Brosh-Nissimov Tal, Mor Zohar, Avramovich Eva, Katchman Eugene, Avidor Boaz, Mor Orna, Turner Dan
Infectious Disease Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Isr Med Assoc J. 2012 Mar;14(3):152-6.
Outbreaks of syphilis have been described among men who have sex with men (MSM) in many western urban communities in the last few years.
To describe the first reported outbreak of syphilis among MSM in Israel within a decade of a constant increase in human immunodeficiency virus (HIV) prevalence.
All patients diagnosed with syphilis were contacted and asked about their sexual behavior, substance use and previous infections. All were tested for HIV and a phylogenetic analysis was performed.
A total of 23 (59%) of all 39 male patients diagnosed with primary or secondary syphilis between August 2008 and August 2009 were interviewed. All were MSM and performed anal intercourse, while 13 (55%) reported unprotected anal intercourse. Most participants (21, 91%) practiced unprotected oral intercourse. Nine participants (39%) reported unprotected oral intercourse while using condoms during anal intercourse. Ten participants (43%) reported sexual contacts while traveling abroad in the previous few months. Most participants (96%) were co-infected with HIV, and 15 (68%) were already aware of their HIV infection. Fifteen (66%) reported the use of recreational drugs, alcohol, or both before or during sex. No common source or core transmitters were identified.
This syphilis outbreak included MSM who were co-infected with HIV and were characterized by risky sexual behavior including multiple partners, unprotected anal intercourse and substance use. Future targeted interventions should focus on HIV-infected MSM for secondary prevention.
在过去几年里，许多西方城市社区的男男性行为者（MSM）中出现了梅毒疫情。
描述以色列首次报告的男男性行为者梅毒疫情，此时距人类免疫缺陷病毒（HIV）患病率持续上升已过去十年。
联系了所有被诊断为梅毒的患者，询问他们的性行为、物质使用情况和既往感染史。所有患者都接受了HIV检测，并进行了系统发育分析。
2008年8月至2009年8月期间，在所有39例被诊断为一期或二期梅毒的男性患者中，共访谈了23例（59%）。所有患者均为男男性行为者，有肛交行为，其中13例（55%）报告有无保护肛交。大多数参与者（21例，91%）有无保护口交行为。9例参与者（39%）报告在肛交时使用避孕套的同时有无保护口交行为。10例参与者（43%）报告在过去几个月出国旅行时有性接触。大多数参与者（96%）合并感染了HIV，15例（68%）已经知晓自己感染了HIV。15例（66%）报告在性交前或性交期间使用过娱乐性药物、酒精或两者皆用。未发现共同传染源或核心传播者。
此次梅毒疫情涉及合并感染HIV的男男性行为者，其特点是性行为风险高，包括多个性伴侣、无保护肛交和物质使用。未来有针对性的干预措施应侧重于对感染HIV的男男性行为者进行二级预防。
