Resum
Background: The syphilis epidemic continues to cause substantial morbidity
worldwide and isworsening despite ongoing control efforts. Syphilis
remains an important public health problem among 3 key populations:
men who have sex with men (MSM), transgender women, and female
sex workers.
Methods: We conducted a retrospective chart review of patients that received
rapid point-of-care treponemal antibody tests from January 2019
to July 2019 in 4 sexually transmitted infection (STI) clinics in Lima, Peru. We assessed patient medical records for human immunodeficiency virus (HIV) infection, history of STIs, as well as sociodemographic and behavioral
characteristics. Cross-sectional descriptive analyses were used to determine factors associated with treponemal positivity. Results: We included 401 patient records in our analyses: 252 MSM, 31 transgenderwomen, and 118 female sexworkers. The overallmedian age of patients
was 29.0 years (interquartile range, 24.0–36.0 years). Positivity on the treponemal testwas 28.9% (95% confidence interval [CI], 24.3%–33.3% overall,
37.7% (95% CI, 31.7%–44.0%) for MSM, 54.8% (95% CI, 36.0%–72.7%) for transgender women, and 3.4% (95% CI, 0.9%–8.5%) for female sex workers. In the bivariate analysis, treponemal positivity was also associated
with receptive anal sex in the last 6 months in MSM (P < 0.01). Additionally, treponemal positivity increased with age (P = 0.0212) and varied by
socioeconomic status (P < 0.01). Multivariate Least Absolute Shrinkage
and Selection Operator logistic regression showed that treponemal positivity
was highly associated with HIV coinfection (adjusted odds ratio, 5.42) and
previous STI other than HIVor syphilis (adjusted odds ratio, 1.54).
Conclusions: A review of the medical records of members of 3 key populations
who had recently received a rapid point-of-care treponemal test in
Lima, Peru, revealed that lifetime prevalence of syphilis was high among
MSM and transgender women, but low among female sex workers. Those
results may indicate a need for more frequent, regular testing among MSM
and transgender women—possibly in conjunction with HIV testing, and
appropriate treatment of those shown to be positive.