Condom Use and Number of Sexual Partners among Male Syphilis Patients who Report Having Sex with Men

Background and objectives: Recent years have seen a resurgence of syphilis in Spain due to changes in sexual behavior. Here we describe the incidence of the disease in our clinic and investigate its relationship with the sexual habits of men who have sex with men (MSM). Patients and methods: A cross-sectional descriptive study of incident cases of syphilis in 2007 and 2008 was performed, followed by a case-control study of sexual behavior in the previous year to compare MSM with and without syphilis. Results: We recorded 26 new cases of syphilis, 19 of which were diagnosed at early stages. Eight patients were infected with human immunodeficiency virus and 15 were classed as MSM. Sixty-five MSM without syphilis were selected as a control group. MSM with syphilis had a larger number of sexual partners: odds ratio (OR), 3.98 (95% confidence interval [CI], 0.90-17.46) for the category "2 to 5 sexual partners"; OR, 3.22 (95% CI, 0.84-12.43) for the category "more than 5 sexual partners". The inconsistent use of condoms was significantly more common among MSM with syphilis than among those without syphilis (OR, 3.96; 95% CI, 1.15-13.61; p=0.02). Conclusions: Syphilis continues to be a public health problem in our setting, particularly among homosexual and bisexual men. In this study, inconsistent use of condoms and a greater number of sexual partners were risk factors for syphilis in MSM. The development of prevention programs targeting this at-risk population should be considered a priority.