Infectious syphilis in women and heterosexual men in major Australian cities: sentinel surveillance data, 2011–2019
Objectives To examine changes in the positive infectious syphilis test rate among women and heterosexual men in major Australian cities, and rate differences by social, biomedical, and behavioural determinants of health. Design, setting Analysis of data extracted from de‐identified patient records f...
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| Veröffentlicht in: | Medical journal of Australia 2023-03, Vol.218 (5), p.223-228 |
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| creator | Carter, Allison McManus, Hamish Ward, James S Vickers, Tobias Asselin, Jason Baillie, Greta Chow, Eric PF Chen, Marcus Y Fairley, Christopher K Bourne, Christopher McNulty, Anna Read, Phillip Heath, Kevin Ryder, Nathan McCloskey, Jenny Carmody, Christopher McCormack, Heather Alexander, Kate Casey, Dawn Stoove, Mark Hellard, Margaret E Donovan, Basil Guy, Rebecca J |
| description | Objectives
To examine changes in the positive infectious syphilis test rate among women and heterosexual men in major Australian cities, and rate differences by social, biomedical, and behavioural determinants of health.
Design, setting
Analysis of data extracted from de‐identified patient records from 34 sexual health clinics participating in the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of Sexually Transmissible Infections and Blood Borne Viruses (ACCESS).
Participants
First tests during calendar year for women and heterosexual men aged 15 years or more in major cities who attended ACCESS sexual health clinics during 2011–2019.
Main outcome measures
Positive infectious syphilis test rate; change in annual positive test rate.
Results
180 of 52 221 tested women (0.34%) and 239 of 36 341 heterosexual men (0.66%) were diagnosed with infectious syphilis. The positive test rate for women was 1.8 (95% confidence interval [CI], 0.9–3.2) per 1000 tests in 2011, 3.0 (95% CI, 2.0–4.2) per 1000 tests in 2019 (change per year: rate ratio [RR], 1.12; 95% CI, 1.01–1.25); for heterosexual men it was 6.1 (95% CI, 3.8–9.2) per 1000 tests in 2011 and 7.6 (95% CI, 5.6–10) per 1000 tests in 2019 (RR, 1.10; 95% CI, 1.03–1.17). In multivariable analyses, the positive test rate was higher for women (adjusted RR [aRR], 1.85; 95% CI, 1.34–2.55) and heterosexual men (aRR, 2.39; 95% CI, 1.53–3.74) in areas of greatest socio‐economic disadvantage than for those in areas of least socio‐economic disadvantage. It was also higher for Indigenous women (aRR, 2.39; 95% CI, 1.22–4.70) and for women who reported recent injection drug use (aRR, 4.87; 95% CI, 2.18–10.9) than for other women; it was lower for bisexual than heterosexual women (aRR, 0.48; 95% CI, 0.29–0.81) and for women who reported recent sex work (aRR, 0.35; 95% CI, 0.29–0.44). The positive test rate was higher for heterosexual men aged 40–49 years (aRR, 2.11; 95% CI, 1.42–3.12) or more than 50 years (aRR, 2.36; 95% CI, 1.53–3.65) than for those aged 15–29 years.
