TABLE 1.
Characteristics of Syphilis Cases Among Men who Have Sex With Men, San Francisco 2001–2011
| Periods |
P Values for Period Comparisons |
|||||
|---|---|---|---|---|---|---|
| Patient Characteristics | Period I: January 1, 2001–June 30, 2002, n (%) |
Period II: July 1, 2002–March 31, 2007, n (%) |
Period III: April 1, 2007–December 31, 2011, n (%) |
Period I vs. Period II |
Period II vs. Period III |
Period I vs. Period III |
| Total | 290 (8.9) | 1380 (42.5) | 1574 (48.5) | |||
| Average no. P&S cases per month | 16.1 | 24.2 | 27.6 | |||
| Stage | 0.89 | 0.11 | 0.47 | |||
| Primary | 100 (34.5) | 469 (34.0) | 580 (36.9) | |||
| Secondary | 190 (65.5) | 911 (66.0) | 994 (63.2) | |||
| Repeat cases | <0.01 | <0.01 | <0.01 | |||
| No | 271 (93.5) | 1148 (83.2) | 1182 (75.1) | |||
| Yes | 19 (6.6) | 232 (16.8) | 392 (24.9) | |||
| Sex* | 0.14 | 0.26 | 0.03 | |||
| MSM | 262 (90.3) | 1282 (92.9) | 1479 (94.0) | |||
| MSW | 26 (9.0) | 78 (5.7) | 57 (3.6) | |||
| Female | 2 (0.7) | 11 (0.8) | 25 (1.6) | |||
| Transgender | 0 | 8 (0.6) | 11 (0.7) | |||
| Unknown | 0 | 1 (0.1) | 2 (0.1) | |||
| Race/ethnicity | 0.61 | 0.01 | 0.98 | |||
| White | 181 (62.4) | 885 (64.1) | 963 (61.2) | |||
| Hispanic | 54 (18.6) | 243 (17.6) | 279 (17.7) | |||
| Black | 26 (9.0) | 93 (6.7) | 163 (10.4) | |||
| API | 22 (7.6) | 114 (8.3) | 129 (8.2) | |||
| Other | 4 (1.4) | 16 (1.2) | 21 (1.3) | |||
| Unknown | 3 (1.0) | 29 (2.1) | 19 (1.3) | |||
| Age, y | 0.11 | <0.01 | <0.01 | |||
| ≤29 | 38 (13.1) | 208 (15.1) | 251 (16.0) | |||
| 30–39 | 142 (49.0) | 569 (41.2) | 465 (29.5) | |||
| 40–49 | 85 (29.3) | 451 (32.7) | 598 (38.0) | |||
| 50+ | 25 (8.6) | 152 (11.0) | 260 (16.5) | |||
| HIV status† | 0.58 | 0.56 | 0.81 | |||
| Positive | 160 (55.2) | 760 (55.1) | 888 (56.4) | |||
| Negative | 66 (22.8) | 345 (25.0) | 382 (24.3) | |||
| Never tested or data not available | 53 (18.3) | 233 (16.9) | 268 (17.0) | |||
| Unknown on day of syphilis but subsequently tested positive | 11 (3.8) | 42 (3.0) | 36 (2.3) | |||
| Diagnosing provider | ||||||
| STD clinic | 101 (34.8) | 487 (35.3) | 468 (29.5) | 0.89 | 0.01 | 0.10 |
| Gay men’s health center | 0 | 73 (5.3) | 278 (17.7) | — | <0.01 | — |
| HIV care clinic | 13 (4.5) | 61 (4.4) | 96 (6.1) | 1.00 | 0.05 | 0.34 |
| HMO | 10 (3.5) | 116 (8.4) | 69 (4.4) | 0.01 | <0.01 | 0.53 |
| Other | 166 (57.2) | 643 (46.6) | 666 (42.3) | 0.01 | 0.02 | <0.01 |
| Castro neighborhood residence | 54 (18.6) | 300 (21.7) | 293 (18.6) | 0.27 | 0.04 | 1.00 |
| Interviewed patients | 247 (85.2) | 1147 (83.1) | 1321 (83.9) | 0.43 | 0.58 | 0.66 |
| Index patient disposition | ||||||
| OOJ | 0 | 1 (0.1) | 6 (0.4) | — | 1.00 | — |
| Partial interview | 0 | 2 (0.2) | 42 (2.7) | — | <0.01 | — |
| Refused | 11 (4.0) | 100 (7.3) | 94 (6.0) | 0.04 | 0.18 | 0.17 |
| Unable to locate | 30 (10.3) | 122 (8.9) | 138 (8.8) | 0.43 | 0.95 | 0.37 |
| Other | 2 (0.7) | 10 (0.7) | 15 (1.0) | 1.00 | 0.55 | 1.00 |
| Among interviewed index patients | ||||||
| Drug use (last 12 mo) | ||||||
| Poppers | 88 (7.7) | 270 (20.4) | — | <0.01 | — | |
| Meth | 235 (20.5) | 353 (26.7) | — | <0.01 | — | |
| Cocaine | 58 (5.1) | 128 (9.7) | — | <0.01 | — | |
| ED medicine | 34 (3.0) | 266 (20.1) | — | <0.01 | — | |
| IDU | 12 (4.9) | 63 (5.5) | 113 (8.6) | 0.76 | 0.01 | 0.05 |
| Met partners at bathhouse or sex club | 70 (28.3) | 215 (18.7) | 208 (15.8) | 0.01 | 0.05 | <0.01 |
| Met partners on the Internet | 65 (26.3) | 461 (40.2) | 649 (49.1) | <0.01 | <0.01 | <0.01 |
| Sex, critical period | ||||||
| >5 male partners | 110 (44.9) | 454 (40.7) | 504 (40.6) | 0.15 | 0.48 | 0.07 |
| Female partners | 22 (9.0) | 50 (4.5) | 61 (4.9) | 0.01 | 0.77 | 0.01 |
| Sex work | 0 | 5 (0.5) | 7 (0.6) | — | 0.78 | — |
| Dispositions for partners in named time frame | ||||||
| Index named any OOJ partners, among indexes who named at least 1 partner | 67 (45.0) | 380 (53.0) | 435 (55.7) | 0.09 | 0.30 | 0.02 |
| Mean no. named partners per index | 2.21 | 2.3 | 2.8 | 0.70 | 0.01 | 0.08 |
| P&S syphilis morbidity from Bay Area counties (excluding San Francisco) | ||||||
| Reported P&S syphilis | 126 | 751 | 1177 | |||
| Bay Area P&S syphilis initially identified in San Francisco | 20 (15.9) | 71 (9.5) | 130 (11.1) | 0.04 | 0.29 | 0.11 |
*
Comparison of MSM vs. non-MSM.
†
Comparison of HIV positive vs. HIV negative.
ED indicates emergency department; meth, methamphetamines; MSW, men who have sex with women.