Case-control study of risk factors for incident syphilis infection among men who have sex with men in Tokyo, Japan

Authors

  • Masahiro Ishikane Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Department of Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan https://orcid.org/0000-0002-8711-7636
  • Yuzo Arima Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
  • Ichiro Itoda Shirakaba Clinic, Tokyo, Japan
  • Takuya Yamagishi Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
  • Takuri Takahashi Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
  • Tamano Matsui Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
  • Tomimasa Sunagawa Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
  • Makoto Ohnishi Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
  • Kazunori Oishi Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan

DOI:

https://doi.org/10.5365/wpsar.2019.10.1.003

Abstract

Introduction: In Japan, syphilis notifications have increased. Men who have sex with men (MSM) in Tokyo have contributed substantially to the increase in syphilis notifications. We thus aimed to determine the correlates of incident syphilis among them.

Methods: MSM who attended a Tokyo clinic that serves sexual minorities were recruited in a case-control study in 2015. A case was seropositive for primary/secondary/asymptomatic syphilis at enrolment visit and seronegative at prior visit or had oral ulcers positive for Treponema pallidum DNA at enrolment. For each case, two controls seronegative at enrolment and prior visit were selected. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated to assess for correlates of case status.

Results: Among 35 cases, the median age was 37 (range = 21–63) years and was similar to the 71 controls. Among HIV-positive participants (26 cases and 67 controls), cases were independently associated with higher frequency of anal or oral sex (OR = 3.4; 95% CI = 1.4–8.6; increase per category from < 1/month, >= 1/month but < 1/week, to >= 1/week) and no or inconsistent condom use during anal or oral sex (OR = 3.0; 95% CI = 1.1–8.3; increase per category from using every time, occasionally, to never), adjusted for residency and time between visits.

Discussion: Modifiable behaviours were associated with incident syphilis, and dissemination of prevention messages are needed.

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Published

09-12-2019

Issue

Section

Original Research