Conclusion
The positive test rate among both urban women and heterosexual men tested was higher in 2019 than in 2011. People who attend reproductive health or alcohol and drug services should be routinely screened for syphilis. |
| doi_str_mv | 10.5694/mja2.51864 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10952992</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2781214467</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4214-d7eb9fbd4600c331e1e1bebff89e1c23c82f18d1099f1f837ee28cfdc65996913</originalsourceid><addsrcrecordid>eNp9kU1u2zAQhYkiQe0k3fQAAZdBUaUiKYlkN4FhNH9wkU0CdEdQ1DCmIVGuKNn1LnfIDXuS0nEaJJuAiwE5H948zkPoM0lP80Jm35qFpqc5EUX2AY0Jo0WSM8730DhNaZ5wKn-N0EEIi3glOeUf0YgVIs-Y4GM0XHkLpnftEHDYLOeudgE7j9dtAx5rX-E59NC1Af4Musbbx9ht9KLt8GQIfadrpz02rncQvuMAvnceahyGbgWurrU3gCvd66-YpoT8fXiMRR6hfavrAJ-e6yG6O_9xO71MZjcXV9PJLDEZJVlScSilLausSFPDGIF4SiitFRKIocwIaomoSCqlJVYwDkCFsZUpcikLSdghOtvpLoeygcpEd9GwWnau0d1Gtdqptx3v5uq-XakomVMpaVQ4eVbo2t8DhF41LhjYfgzizhTlgkSrWcEj-mWHmriu0IF9mUNStQ1KbYNST0FF-Pi1sxf0fzIRIDtg7WrYvCOlfl5P6E70H94joLo</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2781214467</pqid></control><display><type>article</type><title>Infectious syphilis in women and heterosexual men in major Australian cities: sentinel surveillance data, 2011–2019</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Carter, Allison ; McManus, Hamish ; Ward, James S ; Vickers, Tobias ; Asselin, Jason ; Baillie, Greta ; Chow, Eric PF ; Chen, Marcus Y ; Fairley, Christopher K ; Bourne, Christopher ; McNulty, Anna ; Read, Phillip ; Heath, Kevin ; Ryder, Nathan ; McCloskey, Jenny ; Carmody, Christopher ; McCormack, Heather ; Alexander, Kate ; Casey, Dawn ; Stoove, Mark ; Hellard, Margaret E ; Donovan, Basil ; Guy, Rebecca J</creator><creatorcontrib>Carter, Allison ; McManus, Hamish ; Ward, James S ; Vickers, Tobias ; Asselin, Jason ; Baillie, Greta ; Chow, Eric PF ; Chen, Marcus Y ; Fairley, Christopher K ; Bourne, Christopher ; McNulty, Anna ; Read, Phillip ; Heath, Kevin ; Ryder, Nathan ; McCloskey, Jenny ; Carmody, Christopher ; McCormack, Heather ; Alexander, Kate ; Casey, Dawn ; Stoove, Mark ; Hellard, Margaret E ; Donovan, Basil ; Guy, Rebecca J</creatorcontrib><description>Objectives
To examine changes in the positive infectious syphilis test rate among women and heterosexual men in major Australian cities, and rate differences by social, biomedical, and behavioural determinants of health.
Design, setting
Analysis of data extracted from de‐identified patient records from 34 sexual health clinics participating in the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of Sexually Transmissible Infections and Blood Borne Viruses (ACCESS).
Participants
First tests during calendar year for women and heterosexual men aged 15 years or more in major cities who attended ACCESS sexual health clinics during 2011–2019.
Main outcome measures
Positive infectious syphilis test rate; change in annual positive test rate.
Results
180 of 52 221 tested women (0.34%) and 239 of 36 341 heterosexual men (0.66%) were diagnosed with infectious syphilis. The positive test rate for women was 1.8 (95% confidence interval [CI], 0.9–3.2) per 1000 tests in 2011, 3.0 (95% CI, 2.0–4.2) per 1000 tests in 2019 (change per year: rate ratio [RR], 1.12; 95% CI, 1.01–1.25); for heterosexual men it was 6.1 (95% CI, 3.8–9.2) per 1000 tests in 2011 and 7.6 (95% CI, 5.6–10) per 1000 tests in 2019 (RR, 1.10; 95% CI, 1.03–1.17). In multivariable analyses, the positive test rate was higher for women (adjusted RR [aRR], 1.85; 95% CI, 1.34–2.55) and heterosexual men (aRR, 2.39; 95% CI, 1.53–3.74) in areas of greatest socio‐economic disadvantage than for those in areas of least socio‐economic disadvantage. It was also higher for Indigenous women (aRR, 2.39; 95% CI, 1.22–4.70) and for women who reported recent injection drug use (aRR, 4.87; 95% CI, 2.18–10.9) than for other women; it was lower for bisexual than heterosexual women (aRR, 0.48; 95% CI, 0.29–0.81) and for women who reported recent sex work (aRR, 0.35; 95% CI, 0.29–0.44). The positive test rate was higher for heterosexual men aged 40–49 years (aRR, 2.11; 95% CI, 1.42–3.12) or more than 50 years (aRR, 2.36; 95% CI, 1.53–3.65) than for those aged 15–29 years.
