A systematic review and meta-analysis of the prevalence of syphilis among men who have sex with other men between 2000 and 2020, based on data from 275 studies involving more than 600,000 participants in 77 countries, concludes that a large percentage of they have contracted syphilis .
The study has been led by the London School of Hygiene and Tropical Medicine (LSHTM), in partnership with the World Health Organization (WHO) and Avenir Health.
A silent pandemic
Syphilis is a sexually transmitted infection (STI) caused by the bacteria Treponema pallidum . When diagnosed, syphilis is easily treated with penicillin. Sexually transmitted infections, including syphilis, can cause serious health problems if left untreated.
The global prevalence of syphilis among them was 15 times higher than the most recent estimates for men in the general population (7.5% versus 0.5%). The researchers also estimated the prevalence in eight Sustainable Development Goals (SDG) regions and six WHO regions. The Latin America and the Caribbean region had the highest prevalence of syphilis (10.6%), while Australia and New Zealand had the lowest (1.9%). Therefore, there is an urgent need to quantify the burden of syphilis in this high-risk group.
In this new study, pooled estimates of syphilis among men were highest (8.7%) in regions where HIV prevalence is greater than 5%. Lower-middle-income countries also had a high burden (8.7%). Low-income countries had the lowest syphilis prevalence estimates among MSM (3.8%). Estimates of the prevalence of syphilis were high among studies involving exclusively male sex workers, transgender women, and transgender sex workers .
This is because men tend to be at a disadvantage when it comes to testing and treatment for syphilis . Women are routinely screened for syphilis at their first prenatal care visit and are offered family planning tests. Men generally do not have the same number of contacts with the health system as women, and homosexuals face additional barriers due to stigma and shame.