Assessing the drivers of syphilis among men who have sex with men in Switzerland reveals a key impact of screening frequency: A modelling study.

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License: CC BY 4.0
Serval ID
serval:BIB_F8B56F9C05F3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Assessing the drivers of syphilis among men who have sex with men in Switzerland reveals a key impact of screening frequency: A modelling study.
Journal
PLoS computational biology
Author(s)
Balakrishna S., Salazar-Vizcaya L., Schmidt A.J., Kachalov V., Kusejko K., Thurnheer M.C., Roth J.A., Nicca D., Cavassini M., Battegay M., Schmid P., Bernasconi E., Günthard H.F., Rauch A., Kouyos R.D.
Working group(s)
Swiss HIV Cohort Study (SHCS)
ISSN
1553-7358 (Electronic)
ISSN-L
1553-734X
Publication state
Published
Issued date
10/2021
Peer-reviewed
Oui
Volume
17
Number
10
Pages
e1009529
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Over the last decade, syphilis diagnoses among men-who-have-sex-with-men (MSM) have strongly increased in Europe. Understanding the drivers of the ongoing epidemic may aid to curb transmissions. In order to identify the drivers of syphilis transmission in MSM in Switzerland between 2006 and 2017 as well as the effect of potential interventions, we set up an epidemiological model stratified by syphilis stage, HIV-diagnosis, and behavioral factors to account for syphilis infectiousness and risk for transmission. In the main model, we used 'reported non-steady partners' (nsP) as the main proxy for sexual risk. We parameterized the model using data from the Swiss HIV Cohort Study, Swiss Voluntary Counselling and Testing center, cross-sectional surveys among the Swiss MSM population, and published syphilis notifications from the Federal Office of Public Health. The main model reproduced the increase in syphilis diagnoses from 168 cases in 2006 to 418 cases in 2017. It estimated that between 2006 and 2017, MSM with HIV diagnosis had 45.9 times the median syphilis incidence of MSM without HIV diagnosis. Defining risk as condomless anal intercourse with nsP decreased model accuracy (sum of squared weighted residuals, 378.8 vs. 148.3). Counterfactual scenarios suggested that increasing screening of MSM without HIV diagnosis and with nsP from once every two years to twice per year may reduce syphilis incidence (at most 12.8% reduction by 2017). Whereas, increasing screening among MSM with HIV diagnosis and with nsP from once per year to twice per year may substantially reduce syphilis incidence over time (at least 63.5% reduction by 2017). The model suggests that reporting nsP regardless of condom use is suitable for risk stratification when modelling syphilis transmission. More frequent screening of MSM with HIV diagnosis, particularly those with nsP may aid to curb syphilis transmission.
Pubmed
Web of science
Open Access
Yes
Create date
06/11/2021 17:43
Last modification date
23/11/2022 8:17
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