Clinical and epidemiological characteristics of males with syphilis in Białystok, Poland in 2008-2013.

INTRODUCTION: Men who have sex with men (MSM) contribute disproportionally to the spread of several sexually transmitted infections (STIs) in many European and other industrialised countries.

OBJECTIVE: To describe and compare clinical and epidemiological data on MSM and men who have sex with women (MSW) treated for syphilis in Bialystok, Poland in 2008-2013.

MATERIAL AND METHODS: Analyzed characteristics included the age, residency, marital status, professional activity, number of sexual contacts, relation to the source contact, stage of syphilis, concomitant STIs including HIV, adherence to follow-up visits and efficacy of partner notification and contact tracing.

RESULTS: Among 49 male patients with syphilis, 19 (38.8%) were MSM. The average age of MSM and MSW was 31.9 and 31.3 years (P>0.05), respectively. The majority of patients in both groups were residents of urban areas and single. More than five lifetime sexual partners were declared by 47.4% of MSM and 16.7% of MSW (P = 0.01), and 73.7% and 60.0%, respectively (P>0.05), had only casual sexual relationship or steady partner but with additional casual sexual contact(s). Most of the syphilis cases were diagnosed during early symptomatic stage (in 84.2% of MSM and 56.7% of MSW; P>0.05). Other concomitant STIs were detected in 26.3% of MSM and 10.0% of MSW (P>0.05), and HIV infection - in 15.8% and 3.0% (P>0.05), respectively. Partner notification and contact tracing was not possible in 31.6% of MSM and 23.3% of MSW (P>0.05), and 21.1% MSM and 40.0% MSW (P>0.05) did not attend any follow-up visits.

CONCLUSIONS: MSM constituted a substantial proportion of male patients with syphilis, had more sexual contacts, including casual contacts, and more concomitant STIs, including HIV compared to MSW. The follow-up and contact tracing was suboptimal in MSM but also in MSW. Taking into consideration the important role of MSM in the spread of STIs, including syphilis, it is crucial to continue the present study but also to conduct similar investigations on national level.