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A. Lucht 1 , M. Shah 2 , M. Kretzschmar 3,4

Abstract no. TUPDC0106. Does HIV serosorting increase syphilis prevalence among men who have sex with men in Western Europe? - A mathematical modelling study -. A. Lucht 1 , M. Shah 2 , M. Kretzschmar 3,4 1 Labor Krone, Siemensstraße 40, D-32105 Bad Salzuflen, Germany

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A. Lucht 1 , M. Shah 2 , M. Kretzschmar 3,4

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  1. Abstract no. TUPDC0106 Does HIV serosorting increase syphilis prevalence among men who have sex with men in Western Europe? - A mathematical modelling study - A. Lucht1, M. Shah2, M. Kretzschmar3,4 1Labor Krone, Siemensstraße 40, D-32105 Bad Salzuflen, Germany 2Johns Hopkins University, Division of Infectious Diseases, Baltimore, MD, US 3University Medical Centre Utrecht, Julius Centre for Health Sciences & Primary Care, Utrecht, Netherlands, 4Centre for Infectious Diseases Control, RIVM, Bilthoven, Netherlands

  2. Background • Serosorting definition: • “restriction of sexual partnerships to those perceived to be of the same HIV serostatus”. • Serosorting is sometimes used as an HIV risk reduction strategy among men who have sex with men (MSM). • Some studies suggest serosorting may reduce HIV transmission • However, serosorting may increase transmission of other STIs such as syphilis • Syphilis prevalence is high and increasing among MSM in several Western European countries

  3. Study Aims and Methods • Primary Study Aim: • To assess the impact of serosorting on syphilis prevalence among MSM in Western Europe (UK, Netherlands, and Germany) using a deterministic S-I-R-S mathematical model • Secondary outcomes: • To examine the impact of HIV prevalence and sexual risk behaviors on the impact of the serosorting effect Differential Equations describing rates of each compartment Legend: S-susceptible, I = infectious, R = resistant.

  4. Results and Conclusions RESULTS: Effect of serosorting on syphilis prevalence among HIV-positive MSM • Base-Case syphilis prevalence: • Base-case Serosorting • 4-12% HIV- • 7- 37% HIV+ • HIV+: 3.7-4.0% • HIV-: 1.0-2.0% • (range is across UK, Germany, Netherlands) CONCLUSIONS • HIV serosorting increases syphilis prevalence among MSM compared to scenarios without serosorting • Effect is more pronounced in HIV-positive compared to HIV-negative • Even small proportions of serosorting among MSM leads to increases in syphilis prevalence • The size of the serosorting effect on syphilis prevalence is increased by: • higher HIV prevalence in the MSM population, • higher numbers of sexual partnerships of HIV-positive and HIV-negative MSM, • Increased probability of syphilis transmission per partnership (e.g. without condom usage)

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