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pallidum (PATHOGEN) and our survey of social determinants and sexual risk behaviors to elucidate social-sexual networks (ENVIRONMENT).Interplay between these domains will inform new strategies for syphilis control efforts.Syphilis is an important sexually transmitted infection (STI) with serious public health consequences.Among men who have sex with men (MSM) in Lima, the prevalence and incidence are extraordinarily high.Next, through ascertainment of treatment status, host immune response, and pathogen genotype analysis, we will classify cases as reinfection, persistent infection/treatment failure, or recurrence based on incomplete treatment.
Between 40–60 participants will be recruited each month from two clinical sites in Lima, including a public reference STI clinic (Barton Health Center) specialized in at-risk populations including MSM/TW, and a Gay Men’s community center (Epicentro) located in a metropolitan area of Lima.
We project that Barton Health Center will account for 70% of the recruited patients, with 30% recruited at Epicentro.
Men who are 18 years or older will be invited to join the two-year study if they meet at least three of the following high-risk criteria: i) having had a positive syphilis test in the past 2 years, ii) having HIV infection, iii) having any syndromic ulcer-related STI (i.e.
Blood and earlobe scrapings will also be collected for DNA testing, to create molecular markers for subtyping.
We will also perform cytokine testing on collected samples in order to create host immunologic profiles associated with recurrence, re-infection, treatment failure and success.Our group, led by a collaboration between experienced senior investigators from Universidad Peruana Cayetano Heredia (UPCH) and University of California, Los Angeles (UCLA), Epicentro and Barton Health Center will study a cohort of high-risk MSM/TW.