Conclusion
The positive test rate among both urban women and heterosexual men tested was higher in 2019 than in 2011. People who attend reproductive health or alcohol and drug services should be routinely screened for syphilis.</description><identifier>ISSN: 0025-729X</identifier><identifier>EISSN: 1326-5377</identifier><identifier>DOI: 10.5694/mja2.51864</identifier><identifier>PMID: 36854387</identifier><language>eng</language><publisher>Australia: John Wiley and Sons Inc</publisher><subject>Australia - epidemiology ; Cities ; Female ; Gender identity ; Heterosexuality ; HIV Infections - epidemiology ; Humans ; Infectious Diseases ; Male ; Research and Reviews ; Sentinel Surveillance ; Sexual Behavior ; Sexual Health ; Sexually transmitted diseases ; Sexually Transmitted Diseases - epidemiology ; Syphilis - diagnosis ; Syphilis - epidemiology</subject><ispartof>Medical journal of Australia, 2023-03, Vol.218 (5), p.223-228</ispartof><rights>2023 The Authors. published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.</rights><rights>2023 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4214-d7eb9fbd4600c331e1e1bebff89e1c23c82f18d1099f1f837ee28cfdc65996913</citedby><cites>FETCH-LOGICAL-c4214-d7eb9fbd4600c331e1e1bebff89e1c23c82f18d1099f1f837ee28cfdc65996913</cites><orcidid>0000-0002-9544-6798 ; 0000-0002-5055-3266 ; 0000-0003-2151-2622 ; 0000-0003-1766-0657</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.5694%2Fmja2.51864$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.5694%2Fmja2.51864$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36854387$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Carter, Allison</creatorcontrib><creatorcontrib>McManus, Hamish</creatorcontrib><creatorcontrib>Ward, James S</creatorcontrib><creatorcontrib>Vickers, Tobias</creatorcontrib><creatorcontrib>Asselin, Jason</creatorcontrib><creatorcontrib>Baillie, Greta</creatorcontrib><creatorcontrib>Chow, Eric PF</creatorcontrib><creatorcontrib>Chen, Marcus Y</creatorcontrib><creatorcontrib>Fairley, Christopher K</creatorcontrib><creatorcontrib>Bourne, Christopher</creatorcontrib><creatorcontrib>McNulty, Anna</creatorcontrib><creatorcontrib>Read, Phillip</creatorcontrib><creatorcontrib>Heath, Kevin</creatorcontrib><creatorcontrib>Ryder, Nathan</creatorcontrib><creatorcontrib>McCloskey, Jenny</creatorcontrib><creatorcontrib>Carmody, Christopher</creatorcontrib><creatorcontrib>McCormack, Heather</creatorcontrib><creatorcontrib>Alexander, Kate</creatorcontrib><creatorcontrib>Casey, Dawn</creatorcontrib><creatorcontrib>Stoove, Mark</creatorcontrib><creatorcontrib>Hellard, Margaret E</creatorcontrib><creatorcontrib>Donovan, Basil</creatorcontrib><creatorcontrib>Guy, Rebecca J</creatorcontrib><title>Infectious syphilis in women and heterosexual men in major Australian cities: sentinel surveillance data, 2011–2019</title><title>Medical journal of Australia</title><addtitle>Med J Aust</addtitle><description>Objectives
To examine changes in the positive infectious syphilis test rate among women and heterosexual men in major Australian cities, and rate differences by social, biomedical, and behavioural determinants of health.
Design, setting
Analysis of data extracted from de‐identified patient records from 34 sexual health clinics participating in the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of Sexually Transmissible Infections and Blood Borne Viruses (ACCESS).
Participants
First tests during calendar year for women and heterosexual men aged 15 years or more in major cities who attended ACCESS sexual health clinics during 2011–2019.
Main outcome measures
Positive infectious syphilis test rate; change in annual positive test rate.
