphilis and hepatitis B virus (HBV) infections, 9,13,30-32 a limited number of cohort studies with small sample sizes and/or poor retention rates among MSM were conducted recently in China. 33,34 This is the first cohort study among MSM in China to assess the correlates of HIV, syphilis, and HBV seroconversions among this group in Beijing.…”

Neurosyphilis and the impact of HIV infection

“…7,8 Similar trends for MSM have been observed throughout Europe 9 and China. 3,10,11 Some reports suggest that the increasing incidence of syphilis may be due to high-risk behaviours, such as methamphetamine use, 12-14 but as we will discuss later, the higher rates of syphilis and HIV coinfection may also be due to immunological factors.…”