Changing face of the syphilis epidemic in men who have sex with men

There has been renewed interest in the clinical presentation of syphilis since the increasing rates of infectious syphilis in men who have sex with men (MSM) globally.1 Extragenital lesions of syphilis are likely to drive ongoing transmission in this epidemic.1 Locally we have a large population of MSM and high rates of STIs including syphilis. We assumed that increased awareness of syphilis in both MSM and sexual health/primary care clinicians from bespoke health campaigns should have led to earlier diagnosis.2Using our clinic database, we identified MSM diagnosed with infectious syphilis in 2014 and 2017 in two 6-month time periods.

We found 301 cases of infectious syphilis in MSM, of whom 238 had complete data for analysis (127 in 2014 and 111 in 2017). Interestingly, there were no significant differences in testing rates (7895 in 2014 and 7704 in 2017) or HIV positivity (47.2%(2014)vs 53.2%(2017); p=0.360).

Contrary…

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