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8th Annual Conference Of The British HIV Association [BHIVA]19 – 21 April 2002, University of York, York |
[AUTHOR(S):] S Hopkins, C Coleman, J Garvey, F Mulcahy, C Bergin
St James's Hospital, Dublin, Ireland
BHIVA Conf 2002 Apr 19-21;8:O6
INTRODUCTION: Between January 2000 and December 2001, 227 cases of early syphilis were diagnosed and treated in our clinics. Many novel interventions have been initiated to control this outbreak.
METHODS: Demographic details, sexual histories and full investigation for other sexually transmitted infections were performed in all cases. An outbreak control team, consisting of representatives from our clinic, Public Health, the National Disease Surveillance Centre and members of the gay community, was established.
RESULTS: 27 cases of early syphilis were diagnosed in 2000 and 200 cases were diagnosed in 2001. 96 (42%) were primary; 92 (40%) were secondary; 39 (18%) were early latent. The male to female ratio was 215:12. 90% (203) of cases occurred in men who have sex with men (MSM). 85% (197) cases were Irish. The mean number of male partners and female partners in the previous 3 months was 5.86 (range 0-40) and 0.153 (range 0–4), respectively. The patients met their sexual partners in saunas (64%), clubs (74%), Internet (8%), outdoors/park (3%) and abroad (20%). 30 MSM with previously diagnosed HIV infection (range 6 months to 8 years) were diagnosed with early syphilis. 16 MSM were co-diagnosed with HIV and syphilis. 52% of patients were diagnosed as a direct result of novel interventions: designated contact tracing (26%); on-site serological testing for syphilis in gay venues (14%) or through education about the importance of a regular sexually transmitted infection screen (12%). Other interventions included advertisement and publicity campaigns (involving drag queens); designated syphilis clinics; and education forums with gay peer groups.
DISCUSSION: Syphilis increases HIV viral load and is a known factor in HIV acquisition. Additionally, given the high rate of known HIV patients acquiring syphilis (approximately 10% of the clinic HIV MSM cohort), we can expect to see further co-diagnosis in this high-risk group.
PRESENTING AUTHOR: S Hopkins
020419
O6
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