Syphilis is endemic among men who have sex with men (MSM)
and transgender women in Latin America. The objective of this study was to
assess if those who screen positive for syphilis are receiving appropriate care
and treatment.
We use data from the 2011 Peruvian National HIV Sentinel
Surveillance to describe the syphilis care cascade among high-risk MSM and
transgender women. Medical records from participants who had a positive
syphilis screening test at two of the enrolment sites in Lima were reviewed to
determine their subsequent course of care.
We identified a cohort of 314 syphilis seropositive
participants (median age: 30, 33.7% self-identified as transgender). Only
284/314 (90.4%) participants saw a physician for evaluation within 28 days of
their positive test. Of these, 72/284 (25.4%) were asked to return for
confirmatory results before deciding whether or not to start treatment;
however, 45/72 (62.5%) of these participants did not follow up within 28 days.
Of the people prescribed three weekly doses of penicillin, 34/63 (54%) received
all three doses on time.
Many MSM and transgender women with a positive syphilis
screening test are lost at various steps along the syphilis care cascade and
may have persistent infection. Interventions in this population are needed to
increase testing, link seropositive patients into care and ensure that they
receive appropriate and timely treatment.
- 1Department of Medicine/Division of Infectious Diseases, UCLA Geffen School of Medicine, Los Angeles, California, USA.
- 2Asociación Civil Impacta Salud y Educación, Lima, Peru Department of Global Health, University of Washington, Seattle, Washington, USA.
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