{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:49:56Z","timestamp":1791838196857,"version":"4.3.4"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T00:00:00Z","timestamp":1673481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"National Health and Medical Research Council (NHMRC) Emerging Leadership Investigator","award":["GNT1172873"],"award-info":[{"award-number":["GNT1172873"]}]},{"name":"NHMRC Emerging Leadership Investigator","award":["GNT1193955"],"award-info":[{"award-number":["GNT1193955"]}]},{"name":"Australian Government Research Training Program (RTP) Scholarship"},{"name":"Research Entry Scholarship"},{"name":"Australian Government Research Training Program (RTP) Scholarship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We aimed to examine the incidence of syphilis in men who have sex with men (MSM) and identify subgroups of MSM at a higher risk of syphilis infection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a retrospective cohort study of MSM attending a sexual health clinic in Australia, during 2013\u20132019, who had at least 2 syphilis serological tests during the study period. The incidence of syphilis was expressed as per 100 person-years. A cox regression analysis was conducted to identify risk factors for syphilis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 24 391 individual MSM (75 086 consultations) were included. A total of 1404 new syphilis cases were diagnosed with an incidence of 3.7\/100 person-years (95% confidence interval, 3.5\u20133.9). Syphilis incidence was higher in MSM with human immunodeficiency virus ([HIV] 9.3\/100 person-years) than in MSM taking HIV pre-exposure prophylaxis (PrEP) (6.9\/100 person-years) or HIV-negative MSM not taking PrEP (2.2\/100 person-years). Risk factors associated with high incidence of syphilis included the following: MSM with HIV (adjusted hazard ratio [aHR] 2.7), MSM taking HIV PrEP (aHR 2.1), past history of syphilis infection (aHR 2.4), injecting drug use (aHR 2.7), condomless anal sex (aHR 1.7), &amp;gt;4 sexual partners in the last 12 months (aHR 1.2), and concurrent sexually transmitted infection (chlamydia and gonorrhoea) (aHR 1.6).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The incidence of syphilis remains high among MSM, particularly in subgroups with associated risk factors for syphilis infections. These data highlight the need for biomedical and behavioral interventions to be targeted to subgroups of MSM at the highest risk of syphilis infection.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofad017","type":"journal-article","created":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T19:44:50Z","timestamp":1673552690000},"source":"Crossref","is-referenced-by-count":18,"title":["Incidence and Risk Factors for Early Syphilis Among Men Who Have Sex With Men in Australia, 2013\u20132019: A Retrospective Cohort Study"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2560-3233","authenticated-orcid":false,"given":"Ei T","family":"Aung","sequence":"first","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Melbourne, Victoria , Australia"},{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University , Melbourne, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K","family":"Fairley","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Melbourne, Victoria , Australia"},{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University , Melbourne, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason J","family":"Ong","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Melbourne, Victoria , Australia"},{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University , Melbourne, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus Y","family":"Chen","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Melbourne, Victoria , Australia"},{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University , Melbourne, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany R","family":"Phillips","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Melbourne, Victoria , Australia"},{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University , Melbourne, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Tran","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Melbourne, Victoria , Australia"},{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University , Melbourne, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjit","family":"Samra","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Melbourne, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric P F","family":"Chow","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Melbourne, Victoria , Australia"},{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University , Melbourne, Victoria , Australia"},{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne , Melbourne, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,1,12]]},"reference":[{"key":"2023020412073213900_ofad017-B1","doi-asserted-by":"crossref","first-page":"e1110","DOI":"10.1016\/S2214-109X(21)00221-7","article-title":"Prevalence of syphilis among men who have sex with men: a global systematic review and meta-analysis from 2000\u201320","volume":"9","author":"Tsuboi","year":"2021","journal-title":"Lancet Glob Health"},{"key":"2023020412073213900_ofad017-B2","volume-title":"HIV, viral hepatitis and sexually transmissible infections in Australia annual surveillance report 2018","author":"Kirby Institute","year":"2018"},{"key":"2023020412073213900_ofad017-B3","doi-asserted-by":"crossref","first-page":"e178","DOI":"10.1097\/OLQ.0000000000001438","article-title":"Spatial and temporal epidemiology of infectious syphilis in Victoria, Australia, 2015\u20132018","volume":"48","author":"Aung","year":"2021","journal-title":"Sex Transm Dis"},{"key":"2023020412073213900_ofad017-B4","volume-title":"Australian sexually transmitted infection and HIV testing guidelines 2019 for asymptomatic men who have sex with men","author":"STIs in Gay Men Action Group (STIGMA)","year":"2019"},{"key":"2023020412073213900_ofad017-B5","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1093\/cid\/cix329","article-title":"The evidence that increased syphilis testing controls syphilis is compelling: what is needed to act?","volume":"65","author":"Klausner","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2023020412073213900_ofad017-B6","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1093\/cid\/cix326","article-title":"Increased syphilis testing of men who have sex with men: greater detection of asymptomatic early syphilis and relative reduction in secondary syphilis","volume":"65","author":"Chow","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2023020412073213900_ofad017-B7","doi-asserted-by":"crossref","first-page":"e71436","DOI":"10.1371\/journal.pone.0071436","article-title":"Opt-out and opt-in testing increases syphilis screening of HIV-positive men who have sex with men in Australia","volume":"8","author":"Guy","year":"2013","journal-title":"PLoS One"},{"key":"2023020412073213900_ofad017-B8","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1097\/QAI.0000000000000461","article-title":"Condom effectiveness for HIV prevention by consistency of use among men who have sex with men in the United States","volume":"68","author":"Smith","year":"2015","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2023020412073213900_ofad017-B9","author":"Luetkemeyer"},{"key":"2023020412073213900_ofad017-B10","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/S1473-3099(17)30725-9","article-title":"Post-exposure prophylaxis with doxycycline to prevent sexually transmitted infections in men who have sex with men: an open-label randomised substudy of the ANRS IPERGAY trial","volume":"18","author":"Molina","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"2023020412073213900_ofad017-B11","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1097\/OLQ.0b013e3181990c85","article-title":"Risk factors for repeat syphilis in men who have sex with men, San Francisco","volume":"36","author":"Phipps","year":"2009","journal-title":"Sex Transm Dis"},{"key":"2023020412073213900_ofad017-B12","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1086\/598997","article-title":"A population-based study of infectious syphilis rediagnosis in British Columbia 1995\u20132005","volume":"48","author":"Ogilvie","year":"2009","journal-title":"Clin Infect Dis"},{"key":"2023020412073213900_ofad017-B13","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1186\/s12879-019-4269-8","article-title":"Early syphilis: risk factors and clinical manifestations focusing on HIV-positive patients","volume":"19","author":"Arando","year":"2019","journal-title":"BMC Infect Dis"},{"key":"2023020412073213900_ofad017-B14","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofaa019","article-title":"Repeated syphilis episodes in HIV-infected men who have sex with men: a multicenter prospective cohort study on risk factors and the potential role of syphilis immunity","volume":"7","author":"Roth","year":"2020","journal-title":"Open Forum Infect Dis"},{"key":"2023020412073213900_ofad017-B15","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/OLQ.0b013e31827763ea","article-title":"Epidemiologic characteristics of an ongoing syphilis epidemic among men who have sex with