Ishikane Masahiro, Arima Yuzo, Itoda Ichiro, Yamagishi Takuya, Takahashi Takuri, Matsui Tamano, Sunagawa Tomimasa, Ohnishi Makoto, Oishi Kazunori
Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan.
Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan.
Western Pac Surveill Response J. 2019 Dec 9;10(4):1-8. doi: 10.5365/wpsar.2019.10.1.003. eCollection 2019 Oct-Dec.
In Japan, syphilis notifications have increased. Men who have sex with men (MSM) in Tokyo have contributed substantially to the increase in syphilis notifications. We thus aimed to determine the correlates of incident syphilis among them.
MSM who attended a Tokyo clinic that serves sexual minorities were recruited in a case-control study in 2015. A case was seropositive for primary/secondary/asymptomatic syphilis at enrolment visit and seronegative at prior visit or had oral ulcers positive for DNA at enrolment. For each case, two controls seronegative at enrolment and prior visit were selected. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated to assess for correlates of case status.
Among 35 cases, the median age was 37 (range = 21-63) years and was similar to the 71 controls. Among HIV-positive participants (26 cases and 67 controls), cases were independently associated with higher frequency of anal or oral sex (OR = 3.4; 95% CI = 1.4-8.6; increase per category from < 1/month, ≥ 1/month but < 1/week, to ≥ 1/week) and no or inconsistent condom use during anal or oral sex (OR = 3.0; 95% CI = 1.1-8.3; increase per category from using every time, occasionally, to never), adjusted for residency and time between visits.
Modifiable behaviours were associated with incident syphilis, and dissemination of prevention messages are needed.
在日本，梅毒报告病例数有所增加。东京的男男性行为者（MSM）对梅毒报告病例数的增加起到了很大作用。因此，我们旨在确定他们中梅毒发病的相关因素。
2015年，在一项病例对照研究中招募了到一家为性少数群体服务的东京诊所就诊的男男性行为者。病例在入组就诊时梅毒一期/二期/无症状期血清学检测呈阳性，且在前次就诊时血清学检测呈阴性，或者在入组时口腔溃疡的DNA检测呈阳性。对于每例病例，选择两名在入组和前次就诊时血清学检测均呈阴性的对照。使用逻辑回归估计比值比（OR）和95%置信区间（CI），以评估病例状态的相关因素。
在35例病例中，中位年龄为37岁（范围=21-63岁），与71名对照相似。在HIV阳性参与者（26例病例和67名对照）中，病例与更高频率的肛交或口交独立相关（OR=3.4；95%CI=1.4-8.6；每类别从<1/月、≥1/月但<1/周增加到≥1/周），以及在肛交或口交期间未使用或不坚持使用避孕套（OR=3.0；95%CI=1.1-8.3；每类别从每次使用、偶尔使用增加到从不使用），对居住情况和就诊间隔时间进行了调整。
可改变的行为与梅毒发病相关，需要传播预防信息。
