PREVALENCE OF SYPHILIS AND HIV INFECTION AMONG MEN WHO HAVE SEX WITH MEN TESTED IN A NON-GOVERNMENTAL ORGANIZATION IN BELGRADE
Abstract
Introduction/Aim: In Belgrade, syphilis and human immunodeficiency virus (HIV) infection most often occur among men who have sex with men who are often stigmatized and discriminated and hesitate to come to health institutions for testing for these diseases. The aim of this study was to assess prevalence of syphilis and HIV infection among men who have sex with men who were tested in the "check-point" center of the association "Potent" in Belgrade.
Methods: This cross-sectional study included 993 participants tested for HIV and 860 participans tested for syphilis by rapid screening tests HEXAGON SYPHILIS and HEXAGON HIV. The results of rapid HIV tests were confirmed by a positive Western-Blot test at the Infectious Diseases Clinic of the Clinical Center of Serbia, and for syphilis by positive serological tests (VDRL - Venereal Disease Research Laboratory and TPHA - Treponema Pallidum Haemagglutination Assay) at the City Institute for Skin and Venereal Diseases in Belgrade. Proportions, percentages and the χ2 test were used in the statistical analysis of the data.
Results: A positive test for HIV was recorded in 11 (1.1%), and a positive test for syphilis in 34 participants
(3.9%). The youngest newly diagnosed HIV positive case was 22 years old and the oldest 46 years old, while the youngest case with a positive test for syphilis was 19 years old and the oldest 68.
Conclusion: Strategies for testing for syphilis and HIV among men who have sex with men should be diverse, including community testing conducted by non-government organization in cooperation with health facilities.
References
1. Rowley J, Vander Hoorn S, Korenromp E, Low N, Unemo M, Abu-Raddad LJ et al. Chlamydia, gonorrhea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016. Bull World Health Organ 2019; 97(8):548-562P. 10.2471/BLT.18.228486
2. Report on global sexually transmitted infection surveillance, 2018. Geneva: World Health Organization; 2018.
3. Bjekic M, Sipetic-Grujicic S, Begovic-Vuksanovic B, Rafailovic N, Vlajinac H. Syphilis resurgence in Belgrade, Serbia in the new millennium: an outbreak in 2014. Centr Eur J Public Health 2017; 25(4):277-281. doi:10.21101/cejph.a4525
4. Institute of Public Health of Serbia „Dr Milan Jovanović Batut“. Report on communicable diseases in the Republic of Serbia for 2018. Belgrade: Institute of Public Health of Serbia „Dr Milan Jovanovic Batut“; 2019.
5. European Centre for Disease Prevention and Control, WHO Regional Office for Europe. HIV/AIDS surveillance in Europe 2018 – 2017 data. Copenhagen: WHO Regional Office for Europe; 2018.
6. Institute of Public Health of Serbia „Dr Milan Jovanovic Batut“. Report on the realized activities within the response to HIV epidemic in the Republic of Serbia during 2019 with the comparative analysis for the period 2015-2019. Belgrade: Institute of Public Health of Serbia „Dr Milan Jovanovic Batut“; 2019.
7. Infectious Diseases. Rapid screening tests – HUMAN. Available at: https://www.human.de/procucts/rapid-creening-tests/infectious-diseases/ (cited 10.02.2021)
8. Barel S, Sifakis F, Cleghorn H, Beyrer C. Elevated risk for HIV infection among men who have sex with men in low and middle-income countries 2000-2006: a systematic review. PloS Med 2007; 4(12):1901-11. doi:10.1371/journal.pmed.0040339
9. Abara WE, Hess KL, Neblett Fanfair R, Bernstein KT, Paz-Bailey G. Syphilis trends among men who have sex with men in the United States and Western Europe: a systematic review of trend studies published between 2004 and 20015. PloS One 2016; 11(7):e0159309. doi: 10.1371/journal.pone.0159309.
10. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2016, Atlanta: U.S. Department of Health and Human Services; 2017.
11. Buchacz K, Patel P, Taylor M, Kerndt PR, Byers RH, Holmberg SD, et al. Syphilis increases HIV viral load and decreases CD4 cell counts in HIV-infected patients with new syphilis infections. AIDS 2004; 18(15):2075-9. doi:10.1097/00002030-200410210-00012
12. European Centre for Disease Prevention and Control. Syphilis. In: ECDC. Annual epidemiological report for2017. Stockholm: ECDC; 2019.
13. Bjekic M, Vlajinac H, Begovic-Vuksanovic B. Syphilis characteristics in Belgrade population in the period 2009-2018. Health Care 2020; 49(1):9-14. doi: 10.5937/ZZ2001009B
14. Van Aar F, Den Daas C, Van Der Sande MAB, Soetens LC, De Vries HJC, Van Benthem BHB. Outbreaks of syphilis among men who have sex with men attending STI clinics between 2007 and 2015 in the Netherlands: A space-time clustering study. Sex Transm Infect 2017; 93(6):390-5. doi: 10.1136/sextrans-2016-052754
15. Storm M, Deuba K, Damas J, Shrestha U, Rawal B, Bhattarai R et al. Prevalence of HIV, syphilis, and assessmentof the social and structural determinants of sexual risk behaviour and health service utilisation among MSM and transgenderwomen in Terai highway districts of Nepal:findings based on an integrated biologicaland behavioural surveillance survey using respondent driven sampling. BMC Infect Dis 2020; 20(1):402. doi: 10.1186/s12879-020-05122-3
16. National Association of County&City Health Officials. Best Practices for Rapid Syphilis Testing in Outreach and Non-Clinical Settings 2019. Available at: https://www.naccho.org/uploads/downloadable-esources/report_Implementing-RST-Demonstration-Project_FINAL.pdf
17. Bjekic MD, Vlajinac HD. Is COVID-19 affecting the epidemiology of syphilis in Belgrade? Indian J Dermatol Venereol Leprol (in press). doi: 10.25259/IJDVL_76_2021.
18. City Institute of Public Health of Belgrade. Report on the realization of Program of health protection of residents from infectious diseases in the territory of Belgrade in the period 1st January 2020 to 31st December 2020. Belgrade: City Institute of Public Health; 2021: p. 14.