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2016 ; 30
(3
): 134-40
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gab.com Text
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Early Syphilis Among Men Who Have Sex with Men in the US Pacific Northwest,
2008-2013: Clinical Management and Implications for Prevention
#MMPMID27308806
Petrosky E
; Neblett Fanfair R
; Toevs K
; DeSilva M
; Schafer S
; Hedberg K
; Braxton J
; Walters J
; Markowitz L
; Hariri S
AIDS Patient Care STDS
2016[Mar]; 30
(3
): 134-40
PMID27308806
show ga
Substantial increases in syphilis during 2008-2013 were reported in the US
Pacific Northwest state of Oregon, especially among men who have sex with men
(MSM). The authors aimed to characterize the ongoing epidemic and identify
possible gaps in clinical management of early syphilis (primary, secondary, and
latent syphilis ?1 year) among MSM in Multnomah County, Oregon to inform public
health efforts. Administrative databases were used to examine trends in case
characteristics during 2008-2013. Medical records were abstracted for cases
occurring in 2013 to assess diagnosis, treatment, and screening practices. Early
syphilis among MSM increased from 21 cases in 2008 to 229 in 2013. The majority
of cases occurred in HIV-infected patients (range: 55.6%-69.2%) diagnosed with
secondary syphilis (range: 36.2%-52.4%). In 2013, 119 (51.9%) cases were
diagnosed in public sector medical settings and 110 (48.0%) in private sector
settings. Over 80% of HIV-infected patients with syphilis were in HIV care.
Although treatment was adequate and timely among all providers, management
differed by provider type. Among HIV-infected patients, a larger proportion
diagnosed by public HIV providers than private providers were tested for syphilis
at least once in the previous 12 months (89.6% vs. 40.0%; p?0.001). The
characteristics of MSM diagnosed with early syphilis in Multnomah County remained
largely unchanged during 2008-2013. Syphilis control measures were well
established, but early syphilis among MSM continued to increase. The results
suggest a need to improve syphilis screening among private clinics, but few gaps
in clinical management were identified.