{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:42:12Z","timestamp":1777927332765,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"14","license":[{"start":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T00:00:00Z","timestamp":1601424000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:p>\n                    The characteristics and serological responses of primary syphilis are not completely understood. We aimed to describe the characteristics, the serological responses and presumptive treatment of primary syphilis in HIV-positive and -negative men who have sex with men (MSM). We conducted a retrospective review of microbiological and demographic information from MSM presenting with primary syphilis. There were 111 cases of primary syphilis in MSM, the median age was 46 (IQR\u2009=\u200937\u201353years) and 40 (36%) were living with HIV. Fifty percent of MSM presented with painful lesions and 14% with extra-genital lesions. Extra-genital lesions were significantly more likely to be painful than non-genital lesions (OR 4.72; 95%CI\u2009=\u20091.25\u201317.83, p\u2009=\u20090.02). Overall, a reactive serological response demonstrated a sensitivity of 80% (57\/71) compared with\n                    <jats:italic>Treponema pallidum<\/jats:italic>\n                    PCR. Serology was more sensitive in MSM with no previous syphilis (OR\u2009=\u20093.38, 95%CI\u2009=\u20091.00\u201311.43, p\u2009&lt;\u20090.05). MSM presenting with painless lesions were more likely to be treated presumptively (OR\u2009=\u20093.39, 95%CI\u2009=\u20091.38\u20138.33, p\u2009&lt;\u20090.002). There were no differences in the characteristics, serological responses or management according to HIV status. Fifty percent of MSM with primary syphilis presented with painful lesions; extra-genital lesions are more likely to be painful than genital lesions, serology is positive in 80% and there were no differences between HIV-positive and -negative MSM. Understanding the characteristics of primary syphilis will underpin public health campaigns.\n                  <\/jats:p>","DOI":"10.1177\/0956462420956859","type":"journal-article","created":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T08:48:42Z","timestamp":1601455722000},"page":"1359-1363","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Primary syphilis lesion characteristics, serological response and management in HIV-positive and HIV-negative men who have sex with men"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0955-6307","authenticated-orcid":false,"given":"Daniel","family":"Richardson","sequence":"first","affiliation":[{"name":"Brighton &amp; Sussex University NHS Trust, Brighton, UK"},{"name":"Brighton &amp; Sussex Medical School, Brighton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5764-5860","authenticated-orcid":false,"given":"Colin","family":"Fitzpatrick","sequence":"additional","affiliation":[{"name":"Brighton &amp; Sussex University NHS Trust, Brighton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Devlin","sequence":"additional","affiliation":[{"name":"Brighton &amp; Sussex University NHS Trust, Brighton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe","family":"Buss","sequence":"additional","affiliation":[{"name":"Brighton &amp; Sussex University NHS Trust, Brighton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke","family":"Parkes","sequence":"additional","affiliation":[{"name":"Brighton &amp; Sussex University NHS Trust, Brighton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Williams","sequence":"additional","affiliation":[{"name":"Brighton &amp; Sussex University NHS Trust, Brighton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,9,30]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"Addressing the increase in syphilis in England: PHE Action Plan https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/806076\/Addressing_the_increase_in_syphilis_in_England_Action_Plan_June_2019.pdf (2019 accessed 6 May 2020)."},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0956462415595323"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.19.1.29-49.2006"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2015-052219"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2020-054495"},{"key":"e_1_3_4_7_2","first-page":"129","article-title":"Syphilis serology in patients with primary syphilis and non treponemal sexually transmitted diseases in South Africa","volume":"67","author":"Sischy A","year":"1991","unstructured":"Sischy A, da L\u2019Exposto F, Dangor Y, et\u00a0al. Syphilis serology in patients with primary syphilis and non treponemal sexually transmitted diseases in South Africa. Genitourin Med 1991; 67: 129\u2013132.","journal-title":"Genitourin Med"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0956462415624059"},{"key":"e_1_3_4_9_2","unstructured":"Centre for Disease Control. 2015 STD treatment guidelines: syphilis www.cdc.gov\/std\/tg2015\/syphilis.htm (accessed 14 July 2020)."},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1258\/ijsa.2008.008254"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12736"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2019-054253"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-200108000-00004"}],"container-title":["International Journal of STD &amp; AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0956462420956859","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0956462420956859","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0956462420956859","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:41:14Z","timestamp":1777675274000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0956462420956859"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,30]]},"references-count":12,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1177\/0956462420956859"],"URL":"https:\/\/doi.org\/10.1177\/0956462420956859","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,30]]}}}