Prevalence of Treponema pallidum seropositivity and herpes simplex virus type 2 infection in a cohort of men who have sex with men, Bangkok, Thailand, 2006-2010

Thailand Ministry of Public Health - US Centers for Disease Control and Prevention Collaboration, DDC7 Building, 4th Floor, Ministry of Public Health Nonthaburi 11000, Thailand.
International Journal of STD & AIDS (Impact Factor: 1.05). 06/2012; 23(6):424-8. DOI: 10.1258/ijsa.2011.011256
Source: PubMed


We report prevalence of Treponema pallidum (TP) seropositivity and herpes simplex virus type 2 (HSV-2) infection and risk factors associated with their prevalence in a cohort of men who have sex with men (MSM) in Bangkok, Thailand. Between April 2006 and March 2010 we enrolled Thai MSM into a cohort study based at the Silom Community Clinic, with baseline behavioural data and laboratory testing for sexually transmitted infections (STIs). Logistic regression was used to analyse risk factors associated with the prevalence of TP seropositivity and HSV-2 infection. From a total of 1544 enrolled men (mean age 26 years) TP, HSV-2 and HIV seropositive rates were 4.4%, 20.7% and 21.6%, respectively. After multivariable analysis, participating in group sex, reporting paying for sex, reporting sex with a casual partner in a park and being HSV-2 seropositive were associated with TP prevalence. Age ≥30 years, having less than a high school education, past use of recreational drugs, meeting casual sexual partners at a public venue (sauna) and TP seropositivity were associated with HSV-2 infection. The significant baseline prevalence of TP seropositivity and HSV-2 infection in this cohort demonstrates the need for screening and treatment of these STIs and targeted prevention interventions in Thai MSM in Bangkok.

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Available from: Timothy H Holtz
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    ABSTRACT: Key populations at high risk for HIV acquisition and transmission, such as MSM, have long been identified as essential subpopulations for epidemiological surveillance of the HIV epidemic. However, surveillance systems in the context of generalized and widespread HIV epidemics have traditionally excluded these men. Emerging and consistent data highlight the disproportionate burden of HIV among MSM that exists when compared with other men of reproductive age across countries with generalized epidemics. Correlates of prevalent HIV infection include individual-level determinants of HIV acquisition and transmission similar to that found in concentrated HIV epidemics and community-level structural factors, such as stigma, being blackmailed, and history of homophobic abuse. HIV incidence was only available from two countries (Kenya, Thailand) with generalized HIV epidemics, but in both settings was an order of magnitude higher than that of other populations. The data presented here suggest that the dynamics of HIV infection among men are more similar across the world than they are different. Many HIV epidemics among average-risk reproductive age adults are slowing across both generalized and concentrated settings. It is in this context that high HIV incidence is observed among MSM, especially young MSM. This trend suggests a change in the trajectory of these HIV epidemics, a change that we may miss if we continue to understudy these populations based on unproved and dated assumptions.
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