{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T16:04:16Z","timestamp":1789142656137,"version":"build-2803163510"},"reference-count":30,"publisher":"BMJ","issue":"4","funder":[{"name":"NIH grant","award":["P30MH062294"],"award-info":[{"award-number":["P30MH062294"]}]},{"name":"Beijing Education Commission","award":["KM201810025009"],"award-info":[{"award-number":["KM201810025009"]}]},{"name":"Natural Science Fund Commission of China","award":["H2609\/81673232"],"award-info":[{"award-number":["H2609\/81673232"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2019,2,11]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We investigated syphilis prevalence among men who have sex with men (MSM) in China, as well as potential risk factors. Our principal hypothesis was that syphilis would be associated with the use of recreational drugs such as methamphetamines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From April to October 2013, we used several methods to recruit MSM in Qingdao, collecting demographic\/behavioural information via self-administrated questionnaires. Trained health workers collected blood for the<jats:italic>Treponema pallidum<\/jats:italic>particle assay (TPPA) with positives confirmed by a toluidine red unheated serum test. We used an unmatched case\u2013control study to identify factors that might predict syphilis infection using multivariable logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We recruited 447 MSM who agreed to participate and who completed syphilis testing. Of 71 (15.9%) syphilis-positive MSM, 44 (62.0%) used drugs. Of 376 (84.1%) syphilis-negative MSM, 186 (49.5%) used drugs. We found a positive association with syphilis for any recreational drug use (crude OR (cOR) 1.7, 95 % CI 1.0 to 2.8), frequent methamphetamine use (cOR 2.4, 95%\u2009CI 1.1 to 5.3) and multiple drug use (adjusted OR (aOR) 3.4, 95%\u2009CI 1.3 to 9.2). Syphilis-positive men were more likely to have a higher physical depression score (aOR 5.2, 95%\u2009CI 1.1 to 24.4), be &gt; 30 years old (aOR 2.7, 95%\u2009CI 1.5 to 4.8), report a prior STI (aOR 4.1, 95%\u2009CI 2.3 to 7.3) and report a sex party experience (aOR 2.2, 95%\u2009CI 1.1 to 4.4).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Recreational drug use, depression and high-risk sexual behaviours were associated with syphilis infection among MSM in China. Only a multifaceted approach is likely be effective in control of both syphilis and HIV .<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2018-053878","type":"journal-article","created":{"date-parts":[[2019,3,6]],"date-time":"2019-03-06T22:20:35Z","timestamp":1551910835000},"page":"267-272","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Syphilis associated with recreational drug use, depression and high-risk sexual behaviour in men who have sex with men: a case\u2013control study in China"],"prefix":"10.1136","volume":"95","author":[{"given":"Huichao","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuizhen","family":"Xiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojing","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menglong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenhong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiufang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sten H","family":"Vermund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4611-2206","authenticated-orcid":false,"given":"Yifei","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,3,6]]},"reference":[{"key":"2024092304500969000_95.4.267.1","first-page":"1510","article-title":"Holmes KK: update on syphilis","volume":"11","author":"Golden","year":"2016","journal-title":"J Am Med Assoc"},{"key":"2024092304500969000_95.4.267.2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0126320","article-title":"Club drugs and HIV\/STD infection: an exploratory analysis among men who have sex with men in Changsha, China","volume":"10","author":"Chen","year":"2015","journal-title":"PLoS One"},{"key":"2024092304500969000_95.4.267.3","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/j.xphs.2016.09.023","article-title":"Gap analysis for Chinese drug control Institutes to achieve the Standards of world Health organization medicine prequalification","volume":"106","author":"Mao","year":"2017","journal-title":"J Pharm Sci"},{"key":"2024092304500969000_95.4.267.4","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.drugalcdep.2017.09.004","article-title":"Recreational drug use and risk of HIV infection among men who have sex with men: a cross-sectional study in Shenzhen, China","volume":"181","author":"Duan","year":"2017","journal-title":"Drug Alcohol Depend"},{"key":"2024092304500969000_95.4.267.5","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1007\/s10461-016-1477-8","article-title":"Relationship of stigma and depression among newly HIV-Diagnosed Chinese men who have sex with men","volume":"21","author":"Tao","year":"2017","journal-title":"AIDS Behav"},{"key":"2024092304500969000_95.4.267.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0050762","article-title":"Elevated 12-month and lifetime prevalence and comorbidity rates of mood, anxiety, and alcohol use disorders in Chinese men who have sex with men","volume":"8","author":"Yu","year":"2013","journal-title":"PLoS One"},{"key":"2024092304500969000_95.4.267.7","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.drugpo.2018.04.005","article-title":"Ice parties among young men who have sex with men in Thailand: Pleasures, secrecy and risks","volume":"55","author":"Guadamuz","year":"2018","journal-title":"Int J Drug Policy"},{"key":"2024092304500969000_95.4.267.8","doi-asserted-by":"crossref","first-page":"e22","DOI":"10.1016\/S2352-3018(14)70001-3","article-title":"Recreational drug use, polydrug use, and sexual behaviour in HIV-diagnosed men who have sex with men in the UK: results from the cross-sectional ASTRA study","volume":"1","author":"Daskalopoulou","year":"2014","journal-title":"Lancet HIV"},{"key":"2024092304500969000_95.4.267.9","doi-asserted-by":"crossref","unstructured":"Nassereddine H . 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