men, San Francisco","volume":"40","author":"Bernstein","year":"2013","journal-title":"Sex Transm Dis"},{"key":"2023020412073213900_ofad017-B16","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1186\/s12879-017-2332-x","article-title":"The PICASSO cohort: baseline characteristics of a cohort of men who have sex with men and male-to-female transgender women at high risk for syphilis infection in Lima, Peru","volume":"17","author":"Kojima","year":"2017","journal-title":"BMC Infect Dis"},{"key":"2023020412073213900_ofad017-B17","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1071\/SH17118","article-title":"The development of an online risk calculator for the prediction of future syphilis among a high-risk cohort of men who have sex with men and transgender women in Lima, Peru","volume":"15","author":"Allan-Blitz","year":"2018","journal-title":"Sex Health"},{"key":"2023020412073213900_ofad017-B18","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/cid\/ciy182","article-title":"Effects of pre-exposure prophylaxis for the prevention of human immunodeficiency virus infection on sexual risk behavior in men who have sex with men: a systematic review and meta-analysis","volume":"67","author":"Traeger","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2023020412073213900_ofad017-B19","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.30806","article-title":"Comparison of trends in rates of sexually transmitted infections before vs after initiation of HIV preexposure prophylaxis among men who have sex with men","volume":"3","author":"McManus","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2023020412073213900_ofad017-B20","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2019.17134","article-title":"Global epidemiologic characteristics of sexually transmitted infections among individuals using preexposure prophylaxis for the prevention of HIV infection: a systematic review and meta-analysis","volume":"2","author":"Ong","year":"2019","journal-title":"JAMA Netw Open"},{"key":"2023020412073213900_ofad017-B21","author":"Communicable Diseases Network"},{"key":"2023020412073213900_ofad017-B22","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1097\/OLQ.0000000000000553","article-title":"Increased detection of pharyngeal and rectal gonorrhea in men who have sex with men after transition from culture to nucleic acid amplification testing","volume":"44","author":"Cornelisse","year":"2017","journal-title":"Sex Transm Dis"},{"key":"2023020412073213900_ofad017-B23","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1093\/oxfordjournals.aje.a116813","article-title":"Simulation study of confounder-selection strategies","volume":"138","author":"Maldonado","year":"1993","journal-title":"Am J Epidemiol"},{"key":"2023020412073213900_ofad017-B24","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1038\/sj.bjc.6601119","article-title":"Survival analysis part II: multivariate data analysis\u2013an introduction to concepts and methods","volume":"89","author":"Bradburn","year":"2003","journal-title":"Br J Cancer"},{"key":"2023020412073213900_ofad017-B25","author":"Centers for Disease Control and Prevention, (CDC)"},{"key":"2023020412073213900_ofad017-B26","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1177\/09564624221125079","article-title":"Incidence and risk factors for syphilis infection among men who have sex with men: a cohort study from an urban sexual health clinic in Jakarta, Indonesia","volume":"33","author":"Kawi","year":"2022","journal-title":"Int J STD AIDS"},{"key":"2023020412073213900_ofad017-B27","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1097\/QAI.0000000000002231","article-title":"Brief report: sexual mixing patterns by HIV status and PrEP use among men who have sex with men partnerships in Melbourne 2011\u20132018","volume":"83","author":"Chow","year":"2020","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2023020412073213900_ofad017-B28","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1097\/QAD.0000000000002797","article-title":"Increasing preexposure prophylaxis use and \u2018net prevention coverage\u2019 in behavioural surveillance of Australian gay and bisexual men","volume":"35","author":"Holt","year":"2021","journal-title":"AIDS"},{"key":"2023020412073213900_ofad017-B29","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1001\/jama.2019.2947","article-title":"Association of HIV preexposure prophylaxis with incidence of sexually transmitted infections among individuals at high risk of HIV infection","volume":"321","author":"Traeger","year":"2019","journal-title":"JAMA"},{"key":"2023020412073213900_ofad017-B30","doi-asserted-by":"crossref","first-page":"e934","DOI":"10.1093\/cid\/ciab052","article-title":"Clinical