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Syphilis Testing Among Sexually Active Men Who Have Sex With Men and Who Are Receiving Medical Care for Human Immunodeficiency Virus in the United States: Medical Monitoring Project, 2013-2014

Clin Infect Dis. 2019 Mar 5;68(6):934-939. doi: 10.1093/cid/ciy571.

Abstract

Background: Guidelines recommend that sexually active men who have sex with men (MSM) including human immunodeficiency virus (HIV)-positive MSM be tested at least annually for syphilis, with testing every 3-6 months for MSM at elevated risk. We examined the proportion of HIV-positive MSM tested for syphilis in the past 3, 6, and 12 months by their HIV care provider during 2013-2014.

Methods: Using data from the Medical Monitoring Project, a population-based HIV surveillance system, we evaluated the proportion of MSM who had documentation of being tested for syphilis by their HIV care provider in the past 3, 6, and 12 months.

Results: During 2013-2014, 71% (95% confidence interval [CI]: 69%-73%) of sexually active HIV-positive MSM were tested for syphilis in the past year. This proportion was higher among MSM reporting condomless sex: (75%; 95% CI: 72%-78%), and among MSM reporting ≥ 2 sex partners (77%; 95% CI: 74%-79%), in the past 12 months. Among MSM reporting condomless sex, 49% (95% CI: 45%-53%) were tested in the past 6 months, and 26% (95% CI: 22%-30%) in the past 3 months. Among MSM reporting ≥ 2 sex partners, 49% (95% CI: 44%-54%) were tested in the past 6 months and 26% (95% CI: 22%-29%) in the past 3 months.

Conclusions: Nearly one-third of sexually active HIV-positive MSM were not tested annually, and many at increased risk were not tested at recommended frequencies. Efforts to improve compliance with screening guidelines for high-risk HIV-positive MSM are warranted.

Keywords: HIV; STD; men who have sex with men (MSM); syphilis.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Coinfection / diagnosis
  • Coinfection / epidemiology*
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology*
  • HIV Seropositivity
  • Homosexuality, Male*
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Population Surveillance
  • Prevalence
  • Syphilis / diagnosis*
  • Syphilis / epidemiology*
  • Syphilis Serodiagnosis
  • United States / epidemiology
  • Young Adult