Geographic Correlates of Primary and Secondary Syphilis among MSM in the United States

Details

• Alternative Title:
  Ann Epidemiol
• Personal Author:
  Leichliter, Jami S. ; Grey, Jeremy A. ; Cuffe, Kendra M. ; de Voux, Alex ; Cramer, Ryan ; Hexem, Sarah ; Chesson, Harrell W. ; Bernstein, Kyle T.
• Description:
  Purpose.
  
  Primary and secondary (P&S) syphilis in men who have sex with men (MSM) has been increasing; however, there is a lack of research on geographic factors associated with MSM P&S syphilis.
  
  Methods.
  
  We used multiple data sources to examine associations between social and environmental factors and MSM P&S syphilis rates at the state- and county-level in 2014 and 2015, separately. General linear models were used for state-level analyses and hurdle models were used for county-level models. Bivariate analyses (P<0.25) were used to select variables for adjusted models.
  
  Results.
  
  In 2014 and 2015 state models, a higher percentage of impoverished persons (2014 β=1.24; 95%CI=0.28–2.20; 2015 β=1.19; 95%CI=0.42–1.97) was significantly associated with higher MSM P&S syphilis rates. In the 2015 county model, policies related to sexual orientation (marriage, housing, hate crimes) were significant correlates of MSM P&S syphilis rates (P<0.05).
  
  Conclusions.
  
  Our state-level findings that poverty is associated with MSM P&S syphilis are consistent with research at the individual-level across different subpopulations and various STDs. Our findings also suggest that more research is needed to further evaluate potential associations between policies and STDs. Geographic-level interventions to address these determinants may help curtail the rising syphilis rates and their sequelae in MSM.
  
  
• Subjects:
  Article Geography Men Who Have Sex With Men Syphilis
• Source:
  Ann Epidemiol. 32:14-19.e1
• Pubmed ID:
  30799206
• Pubmed Central ID:
  PMC6443236
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Volume:
  32
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:f9b4af7b1e1da8e20cc057ee999c36d94785d0f702b1990c4269479341479701
• Download URL:
  https://stacks.cdc.gov/view/cdc/77174/cdc_77174_DS1.pdf
• File Type:
  [PDF - 342.47 KB ]