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- W3181021319 abstract "<h3></h3> There has been a significant increase in infectious syphilis in men who have sex with men(MSM) Recent data also suggests a corresponding increase in ano-rectal syphilis. Despite this, there is a lack of syphilis testing in MSM with ano-rectal symptoms. The aim of this study is to describe the presentation and management of MSM with ano-rectal syphilis. The sexual health clinic in Brighton sees 6500 MSM per year for sexually transmitted infection testing and treatment. We reviewed the electronic clinic notes of MSM with ano-rectal syphilis from January 2017 to August 2020 and collected data on patient demographics, HIV status, previous syphilis, syphilis serology including VDRL titre, TP-PCR testing and details of treatment. In the study period, 128 MSM were diagnosed with early syphilis, 108(84%) with genital lesion(s), 4(3%) with oral lesion(s) and 16(13%,95%CI=7.3–19.5) with painful ano-rectal lesion(s). All 16 had reactive serology and 12/16 had a TP-PCR taken of which 12/12 was positive. The median age was 51 years (IQR 40–58) and 7/16(44%) were HIV positive and 4/16(25%) had a previous history of syphilis. Clinicians treated 6/16(38%) presumptively for syphilis on the day of presentation; the 10/16 who were not treated presumptively on the day waited a median of 8 days(6–28) for treatment. HIV positive MSM with ano-rectal syphilis were significantly more likely to have had previous treated syphilis(OR=24.4, 95%CI1.03–580.7, p<0.05) than HIV negative MSM, and clinicians were significantly more likely to treat HIV positive MSM presumptively on the day(OR=20.0, 95%CI=1.4–282.5, p<0.03). We have shown that a small, but significant number of MSM with syphilis present with painful ano-rectal symptoms and suggest that all MSM with ano-rectal symptoms should be tested for syphilis. Point of care testing for syphilis from ano-rectal samples would support syphilis control and prevention." @default.
- W3181021319 created "2021-07-19" @default.
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- W3181021319 date "2021-07-01" @default.
- W3181021319 modified "2023-09-27" @default.
- W3181021319 title "P024 Painful ano-rectal syphilis in men who have sex with men (MSM)" @default.
- W3181021319 doi "https://doi.org/10.1136/sextrans-2021-sti.171" @default.
- W3181021319 hasPublicationYear "2021" @default.
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