Abstract：
Syphilis, a sexually transmitted infection, has reemerged in many vulnerable groups around the world. The objective of the current study was to determine the prevalence and incidence of syphilis among people who attended a specialized HIV clinic in Mexico from 2011 to 2015. Databases from the laboratory were analyzed, and the following four groups were formed: people seeking HIV-1 voluntary counseling and testing (VCT), people in prison (PPr), people living with HIV (PLWH), and patients from primary care clinics (others). The diagnosis of syphilis was made using the reverse algorithm; antibody titers were examined to determine the stage of infection. Baseline data were analyzed and, with follow-up information, a retrospective dynamic cohort was formed. Factors associated with the seroprevalence of syphilis and active syphilis were evaluated by the chi-square test. Moreover, risk factors for the incidence of syphilis were described. A total of 81,863 baseline individuals were analyzed. The seroprevalence of syphilis was 9.9% in the VCT group, 8.2% in the PPr group, 37.0% in the PLWH group, and 8.7% in the others group; the prevalence of active syphilis was 1.7-13.1%. A total of 11,124 people were followed up. The incidence (cases per 100 person-years) was 3.5 among the VCT group, 16.0 among the PLWH group, and < 0.1 among both the PPr and others groups, respectively; moreover, the frequency of reinfections was 11.1-24.4%. The high prevalence and incidence of syphilis, active syphilis, and reinfections among men, transgender people, individuals aged 20-39 years, and people with a history of HIV or hepatitis B suggest that it is critical to improve prevention, diagnosis, and treatment measures to stop the reemergence of syphilis. There are also new factors such as methamphetamine use, group sex, or contacting partners over the internet that are associated with syphilis. In addition, HIV preexposure prophylaxis could contribute to the increased incidence of syphilis by providing false security in the prevention of STIs, thereby increasing risky sexual behaviors.
摘要：
梅毒,性传播感染,在世界各地的许多弱势群体中重新出现。本研究的目的是确定2011年至2015年在墨西哥专门的HIV诊所就诊的人群中梅毒的患病率和发病率。分析了实验室的数据库，组成以下四组：寻求HIV-1自愿咨询和检测（VCT）的人，监狱中的人（PPr），艾滋病毒感染者（PLWH），和初级保健诊所的患者（其他）。使用反向算法诊断梅毒；检查抗体滴度以确定感染阶段。分析了基线数据，有了后续信息，形成了一个回顾性动态队列.通过卡方检验评估与梅毒和活动性梅毒血清阳性率相关的因素。此外，对梅毒发病的危险因素进行了描述。总共分析了81,863名基线个体。VCT组梅毒血清阳性率为9.9%,PPr组为8.2%，PLWH组为37.0%，在其他组中为8.7％；活动性梅毒的患病率为1.7-13.1％。共追踪了11,124人。VCT组的发病率（每100人年病例）为3.5，在PLWH组中16.0，在PPr和其他组中都<0.1，分别；此外，再感染的频率为11.1-24.4%。梅毒的患病率和发病率较高，活动性梅毒,和男性的再感染，变性人,20-39岁的人，有艾滋病毒或乙型肝炎病史的人建议改善预防至关重要，诊断,和治疗措施，以阻止梅毒的复发。还有新的因素如甲基苯丙胺的使用,集体性,或通过互联网联系与梅毒相关的合作伙伴。此外,艾滋病毒暴露前预防可能通过在性传播感染的预防中提供虚假的安全性而导致梅毒发病率增加。从而增加危险的性行为。
