Making Smart Choices about Sexual Activity by Stephanie C. Perkins

This study stratified the patients by gender of sex partner, and there was no difference found in the incidence of syphilis between heterosexual contacts (58%) and homosexual contacts (49%). Sixty-five of 127 contacts (51%) were infected with syphilis. interviewed contacts from the previous 12 weeks of patients with primary or secondary syphilis and reported the percentage who were diagnosed with syphilis either at the time of interview or in the 3 months following their last contact with the index syphilis case. Of 1464 contacts who met their criteria for early latent syphilis, 809 (55%) were infected with syphilis. There were 927 contacts of primary and secondary syphilis for whom follow-up information was obtained, and syphilis was identified in 589 (64%). Of note, the parameters for primary and secondary syphilis were not defined, and patients with early latent syphilis were classified as asymptomatic patients with a ‘definite history of onset of syphilis of less than 4 years or, in the absence of this criterion, those who were under 30 years of age’. In 1941–1945 in Tennessee, von Werssowetz studied the prevalence and incidence of syphilis in identified contacts of patients with primary, secondary and early latent syphilis.

Several studies have reported syphilis prevalence and incidence among individuals named in contact investigation studies, primarily in the era before prophylactic treatment of contacts became standard of care. In this paper, we will review the literature on syphilis transmissibility and susceptibility, discuss how prevention efforts can alter syphilis transmission and outline key unanswered questions and areas for future research. 5 Prevention tools, such as condoms, risk-reduction counselling and syphilis screening and treatment, can alter syphilis rates by modifying these key parameters. The rate of spread of syphilis in a population is related to the transmission probability per sexual partnership, the average rate of acquisition of sexual partners and the duration of infectiousness. 3, 4 Understanding the dynamics of syphilis transmission can provide insight into syphilis prevalence and incidence, and inform how to optimise prevention efforts to reduce the incidence of syphilis.

1 Syphilis rates are rising among men who have sex with men (MSM) in the USA, 2 and similar trends in syphilis infections have been reported throughout Europe in cities with large populations of MSM.

The global burden of syphilis infection is high, with an estimated 10.6 million incident cases occurring annually.

Making Smart Choices about Sexual Activity by Stephanie C. Perkins