{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:10:43Z","timestamp":1753877443792,"version":"3.41.2"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"2","funder":[{"name":"Veterans Health Administration"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To measure the incidence of syphilis diagnoses among people with HIV vs those without HIV in a national multiyear retrospective cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Treponemal and nontreponemal tests, HIV status, and demographic data were identified among all individuals receiving Veterans Health Administration (VHA) care between January 1, 2009, and December 31, 2019. Syphilis testing rates and incident syphilis diagnoses as defined by a laboratory algorithm were stratified by HIV status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Syphilis was diagnosed in 1.2% (n\u2005=\u20052283) of 194 322 tested individuals in VHA care in 2019. Among individuals with HIV tested for syphilis, 6.1% met criteria for syphilis compared with 0.7% without HIV. Syphilis incidence in 2019 was 35\/100 000, a 17% increase from 2009 (30\/100 000). In 2019, syphilis incidence was 3381 per 100 000 persons among individuals with HIV and 19 per 100 000 in those without HIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Using a laboratory-based diagnostic algorithm, a 178-fold difference in syphilis incidence was observed between individuals with and without HIV in 2019. US syphilis incidence data that incorporate HIV status are needed. Interventions to monitor and prevent sexually transmitted infections should address the role of HIV status.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ofid\/ofab030","type":"journal-article","created":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T21:27:07Z","timestamp":1611437227000},"source":"Crossref","is-referenced-by-count":4,"title":["Differences in Syphilis Incidence Using a Laboratory Algorithm in People With and Without HIV in an 11-Year Nationwide Cohort Study"],"prefix":"10.1093","volume":"8","author":[{"given":"Marissa M","family":"Maier","sequence":"first","affiliation":[{"name":"OHSU Division of Infectious Diseases, VA Portland Healthcare System, Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ina","family":"Gylys-Colwell","sequence":"additional","affiliation":[{"name":"Health Services Research & Development, VA Puget Sound Healthcare System, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elliott","family":"Lowy","sequence":"additional","affiliation":[{"name":"Health Services Research & Development, VA Puget Sound Healthcare System, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joleen","family":"Borgerding","sequence":"additional","affiliation":[{"name":"Health Services Research & Development, VA Puget Sound Healthcare System, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Puja","family":"Van Epps","sequence":"additional","affiliation":[{"name":"Department of Medicine, Case Western Reserve University School of Medicine, Veterans Affairs Northeast Ohio Healthcare System, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Ohl","sequence":"additional","affiliation":[{"name":"Center for Access and Delivery Research and Evaluation (CADRE), Department of Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald G","family":"Hauser","sequence":"additional","affiliation":[{"name":"Pathology and Laboratory Medicine Department, Veterans Affairs Connecticut Healthcare, New Haven, Connecticut, USA"},{"name":"Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maggie","family":"Chartier","sequence":"additional","affiliation":[{"name":"HIV, Hepatitis and Related Conditions Programs, Office of Specialty Care Services, Veterans Health Administration, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6488-435X","authenticated-orcid":false,"given":"Lauren","family":"Beste","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, VA Puget Sound Health Care System, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,1,22]]},"reference":[{"year":"2017","author":"Centers for Disease Control and Prevention, National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention.","key":"2021021217190035000_CIT0001"},{"key":"2021021217190035000_CIT0002","doi-asserted-by":"crossref","first-page":"349","DOI":"10.15585\/mmwr.mm6613a1","article-title":"State-specific rates of primary and secondary syphilis among men who have sex with men\u2014United States, 2015","volume":"66","author":"de Voux","year":"2017","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021021217190035000_CIT0003","doi-asserted-by":"crossref","first-page":"94","DOI":"10.7326\/0003-4819-121-2-199407150-00003","article-title":"Altered clinical presentation of early syphilis in patients with human immunodeficiency virus infection","volume":"121","author":"Hutchinson","year":"1994","journal-title":"Ann Intern Med"},{"key":"2021021217190035000_CIT0004","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1056\/NEJM199707313370504","article-title":"A randomized trial of enhanced therapy