Condom Use and Number of Sexual Partners among Male Syphilis Patients who Report Having Sex with Men

Repiso, B.; Frieyro, M.; Rivas-Ruiz, F.; De Troya, M.

doi:10.1016/S1578-2190(10)70731-9

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Abstract

Background and objectives

Recent years have seen a resurgence of syphilis in Spain due to changes in sexual behavior. Here we describe the incidence of the disease in our clinic and investigate its relationship with the sexual habits of men who have sex with men (MSM).

Patients and methods

A cross-sectional descriptive study of incident cases of syphilis in 2007 and 2008 was performed, followed by a case-control study of sexual behavior in the previous year to compare MSM with and without syphilis.

Results

We recorded 26 new cases of syphilis, 19 of which were diagnosed at early stages. Eight patients were infected with human immunodeficiency virus and 15 were classed as MSM. Sixty-five MSM without syphilis were selected as a control group. MSM with syphilis had a larger number of sexual partners: odds ratio (OR), 3.98 (95% confidence interval [CI], 0.90–17.46) for the category “2 to 5 sexual partners”; OR, 3.22 (95% CI, 0.84–12.43) for the category “more than 5 sexual partners”. The inconsistent use of condoms was significantly more common among MSM with syphilis than among those without syphilis (OR, 3.96; 95% CI, 1.15–13.61; P=.02).

Conclusions

Syphilis continues to be a public health problem in our setting, particularly among homosexual and bisexual men. In this study, inconsistent use of condoms and a greater number of sexual partners were risk factors for syphilis in MSM. The development of prevention programs targeting this at-risk population should be considered a priority.

Keywords:

Syphilis

Homosexuality

Sexual partners

Male condoms

Resumen

Introducción y objetivos

La sífilis ha aumentado en España en los últimos años, debido a cambios en los hábitos sexuales. Describimos la incidencia de sífilis en nuestra consulta y estudiamos los hábitos sexuales de los hombres que tienen sexo con otros hombres (HSH).

Pacientes y métodos

Estudio transversal descriptivo de los casos incidentes de sífilis en los años 2007 y 2008, y estudio caso-control de los hábitos sexuales en el último año de los HSH diagnosticados o no de sífilis.

Resultados

Registramos 26 nuevos casos de sífilis, 19 de ellos en el estadio de sífilis precoz. 8 pacientes estaban infectados por el virus de la inmunodeficiencia humana y 15 eran HSH. Como grupo control se seleccionaron 65 HSH sin sífilis. Demostramos un mayor número de parejas sexuales en los HSH afectos de sífilis, 3,98 (IC 95% = 0,90–17,46) veces más en la categoría «entre 2 y 5 parejas» y 3,22 (IC 95% = 0,84–12,43) en la categoría de «más de 5 parejas». En el apartado de uso de preservativo estas diferencias fueron significativas (p = 0,02), siendo 3,96 veces superior (IC 95% = 1,15–13,61) el empleo inconstante del mismo en el grupo de HSH con sífilis.

Conclusiones

La sífilis continúa siendo un problema de salud pública en nuestro medio, particularmente entre homo y bisexuales. El inconstante uso de preservativo y un mayor número de parejas sexuales son factores de riesgo de sífilis en los HSH de nuestra serie. Es prioritario desarrollar programas de prevención dirigidos a la población de riesgo.

Palabras clave:

Sífilis

Homosexualidad

Parejas sexuales

Preservativo masculino

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