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

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...

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Autores principales:	Suraj Balakrishna, Luisa Salazar-Vizcaya, Axel J Schmidt, Viacheslav Kachalov, Katharina Kusejko, Maria Christine Thurnheer, Jan A Roth, Dunja Nicca, Matthias Cavassini, Manuel Battegay, Patrick Schmid, Enos Bernasconi, Huldrych F Günthard, Andri Rauch, Roger D Kouyos, Swiss HIV Cohort Study (SHCS)
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/70129b0e461d4b47bd16770a3343d824
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spelling	oai:doaj.org-article:70129b0e461d4b47bd16770a3343d8242021-12-02T19:57:41ZAssessing the drivers of syphilis among men who have sex with men in Switzerland reveals a key impact of screening frequency: A modelling study.1553-734X1553-735810.1371/journal.pcbi.1009529https://doaj.org/article/70129b0e461d4b47bd16770a3343d8242021-10-01T00:00:00Zhttps://doi.org/10.1371/journal.pcbi.1009529https://doaj.org/toc/1553-734Xhttps://doaj.org/toc/1553-7358Over 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.Suraj BalakrishnaLuisa Salazar-VizcayaAxel J SchmidtViacheslav KachalovKatharina KusejkoMaria Christine ThurnheerJan A RothDunja NiccaMatthias CavassiniManuel BattegayPatrick SchmidEnos BernasconiHuldrych F GünthardAndri RauchRoger D KouyosSwiss HIV Cohort Study (SHCS)Public Library of Science (PLoS)articleBiology (General)QH301-705.5ENPLoS Computational Biology, Vol 17, Iss 10, p e1009529 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Biology (General) QH301-705.5
spellingShingle	Biology (General) QH301-705.5 Suraj Balakrishna Luisa Salazar-Vizcaya Axel J Schmidt Viacheslav Kachalov Katharina Kusejko Maria Christine Thurnheer Jan A Roth Dunja Nicca Matthias Cavassini Manuel Battegay Patrick Schmid Enos Bernasconi Huldrych F Günthard Andri Rauch Roger D Kouyos Swiss HIV Cohort Study (SHCS) Assessing the drivers of syphilis among men who have sex with men in Switzerland reveals a key impact of screening frequency: A modelling study.
description	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.
format	article
author	Suraj Balakrishna Luisa Salazar-Vizcaya Axel J Schmidt Viacheslav Kachalov Katharina Kusejko Maria Christine Thurnheer Jan A Roth Dunja Nicca Matthias Cavassini Manuel Battegay Patrick Schmid Enos Bernasconi Huldrych F Günthard Andri Rauch Roger D Kouyos Swiss HIV Cohort Study (SHCS)
author_facet	Suraj Balakrishna Luisa Salazar-Vizcaya Axel J Schmidt Viacheslav Kachalov Katharina Kusejko Maria Christine Thurnheer Jan A Roth Dunja Nicca Matthias Cavassini Manuel Battegay Patrick Schmid Enos Bernasconi Huldrych F Günthard Andri Rauch Roger D Kouyos Swiss HIV Cohort Study (SHCS)
author_sort	Suraj Balakrishna
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.
title_short	Assessing the drivers of syphilis among men who have sex with men in Switzerland reveals a key impact of screening frequency: A modelling study.
title_full	Assessing the drivers of syphilis among men who have sex with men in Switzerland reveals a key impact of screening frequency: A modelling study.
title_fullStr	Assessing the drivers of syphilis among men who have sex with men in Switzerland reveals a key impact of screening frequency: A modelling study.
title_full_unstemmed	Assessing the drivers of syphilis among men who have sex with men in Switzerland reveals a key impact of screening frequency: A modelling study.
title_sort	assessing the drivers of syphilis among men who have sex with men in switzerland reveals a key impact of screening frequency: a modelling study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/70129b0e461d4b47bd16770a3343d824
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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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