Prevalence and factors associated with syphilis among men who have sex with men in Brazil

Abstract

Purpose: This study aimed to analyze the prevalence of syphilis and assess the factors associated with its diagnosis throughout life. Methods: Cross-sectional study conducted from January to April 2022 with 812 MSM users of dating apps in Brazil. Sociodemographic, behavioral, and sexual aspects, health issues, and the use of dating apps variables were analyzed. Results: Multivariate logistic regression estimated the predictors of syphilis at a 95% confidence interval. The prevalence of syphilis diagnoses was 34.23% (95% CI = 30.94–37.46), and the factors associated with the diagnosis throughout life were age ≥ 30 years (adjusted prevalence ratio [aPR] = 1.49; adjusted 95% confidence interval [a95%CI] = 1.15–1.92), more than three sexual relations with Cis men (aPR = 1.40; a95%CI = 1.03–1.90), sex simultaneously with two people or more during social distancing (aPR = 1.31; a95%CI = 1.00–1.73), use of a licit (or illicit) substance in the last 3 months (aPR = 1.35; a95%CI = 1.05–1.74), using condom less than half of the time in anal sex in the last 3 months (aPR = 1.42, a95%CI = 1.07–1.89), being a PrEP user (aPR = 1.10; a95%CI = 0.81–1.51) and having used the Grindr® app in the last 3 months (aPR = 1.38; a95%CI = 1.04–1.83). Conclusion: The prevalence of syphilis among MSM users of dating apps is at worrying levels. Thus, frequent testing (less than 3 months for MSM using PrEP and semi-annual for everyone, regardless of the risk), access to DoxiPEP for this population, consistent use of condoms, and the use of apps as a strategic intervention and educommunication platforms are essential to prevent the spread of syphilis.