Sexual Risk Behaviors Among Persons Diagnosed With Primary and Secondary Syphilis Who Reported High-Risk Substance Use: Data From the National Notifiable Diseases Surveillance System, 2018.


Journal

Sexually transmitted diseases
ISSN: 1537-4521
Titre abrégé: Sex Transm Dis
Pays: United States
ID NLM: 7705941

Informations de publication

Date de publication:
01 02 2022
Historique:
pubmed: 4 9 2021
medline: 18 3 2022
entrez: 3 9 2021
Statut: ppublish

Résumé

Recent increases in high-risk substance use (HRSU; i.e., injection drug use, heroin, methamphetamine, crack/cocaine) have coincided with rising primary and secondary (P&S) syphilis rates. To further understand these trends, we examined sexual risk behaviors among women, men who have sex with women only (MSW), and men who have sex with men (MSM) who were diagnosed with P&S syphilis in 2018 and reported HRSU. Data on HRSU and sexual risk behaviors among persons with P&S syphilis were drawn from syphilis case reports in 2018 from the National Notifiable Diseases Surveillance System. Persons with P&S syphilis were asked about sexual risk behaviors in the past 12 months including exchange sex for drugs/money, sex while intoxicated and/or high on drugs, sex with a person who injects drugs (PWID), sex with an anonymous partner, and number of sex partners. We describe percentages and adjusted prevalence ratios (aPRs) for women, MSW, and MSM reporting these behaviors by age, race/Hispanic ethnicity, type of drug used, and incarceration history (both in the past 12 months). Among 19,634 persons diagnosed with P&S syphilis in 2018 with information on HRSU, 29.3% of women, 22.7% of MSW, and 12.4% of MSM reported HRSU. Among those reporting HRSU, percentages reporting exchange sex ranged from 17% to 35% (highest for women), whereas reports of anonymous sex ranged from 44% to 71% (highest for MSM). In this population, sexual risk behaviors were more commonly reported among those with a recent incarceration history than those without such history. Among those reporting injection drug use or heroin use, percentages reporting sex with a PWID ranged from 51% to 77%. In adjusted models, HRSU was significantly associated with one or more sexual risk behaviors for women (aPR, 2.63 [95% confidence interval {CI}, 2.39-2.90]; MSW: aPR, 1.38 [95% CI, 1.31-1.46]; and MSM: aPR, 1.30 [95% CI, 1.26-1.34]). Collaborative partnerships across the US public health system could help address barriers to timely clinical care among persons diagnosed with P&S syphilis who report HRSU.

Sections du résumé

BACKGROUND
Recent increases in high-risk substance use (HRSU; i.e., injection drug use, heroin, methamphetamine, crack/cocaine) have coincided with rising primary and secondary (P&S) syphilis rates. To further understand these trends, we examined sexual risk behaviors among women, men who have sex with women only (MSW), and men who have sex with men (MSM) who were diagnosed with P&S syphilis in 2018 and reported HRSU.
METHODS
Data on HRSU and sexual risk behaviors among persons with P&S syphilis were drawn from syphilis case reports in 2018 from the National Notifiable Diseases Surveillance System. Persons with P&S syphilis were asked about sexual risk behaviors in the past 12 months including exchange sex for drugs/money, sex while intoxicated and/or high on drugs, sex with a person who injects drugs (PWID), sex with an anonymous partner, and number of sex partners. We describe percentages and adjusted prevalence ratios (aPRs) for women, MSW, and MSM reporting these behaviors by age, race/Hispanic ethnicity, type of drug used, and incarceration history (both in the past 12 months).
RESULTS
Among 19,634 persons diagnosed with P&S syphilis in 2018 with information on HRSU, 29.3% of women, 22.7% of MSW, and 12.4% of MSM reported HRSU. Among those reporting HRSU, percentages reporting exchange sex ranged from 17% to 35% (highest for women), whereas reports of anonymous sex ranged from 44% to 71% (highest for MSM). In this population, sexual risk behaviors were more commonly reported among those with a recent incarceration history than those without such history. Among those reporting injection drug use or heroin use, percentages reporting sex with a PWID ranged from 51% to 77%. In adjusted models, HRSU was significantly associated with one or more sexual risk behaviors for women (aPR, 2.63 [95% confidence interval {CI}, 2.39-2.90]; MSW: aPR, 1.38 [95% CI, 1.31-1.46]; and MSM: aPR, 1.30 [95% CI, 1.26-1.34]).
CONCLUSIONS
Collaborative partnerships across the US public health system could help address barriers to timely clinical care among persons diagnosed with P&S syphilis who report HRSU.

Identifiants

pubmed: 34475356
doi: 10.1097/OLQ.0000000000001546
pii: 00007435-202202000-00002
pmc: PMC10262692
mid: NIHMS1902421
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

99-104

Subventions

Organisme : Intramural CDC HHS
ID : CC999999
Pays : United States

Informations de copyright

Copyright © 2021 American Sexually Transmitted Diseases Association. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of Interest and Sources of Funding: None declared.

