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. 2014 Dec;47(6):533-41.
doi: 10.1016/j.jmii.2013.11.003. Epub 2013 Dec 31.

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  1 , Wen-Chun Liu  2 , Sui-Yuan Chang  3 , Bing-Ru Wu  4 , Pei-Ying Wu  5 , Mao-Song Tsai  2 , Chien-Ching Hung  6 , Chih-Yin Lew-Ting  7
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Free article

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 et al. J Microbiol Immunol Infect. 2014 Dec.
Free article

Abstract

Background/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.

Keywords: Recreational drug; Risky sexual behavior; Serosorting; Sexually transmitted infection.

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