SÍFILIS EM USUÁRIOS DA PROFILAXIA PRÉ EXPOSIÇÃO AO HIV NO MATO GROSSO DO SUL, 2018-2023

Abstract

Introduction: Syphilis is a serious global public health problem that affects the general population. The use of HIV Pre-Exposure Prophylaxis (PrEP) is also indicated for people who are at increased risk of acquiring STIs. In this sense, the incidence of syphilis in PrEP users is an important indication that STI prevention methods need to be reinforced in this population. Objective: To study the epidemiological aspects of acquired syphilis in people using HIV Pre-Exposure Prophylaxis (PrEP) in Mato Grosso do Sul, between 2018 and 2023. Method: This study is cross-sectional, descriptive, retrospective and used secondary data from the Information System for Notifiable Diseases (SINAN/DATASUS) of acquired syphilis and PrEP users in the Medication Logistics Control System (SICLOM) of Mato Grosso do Sul. A probabilistic linkage of the SINAN database and PrEP users from SICLOM was performed from 2018 to 2023. An incidence analysis was performed and the associated factors of acquired syphilis cases in PrEP users were identified, and a linear regression analysis was performed to analyze the association between the number of people using pre-exposure prophylaxis (PrEP) and cases of acquired syphilis. Results: An incidence of syphilis of 14.5% (95% CI: 6.8-17.5) was observed among PrEP users in Mato Grosso do Sul, with users presenting at least one episode of active acquired syphilis while using prophylaxis. The mean age of users was 31.6 years (SD±9.1), with 54% in the age range of 26 to 40 years. The majority of PrEP users with syphilis were cisgender men (85.5%), white (48.2%), with 12 or more years of education (66.7%) and living in urban areas (94.1%). Analysis of associated factors showed that transsexual/transvestite women [ORa 4.95 (95% CI: 2.80-8.78)], homosexual/gay/lesbian women [ORa 3.19 (95% CI: 1.91-5.31)] and bisexual women [ORa 3.35 (95% CI: 1.95-5.76)] had higher chances of syphilis infection. Age over 41 years conferred a protective factor against syphilis [ORa 0.06 (95% CI: 0.03-0.99)]. The linear regression model showed a negative and significant association with cases of acquired syphilis (β = -2.34; p < 0.001), suggesting that the number of syphilis cases tends to increase when the number of people using PrEP decreases. Conclusion: The high incidence of syphilis among PrEP users in Mato Grosso do Sul reveals the vulnerability of this population and the need for specific actions. Groups such as trans women/transvestites, homosexuals, gays, lesbians and bisexuals were at higher risk. Combined prevention strategies and increased access to PrEP are essential.

KEYWORDS: Syphilis, HIV Pre-Exposure Prophylaxis, PrEP, associated factors.