Results
180 of 52 221 tested women (0.34%) and 239 of 36 341 heterosexual men (0.66%) were diagnosed with infectious syphilis. The positive test rate for women was 1.8 (95% confidence interval [CI], 0.9–3.2) per 1000 tests in 2011, 3.0 (95% CI, 2.0–4.2) per 1000 tests in 2019 (change per year: rate ratio [RR], 1.12; 95% CI, 1.01–1.25); for heterosexual men it was 6.1 (95% CI, 3.8–9.2) per 1000 tests in 2011 and 7.6 (95% CI, 5.6–10) per 1000 tests in 2019 (RR, 1.10; 95% CI, 1.03–1.17). In multivariable analyses, the positive test rate was higher for women (adjusted RR [aRR], 1.85; 95% CI, 1.34–2.55) and heterosexual men (aRR, 2.39; 95% CI, 1.53–3.74) in areas of greatest socio‐economic disadvantage than for those in areas of least socio‐economic disadvantage. It was also higher for Indigenous women (aRR, 2.39; 95% CI, 1.22–4.70) and for women who reported recent injection drug use (aRR, 4.87; 95% CI, 2.18–10.9) than for other women; it was lower for bisexual than heterosexual women (aRR, 0.48; 95% CI, 0.29–0.81) and for women who reported recent sex work (aRR, 0.35; 95% CI, 0.29–0.44). The positive test rate was higher for heterosexual men aged 40–49 years (aRR, 2.11; 95% CI, 1.42–3.12) or more than 50 years (aRR, 2.36; 95% CI, 1.53–3.65) than for those aged 15–29 years.
Conclusion
The positive test rate among both urban women and heterosexual men tested was higher in 2019 than in 2011. People who attend reproductive health or alcohol and drug services should be routinely screened for syphilis.</description><subject>Australia - epidemiology</subject><subject>Cities</subject><subject>Female</subject><subject>Gender identity</subject><subject>Heterosexuality</subject><subject>HIV Infections - epidemiology</subject><subject>Humans</subject><subject>Infectious Diseases</subject><subject>Male</subject><subject>Research and Reviews</subject><subject>Sentinel Surveillance</subject><subject>Sexual Behavior</subject><subject>Sexual Health</subject><subject>Sexually transmitted diseases</subject><subject>Sexually Transmitted Diseases - epidemiology</subject><subject>Syphilis - diagnosis</subject><subject>Syphilis - epidemiology</subject><issn>0025-729X</issn><issn>1326-5377</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp9kU1u2zAQhYkiQe0k3fQAAZdBUaUiKYlkN4FhNH9wkU0CdEdQ1DCmIVGuKNn1LnfIDXuS0nEaJJuAiwE5H948zkPoM0lP80Jm35qFpqc5EUX2AY0Jo0WSM8730DhNaZ5wKn-N0EEIi3glOeUf0YgVIs-Y4GM0XHkLpnftEHDYLOeudgE7j9dtAx5rX-E59NC1Af4Musbbx9ht9KLt8GQIfadrpz02rncQvuMAvnceahyGbgWurrU3gCvd66-YpoT8fXiMRR6hfavrAJ-e6yG6O_9xO71MZjcXV9PJLDEZJVlScSilLausSFPDGIF4SiitFRKIocwIaomoSCqlJVYwDkCFsZUpcikLSdghOtvpLoeygcpEd9GwWnau0d1Gtdqptx3v5uq-XakomVMpaVQ4eVbo2t8DhF41LhjYfgzizhTlgkSrWcEj-mWHmriu0IF9mUNStQ1KbYNST0FF-Pi1sxf0fzIRIDtg7WrYvCOlfl5P6E70H94joLo</recordid><startdate>20230320</startdate><enddate>20230320</enddate><creator>Carter, Allison</creator><creator>McManus, Hamish</creator><creator>Ward, James S</creator><creator>Vickers, Tobias</creator><creator>Asselin, Jason</creator><creator>Baillie, Greta</creator><creator>Chow, Eric PF</creator><creator>Chen, Marcus Y</creator><creator>Fairley, Christopher K</creator><creator>Bourne, Christopher</creator><creator>McNulty, Anna</creator><creator>Read, Phillip</creator><creator>Heath, Kevin</creator><creator>Ryder, Nathan</creator><creator>McCloskey, Jenny</creator><creator>Carmody, Christopher</creator><creator>McCormack, Heather</creator><creator>Alexander, Kate</creator><creator>Casey, Dawn</creator><creator>Stoove, Mark</creator><creator>Hellard, Margaret E</creator><creator>Donovan, Basil</creator><creator>Guy, Rebecca J</creator><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9544-6798</orcidid><orcidid>https://orcid.org/0000-0002-5055-3266</orcidid><orcidid>https://orcid.org/0000-0003-2151-2622</orcidid><orcidid>https://orcid.org/0000-0003-1766-0657</orcidid></search><sort><creationdate>20230320</creationdate><title>Infectious