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High HIV Seroprevalence Associated with Diagnosis of Gonorrhea or Syphilis in Men Who Have Sex with Men L. TORIAN*1, H. MAKKI1, I. MENZIES1, D. BENSON2, and I. WEISFUSE2.
1New York City Dept. of Hlth, Office of AIDS; and 2Res./HIV Serosurveys and Bureau of STD Control Background/Objective: To measure trends in HIV seroprevalence (P) associated with a diagnosis of gonorrhea (GC) or syphilis in men who have sex with men (MSM) who presented to NYCDOH STD clinics during 1990–1998.
Method: An unlinked HIV-1 serosurvey was done using remnant serum originally drawn for routine serologic tests for syphilis.
Results: During 1990–98 P declined from 9%–5% in the sample overall (N=99,169), from 10%–6% in men (N=64, 116), and from 47%–19% in MSM (N=3,640) (P for trends <0.01). Among MSM, P declined from 34%–10% in whites (N=1,089), from 56%–32% in blacks (N=1524), from 47%–13% in Hispanics (N=690), and in all of the 5-year age groups. P in all men with GC (N=9,839) was stable at 10–12%, and P in all men with syphilis (any stage disease, N=6,240) rose from 13–16%. During this period P declined from 57%–39% in MSM with GC (N=445, P<0.01) and remained stable at 50% in MSM with syphilis (N=191, P>0.05). By logistic regression it was determined that among MSM, P was associated with a diagnosis of GC or syphilis (OR 1.5, 95% CI 1.4, 1.6), having an age over 25 (OR 1.6, 95% CI 1.5, 1.7) and nonwhite race/ethnicity (OR 1.6, 95% CI 1.5, 1.7). MSM with GC or syphilis was less likely than MSM with other STDs to have ever had a confidential test for HIV (52% vs. 68%, P<0.01). Overall, MSM who tested negative in this blinded serosurvey were more likely to know their HIV serostatus from a previous confidential test than those who tested positive in the serosurvey (67% vs. 60%, p<0.05).
Conclusion: Although P declined overall and in the MSM subsample, a diagnosis of GC or syphilis remained a significant predictor of HIV infection in MSM, as were age over 25 years and nonwhite race/ethnicity. New strategies to reduce the incidence of STD and encourage HIV testing in MSM with these and other STDs are needed.
Key Words: HIV seroprevalence, men who have sex with men, Sexually transmitted disease
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