for early syphilis in patients with and without human immunodeficiency virus infection","volume":"337","author":"Rolfs","year":"1997","journal-title":"N Engl J Med"},{"key":"2021021217190035000_CIT0005","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1093\/infdis\/161.4.810","article-title":"Detection of human immunodeficiency virus type 1 (HIV-1) in genital ulcer exudate of HIV-1-infected men by culture and gene amplification","volume":"161","author":"Plummer","year":"1990","journal-title":"J Infect Dis"},{"key":"2021021217190035000_CIT0006","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1093\/infdis\/160.3.380","article-title":"Isolation of human immunodeficiency virus from genital ulcers in Nairobi prostitutes","volume":"160","author":"Kreiss","year":"1989","journal-title":"J Infect Dis"},{"key":"2021021217190035000_CIT0007","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1001\/jama.280.1.61","article-title":"Frequent recovery of HIV-1 from genital herpes simplex virus lesions in HIV-1-infected men","volume":"280","author":"Schacker","year":"1998","journal-title":"JAMA"},{"key":"2021021217190035000_CIT0008","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1093\/cid\/ciy348","article-title":"Risk factors and incidence of syphilis in human immunodeficiency virus (HIV)-infected persons: the HIV Outpatient Study, 1999\u20132015","volume":"67","author":"Novak","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2021021217190035000_CIT0009","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1097\/OLQ.0000000000000986","article-title":"Increasing syphilis detection among patients assigned male at birth screened at a Boston community health center specializing in sexual and gender minority health, 2005\u20132015","volume":"46","author":"Hazra","year":"2019","journal-title":"Sex Transm Dis"},{"volume-title":"Sexually transmitted disease surveillance 2017\u2014special focus profiles","year":"2017","author":"Centers for Disease Control and Prevention, National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention","key":"2021021217190035000_CIT0010"},{"key":"2021021217190035000_CIT0011","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.2105\/AJPH.2004.042432","article-title":"Rural definitions for health policy and research","volume":"95","author":"Hart","year":"2005","journal-title":"Am J Public Health"},{"key":"2021021217190035000_CIT0012","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1097\/OLQ.0000000000000836","article-title":"Going off grid: modeling an automated record search to process electronically reported reactive nontreponemal syphilis tests","volume":"46","author":"Matthias","year":"2018","journal-title":"Sex Transm Dis"},{"key":"2021021217190035000_CIT0013","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12879-018-3038-4","article-title":"Increasing incidence of syphilis among patients engaged in HIV care in Alberta, Canada: a retrospective clinic-based cohort study","volume":"18","author":"Lang","year":"2018","journal-title":"BMC Infec Dis"},{"year":"2019","author":"US Department of Veterans Affairs.","key":"2021021217190035000_CIT0014"},{"year":"2016","author":"Center for Behavioral Health Statistics and Quality.","key":"2021021217190035000_CIT0015"},{"key":"2021021217190035000_CIT0016","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1097\/OLQ.0000000000001250","article-title":"Network interconnectivity and community detection in HIV\/syphilis contact networks among men who have sex with men","volume":"47","author":"Billock","year":"2020","journal-title":"Sex Transm Dis"},{"key":"2021021217190035000_CIT0017","doi-asserted-by":"crossref","first-page":"378","DOI":"10.2105\/AJPH.92.3.378","article-title":"Relationships of stigma and shame to gonorrhea and HIV screening","volume":"92","author":"Fortenberry","year":"2002","journal-title":"Am J Public Health"},{"key":"2021021217190035000_CIT0018","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1089\/apc.2013.0316","article-title":"Sexually transmitted infection related stigma and shame among African American male youth: implications for testing practices, partner notification, and treatment","volume":"28","author":"Morris","year":"2014","journal-title":"AIDS Patient Care STDS"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofab030\/35958069\/ofab030.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ofid\/article-pdf\/8\/2\/ofab030\/36247408\/ofab030.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ofid\/article-pdf\/8\/2\/ofab030\/36247408\/ofab030.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T04:49:06Z","timestamp":1618980546000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofab030\/6108156"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,22]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofab030","relation":{},"ISSN":["2328-8957"],"issn-type":[{"type":"electronic","value":"2328-8957"}],"subject":[],"published-other":{"date-parts":[[2021,2,1]]},"published":{"date-parts":[[2021,1,22]]},"article-number":"ofab030"}}