presentation of incident syphilis among men who have sex with men taking HIV Pre-exposure prophylaxis in Melbourne, Australia","volume":"73","author":"Peel","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2023020412073213900_ofad017-B31","doi-asserted-by":"crossref","first-page":"e417","DOI":"10.1016\/S2666-5247(22)00035-0","article-title":"Characterisation of Treponema pallidum lineages within the contemporary syphilis outbreak in Australia: a genomic epidemiological analysis","volume":"3","author":"Taouk","year":"2022","journal-title":"Lancet Microbe"},{"key":"2023020412073213900_ofad017-B32","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1097\/OLQ.0b013e318238b85d","article-title":"Will changes in gay men's sexual behavior reduce syphilis rates?","volume":"38","author":"Gray","year":"2011","journal-title":"Sex Transm Dis"},{"key":"2023020412073213900_ofad017-B33","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1097\/OLQ.0b013e318238b846","article-title":"Would gay men change their sexual behavior to reduce syphilis rates?","volume":"38","author":"McCann","year":"2011","journal-title":"Sex Transm Dis"},{"key":"2023020412073213900_ofad017-B34","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1097\/OLQ.0b013e3181ca3c0a","article-title":"Frequent testing of highly sexually active gay men is required to control syphilis","volume":"37","author":"Gray","year":"2010","journal-title":"Sex Transm Dis"},{"key":"2023020412073213900_ofad017-B35","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1136\/sextrans-2020-054592","article-title":"Factors associated with reporting antibiotic use as STI prophylaxis among HIV PrEP users: findings from a cross-sectional online community survey, May\u2013July 2019, UK","volume":"97","author":"O'Halloran","year":"2021","journal-title":"Sex Transm Infect"},{"key":"2023020412073213900_ofad017-B36","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1136\/sextrans-2022-055425","article-title":"BASHH Updated position statement on doxycycline as prophylaxis for sexually transmitted infections","volume":"98","author":"Kohli","year":"2022","journal-title":"Sex Transm Infect"},{"key":"2023020412073213900_ofad017-B37","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1093\/cid\/ciac056","article-title":"Detection of Treponema pallidum DNA during early syphilis stages in peripheral blood, oropharynx, ano-rectum and urine as a proxy for transmissibility","volume":"75","author":"Nieuwenburg","year":"2022","journal-title":"Clin Infect Dis"},{"key":"2023020412073213900_ofad017-B38","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1186\/s12879-021-06686-4","article-title":"Exploring the attitudes of men who have sex with men on anal self-examination for early detection of primary anorectal syphilis: a qualitative study","volume":"21","author":"Aung","year":"2021","journal-title":"BMC Infect Dis"},{"key":"2023020412073213900_ofad017-B39","doi-asserted-by":"crossref","DOI":"10.1128\/JCM.00572-19","article-title":"Treponema pallidum nucleic acid amplification testing to augment syphilis screening among men who have sex with men","volume":"57","author":"Golden","year":"2019","journal-title":"J Clin Microbiol"},{"key":"2023020412073213900_ofad017-B40","doi-asserted-by":"crossref","first-page":"941041","DOI":"10.3389\/fmed.2022.941041","article-title":"Adherence to weekly anal self-examination among men who have sex with men for detection of anal syphilis","volume":"9","author":"Aung","year":"2022","journal-title":"Front Med (Lausanne)"},{"key":"2023020412073213900_ofad017-B41","doi-asserted-by":"crossref","first-page":"8962","DOI":"10.1038\/s41598-022-12881-3","article-title":"A cross-sectional survey on attitudes of men who have sex with men towards anal self-examination for detection of anal syphilis","volume":"12","author":"Aung","year":"2022","journal-title":"Sci Rep"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofad017\/48652425\/ofad017.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/10\/2\/ofad017\/49090125\/ofad017.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/10\/2\/ofad017\/49090125\/ofad017.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,4]],"date-time":"2023-02-04T12:08:23Z","timestamp":1675512503000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofad017\/6986302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,12]]},"references-count":41,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofad017","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,2,1]]},"published":{"date-parts":[[2023,1,12]]},"article-number":"ofad017"}}