syphilis in women and heterosexual men in major Australian cities: sentinel surveillance data, 2011–2019</title><author>Carter, Allison ; McManus, Hamish ; Ward, James S ; Vickers, Tobias ; Asselin, Jason ; Baillie, Greta ; Chow, Eric PF ; Chen, Marcus Y ; Fairley, Christopher K ; Bourne, Christopher ; McNulty, Anna ; Read, Phillip ; Heath, Kevin ; Ryder, Nathan ; McCloskey, Jenny ; Carmody, Christopher ; McCormack, Heather ; Alexander, Kate ; Casey, Dawn ; Stoove, Mark ; Hellard, Margaret E ; Donovan, Basil ; Guy, Rebecca J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4214-d7eb9fbd4600c331e1e1bebff89e1c23c82f18d1099f1f837ee28cfdc65996913</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Australia - epidemiology</topic><topic>Cities</topic><topic>Female</topic><topic>Gender identity</topic><topic>Heterosexuality</topic><topic>HIV Infections - epidemiology</topic><topic>Humans</topic><topic>Infectious Diseases</topic><topic>Male</topic><topic>Research and Reviews</topic><topic>Sentinel Surveillance</topic><topic>Sexual Behavior</topic><topic>Sexual Health</topic><topic>Sexually transmitted diseases</topic><topic>Sexually Transmitted Diseases - epidemiology</topic><topic>Syphilis - diagnosis</topic><topic>Syphilis - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Carter, Allison</creatorcontrib><creatorcontrib>McManus, Hamish</creatorcontrib><creatorcontrib>Ward, James S</creatorcontrib><creatorcontrib>Vickers, Tobias</creatorcontrib><creatorcontrib>Asselin, Jason</creatorcontrib><creatorcontrib>Baillie, Greta</creatorcontrib><creatorcontrib>Chow, Eric PF</creatorcontrib><creatorcontrib>Chen, Marcus Y</creatorcontrib><creatorcontrib>Fairley, Christopher K</creatorcontrib><creatorcontrib>Bourne, Christopher</creatorcontrib><creatorcontrib>McNulty, Anna</creatorcontrib><creatorcontrib>Read, Phillip</creatorcontrib><creatorcontrib>Heath, Kevin</creatorcontrib><creatorcontrib>Ryder, Nathan</creatorcontrib><creatorcontrib>McCloskey, Jenny</creatorcontrib><creatorcontrib>Carmody, Christopher</creatorcontrib><creatorcontrib>McCormack, Heather</creatorcontrib><creatorcontrib>Alexander, Kate</creatorcontrib><creatorcontrib>Casey, Dawn</creatorcontrib><creatorcontrib>Stoove, Mark</creatorcontrib><creatorcontrib>Hellard, Margaret E</creatorcontrib><creatorcontrib>Donovan, Basil</creatorcontrib><creatorcontrib>Guy, Rebecca J</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library (Open Access Collection)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medical journal of Australia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Carter, Allison</au><au>McManus, Hamish</au><au>Ward, James S</au><au>Vickers, Tobias</au><au>Asselin, Jason</au><au>Baillie, Greta</au><au>Chow, Eric PF</au><au>Chen, Marcus Y</au><au>Fairley, Christopher K</au><au>Bourne, Christopher</au><au>McNulty, Anna</au><au>Read, Phillip</au><au>Heath, Kevin</au><au>Ryder, Nathan</au><au>McCloskey, Jenny</au><au>Carmody, Christopher</au><au>McCormack, Heather</au><au>Alexander, Kate</au><au>Casey, Dawn</au><au>Stoove, Mark</au><au>Hellard, Margaret E</au><au>Donovan, Basil</au><au>Guy, Rebecca J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Infectious syphilis in women and heterosexual men in major Australian cities: sentinel surveillance data, 2011–2019</atitle><jtitle>Medical journal of Australia</jtitle><addtitle>Med J Aust</addtitle><date>2023-03-20</date><risdate>2023</risdate><volume>218</volume><issue>5</issue><spage>223</spage><epage>228</epage><pages>223-228</pages><issn>0025-729X</issn><eissn>1326-5377</eissn><abstract>Objectives
To examine changes in the positive infectious syphilis test rate among women and heterosexual men in major Australian cities, and rate differences by social, biomedical, and behavioural determinants of health.