Références

Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2018. Atlanta, GA: U.S. Department of Health and Human Services, 2019.
Centers for Disease Control and Prevention. Syphilis Surveillance Supplemental Slides, 2014–2018: Technical Notes. Atlanta, GA: U.S. Department of Health and Human Services, 2020.
Zule WA, Costenbader EC, Meyer WJ, et al. Methamphetamine use and risky sexual behaviors during heterosexual encounters. Sex Transm Dis 2007; 34:689–694.
Khan MR, Berger A, Hemberg J, et al. Non-injection and injection drug use and STI/HIV risk in the United States: The degree to which sexual risk behaviors versus sex with an STI-infected partner account for infection transmission among drug users. AIDS Behav 2013; 17:1185–1194.
Walters SM, Reilly KH, Neaigus A, et al. Awareness of pre-exposure prophylaxis (PrEP) among women who inject drugs in NYC: The importance of networks and syringe exchange programs for HIV prevention. Harm Reduct J 2017; 14:40.
Kuyper LM, Lampinen TM, Li K, et al. Factors associated with sex trade involvement among male participants in a prospective study of injection drug users. Sex Transm Infect 2004; 80:531–535.
Wise A, Finlayson T, Nerlander L, et al. Incarceration, sexual risk-related behaviors and HIV infection among women at increased risk of HIV infection, 20 United States cities. J Acquir Immune Defic Syndr 2017; 75:S261–S267.
Hogben M, Leichliter JS. Social determinants and sexually transmitted disease disparities. Sex Transm Dis 2008; 35(12 Suppl):S13–S18.
Reno H, Fox B, Highfill C, et al. The emerging intersection between injection drug use and early syphilis in nonurban areas of Missouri, 2012–2018. J Infect Dis 2020; 222(Suppl 5):S465–S470.
Centers for Disease Control and Prevention. HIV Infection Risk, Prevention, and Testing Behaviors among Persons Who Inject Drugs—National HIV Behavioral Surveillance: Injection Drug Use, 23 U.S. Cities, 2018. HIV Surveillance Special Report 24. Available at: http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html . Published February 2020. Accessed June 8, 2021.
Brookmeyer KA, Haderxhanaj LT, Hogben M, et al. Sexual risk behaviors and STDs among persons who inject drugs: A national study. Prev Med 2019; 126:105779.
Centers for Disease Control and Prevention. National Notifiable Diseases Surveillance System (NNDSS). Available at: https://wwwn.cdc.gov/nndss/ . Accessed June 8, 2021.
Kidd SE, Grey JA, Torrone EA, et al. Increased methamphetamine, injection drug, and heroin use among women and heterosexual men with primary and secondary syphilis—United States, 2013–2017. MMWR Morb Mortal Wkly Rep 2019; 68:144–148.
German D, Latkin CA. Social stability and HIV risk behavior: Evaluating the role of accumulated vulnerability. AIDS Behav 2012; 16:168–178.
Valentine JA, Bolan GA. Syphilis elimination: Lessons learned again. Sex Transm Dis 2018; 45(9S Suppl 1):S80–S85.
Jenness SM, Neaigus A, Hagan H, et al. Heterosexual HIV and sexual partnerships between injection drug users and noninjection drug users. AIDS Patient Care STDS 2010; 24:175–181.
Ibragimov U, Beane S, Friedman SR, et al. Evidence for HIV transmission across key populations: A longitudinal analysis of HIV and AIDS rates among Black people who inject drugs and Black heterosexuals in 84 large U.S. metropolitan areas, 2008–2016. Ann Epidemiol 2021; 55:69–77.e5.
Khan MR, Epperson MW, Mateu-Gelabert P, et al. Incarceration, sex with an STI- or HIV-infected partner and infection with an STI or HIV in Bushwick, Brooklyn, NY: A social network perspective. Am J Public Health 2011; 101:1110–1117.
Abara WE, Zlotorzynska M, Kirkcaldy RD, et al. Bacterial sexually transmitted infection testing and diagnoses among men who have sex with men and report prescription opioid misuse—American Men’s Internet Survey, 2017–2018. Ann Epidemiol 2021; 58:1–6.
U.S. Department of Health and Human Services. Sexually Transmitted Infections National Strategic Plan for the United States: 2021–2025. Washington, DC: U.S. Department of Health and Human Services, 2020.
Stevens R, Icard L, Jemmott JB, et al. Risky trade: Individual and neighborhood-level socio-demographics associated with transactional sex among urban African American MSM. J Urban Health 2017; 94:676–682.
Strathdee SA, Bristow CC, Gaines T, et al. Collateral damage: A narrative review on epidemics of substance use disorders and their relationships to sexually transmitted infections in the United States. Sex Transm Dis 2021; 48:466–473.

Auteurs

Casey E Copen (CE)

From the Division of STD Prevention, National Center for HIV/AIDS, Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention, Centers for Disease Control and Prevention, Atlanta, GA.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH