Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Center for Esoteric Testing, Laboratory Corporation of America Holdings, Burlington, NC, USA.
J Epidemiol Glob Health. 2019 Sep;9(3):153-157. doi: 10.2991/jegh.k.190620.001.
The Centers for Disease Control and Prevention (CDC) recommends syphilis screening at least annually for sexually active men who have sex with men (MSM). The objective of this study is to assess the frequency of MSM testing for syphilis and how syphilis test results compared with results of rectal gonorrhea and chlamydia tests. In collaboration with a large US commercial laboratory, we identified men aged 15-60 years who had rectal chlamydia or gonorrhea tests during 09/01/2013-09/30/2015 as presumed MSM. We classified MSM as having current or past syphilis if during the study period they had (1) either a reactive qualitative non-treponemal test or at least a 1:1 quantitative non-treponemal test, and (2) they had a reactive treponemal test. Of 52,771 MSM, 14.3% had no syphilis testing, 4.8% had only treponemal testing (37.8% were reactive), 63.2% had only non-treponemal testing (2.0% were reactive), and 17.7% had both non-treponemal and treponemal testing (86.6% had current or past syphilis). Of those MSM who had reactive qualitative non-treponemal tests, at least 90% had no quantitative non-treponemal tests. Current or past syphilis was more common among MSM with positive rectal gonorrhea or chlamydia tests (24.1%) than MSM with negative rectal gonorrhea and chlamydia tests (13.0%, < 0.005). Of MSM with any syphilis testing during 09/01/2013-09/30/2014, 64.8% also had annual repeat testing. Syphilis testing in general and repeat syphilis testing were frequent but suboptimal among MSM. It is important to continually monitor syphilis for MSM, especially for those MSM who had rectal chlamydia or gonorrhea infection.
美国疾病控制与预防中心（CDC）建议，对于有性行为的男男性行为者（MSM），至少每年进行一次梅毒筛查。本研究的目的是评估 MSM 进行梅毒检测的频率，以及梅毒检测结果与直肠淋病和衣原体检测结果的对比情况。我们与一家大型美国商业实验室合作，确定了在 2013 年 9 月 1 日至 2015 年 9 月 30 日期间接受直肠衣原体或淋病检测的 15-60 岁男性为假定的 MSM。如果在研究期间，他们（1）进行了阳性定性非梅毒螺旋体检测或至少进行了 1:1 定量非梅毒螺旋体检测，以及（2）进行了阳性梅毒螺旋体检测，则将 MSM 归为现症或既往梅毒感染。在 52771 名 MSM 中，有 14.3%的人没有进行梅毒检测，4.8%的人只进行了梅毒螺旋体检测（37.8%为阳性），63.2%的人只进行了非梅毒螺旋体检测（2.0%为阳性），17.7%的人同时进行了非梅毒螺旋体和梅毒螺旋体检测（86.6%为现症或既往梅毒感染）。在进行了阳性定性非梅毒螺旋体检测的 MSM 中，至少有 90%的人没有进行定量非梅毒螺旋体检测。与直肠淋病或衣原体检测阴性的 MSM（13.0%，<0.005）相比，直肠淋病或衣原体检测阳性的 MSM 中现症或既往梅毒感染更为常见（24.1%）。在 2013 年 9 月 1 日至 2014 年 9 月 30 日期间进行了任何梅毒检测的 MSM 中，有 64.8%的人进行了年度重复检测。总体而言，MSM 中梅毒检测和重复梅毒检测的频率较高，但并不理想。对于有直肠衣原体或淋病感染的 MSM，应持续监测梅毒。