Design, setting
Analysis of data extracted from de‐identified patient records from 34 sexual health clinics participating in the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of Sexually Transmissible Infections and Blood Borne Viruses (ACCESS).
Participants
First tests during calendar year for women and heterosexual men aged 15 years or more in major cities who attended ACCESS sexual health clinics during 2011–2019.
Main outcome measures
Positive infectious syphilis test rate; change in annual positive test rate.
Results
180 of 52 221 tested women (0.34%) and 239 of 36 341 heterosexual men (0.66%) were diagnosed with infectious syphilis. The positive test rate for women was 1.8 (95% confidence interval [CI], 0.9–3.2) per 1000 tests in 2011, 3.0 (95% CI, 2.0–4.2) per 1000 tests in 2019 (change per year: rate ratio [RR], 1.12; 95% CI, 1.01–1.25); for heterosexual men it was 6.1 (95% CI, 3.8–9.2) per 1000 tests in 2011 and 7.6 (95% CI, 5.6–10) per 1000 tests in 2019 (RR, 1.10; 95% CI, 1.03–1.17). In multivariable analyses, the positive test rate was higher for women (adjusted RR [aRR], 1.85; 95% CI, 1.34–2.55) and heterosexual men (aRR, 2.39; 95% CI, 1.53–3.74) in areas of greatest socio‐economic disadvantage than for those in areas of least socio‐economic disadvantage. It was also higher for Indigenous women (aRR, 2.39; 95% CI, 1.22–4.70) and for women who reported recent injection drug use (aRR, 4.87; 95% CI, 2.18–10.9) than for other women; it was lower for bisexual than heterosexual women (aRR, 0.48; 95% CI, 0.29–0.81) and for women who reported recent sex work (aRR, 0.35; 95% CI, 0.29–0.44). The positive test rate was higher for heterosexual men aged 40–49 years (aRR, 2.11; 95% CI, 1.42–3.12) or more than 50 years (aRR, 2.36; 95% CI, 1.53–3.65) than for those aged 15–29 years.
Conclusion
The positive test rate among both urban women and heterosexual men tested was higher in 2019 than in 2011. People who attend reproductive health or alcohol and drug services should be routinely screened for syphilis.</abstract><cop>Australia</cop><pub>John Wiley and Sons Inc</pub><pmid>36854387</pmid><doi>10.5694/mja2.51864</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-9544-6798</orcidid><orcidid>https://orcid.org/0000-0002-5055-3266</orcidid><orcidid>https://orcid.org/0000-0003-2151-2622</orcidid><orcidid>https://orcid.org/0000-0003-1766-0657</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0025-729X |
| ispartof | Medical journal of Australia, 2023-03, Vol.218 (5), p.223-228 |
| issn | 0025-729X 1326-5377 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10952992 |
| source | MEDLINE; Access via Wiley Online Library |
| subjects | Australia - epidemiology Cities Female Gender identity Heterosexuality HIV Infections - epidemiology Humans Infectious Diseases Male Research and Reviews Sentinel Surveillance Sexual Behavior Sexual Health Sexually transmitted diseases Sexually Transmitted Diseases - epidemiology Syphilis - diagnosis Syphilis - epidemiology |
| title | Infectious syphilis in women and heterosexual men in major Australian cities: sentinel surveillance data, 2011–2019 |
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