Evidence map›Paper›PMID 24928295›Full record

Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2014

Syphilis predicts HIV incidence among men and transgender women who have sex with men in a preexposure prophylaxis trial.

Marc M Solomon, Kenneth H Mayer, David V Glidden, Albert Y Liu, Vanessa M McMahan, Juan V Guanira, Suwat Chariyalertsak, Telmo Fernandez, Robert M Grant, iPrEx Study Team

2 registry-linked trialsOpen access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 95 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
95citing papers in PubMed, 5 pooled it
9.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04793750 nacompletednot on this mapstarted 2021, after this paper: background citation

Ending the HIV Epidemic Through Point-of-Care Technologies (EHPOC): Performance Evaluation of Novel POC HIV Tests in Baltimore

TypeinterventionalSponsorJohns Hopkins UniversityRan2021 to 2025Enrolled224ConditionsHIV Infections, SyphilisArmsCepheid GeneXpert HIV-1 Qual POC HIV VL test, DPP HIV-Syphilis test system, OraQuick
NCT04962997 completednot on this mapstarted 2021, after this paper: background citation

Health Status of Transgender Women in French Guiana and Paris: a Cross-sectional View (TransGuyane)

TypeobservationalSponsorCentre Hospitalier de CayenneRan2021 to 2023Enrolled46ConditionsSexual Health, Mental HealthArmsData collection
3 · Its place in the literature

Who cites it

95 citing papers in PubMed, 5 syntheses or guidelines pooled it, 161 citations in OpenAlex.

  1. Pooled it
  2. Sexually Transmitted Infections Treatment Guidelines, 2021.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2021
    Guideline
  3. Pooled it
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  5. Sexually transmitted diseases treatment guidelines, 2015.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2015
    Guideline
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  9. Cabotegravir Maintains Protective Efficacy in the Setting of Bacterial Sexually Transmitted Infections: A Secondary Analysis of HPTN 083.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
    Article
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35 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 8 institutions in 4 countries.

Marc M SolomonThe Gladstone Institutes University of California, San Francisco.
Kenneth H MayerFenway Health, Beth Israel Deaconess Medical Center, Fenway Institute Harvard Medical School, Boston, Massachusetts.
David V GliddenUniversity of California, San Francisco.
Albert Y LiuBridge HIV, San Francisco Department of Public Health, California.
Vanessa M McMahanThe Gladstone Institutes.
Juan V GuaniraInvestigaciones Medicas en Salud, Lima, Peru.
Suwat ChariyalertsakResearch Institute for Health Sciences and Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Thailand.
Telmo FernandezFundacion Ecuatoriana Equidad, Guayaquil, Ecuador.
Robert M GrantThe Gladstone Institutes University of California, San Francisco.
iPrEx Study Team
EsSALUD · PEGladstone Institutes · USUniversity of California, San Francisco · USChiang Mai University · THFenway Health · USHarvard University · USInstituto Ecuatoriano de Enfermedades Digestivas · ECSan Francisco Department of Public Health · US

Funding

UCSF CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR024131 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHNSTON, S. CLAIBORNE · 2006 to 2011
$111.2M
Engaging University of California Stakeholders for Biorespository ResearchUL1TR000004 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GRANDIS, JENNIFER RUBIN · 2012 to 2015
$78.0M
Chemoprophylaxis for HIV Prevention in Men SupplementU01AI064002 · NIAID · J. DAVID GLADSTONE INSTITUTES · PI GRANT, ROBERT M. · 2005 to 2011
$41.3M
BIOLOGY OF INFECTIOUS DISEASES TRAINING PROGRAMT32AI007641 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MATTHEW G DORSEY · 2000 to 2026
$6.9M
Chemoprophylaxis and HIV-Host InteractionsR01AI062333 · NIAID · J. DAVID GLADSTONE INSTITUTES · PI GRANT, ROBERT M. · 2004 to 2011
$6.2M
NCATS NIH HHS UL1 TR000004NCRR NIH HHS UL1 RR024131NIAID NIH HHS R01 AI062333NIAID NIH HHS R01AI062333NIAID NIH HHS T32 AI007641NIAID NIH HHS U01 AI064002NIAID NIH HHS UO1 AI64002
6 · The paper itself

Abstract

backgroundSyphilis infection may potentiate transmission of human immunodeficiency virus (HIV). We sought to determine the extent to which HIV acquisition was associated with syphilis infection within an HIV preexposure prophylaxis (PrEP) trial and whether emtricitabine/tenofovir (FTC/TDF) modified that association.

methodsThe Preexposure Prophylaxis Initiative (iPrEx) study randomly assigned 2499 HIV-seronegative men and transgender women who have sex with men (MSM) to receive oral daily FTC/TDF or placebo. Syphilis prevalence at screening and incidence during follow-up were measured. Hazard ratios for the effect of incident syphilis on HIV acquisition were calculated. The effect of FTC/TDF on incident syphilis and HIV acquisition was assessed.

resultsOf 2499 individuals, 360 (14.4%) had a positive rapid plasma reagin test at screening; 333 (92.5%) had a positive confirmatory test, which did not differ between the arms (FTC/TDF vs placebo, P = .81). The overall syphilis incidence during the trial was 7.3 cases per 100 person-years. There was no difference in syphilis incidence between the study arms (7.8 cases per 100 person-years for FTC/TDF vs 6.8 cases per 100 person-years for placebo, P = .304). HIV incidence varied by incident syphilis (2.8 cases per 100 person-years for no syphilis vs 8.0 cases per 100 person-years for incident syphilis), reflecting a hazard ratio of 2.6 (95% confidence interval, 1.6-4.4; P < .001). There was no evidence for interaction between randomization to the FTC/TDF arm and incident syphilis on HIV incidence.

conclusionsIn HIV-seronegative MSM, syphilis infection was associated with HIV acquisition in this PrEP trial; a syphilis diagnosis should prompt providers to offer PrEP unless otherwise contraindicated.

Indexed as

AdenineAdultAnti-HIV AgentsDeoxycytidineEmtricitabineFemaleHIV InfectionsHomosexuality, MaleHumansIncidenceMaleMiddle AgedOrganophosphonatesPlacebosPre-Exposure ProphylaxisPrevalenceAdenineAnti-HIV AgentsDeoxycytidineEmtricitabineOrganophosphonatesPlacebosTenofovirchemoprophylaxisHIV preventionMSMpreexposure prophylaxissyphilis

Identifiers

PMID24928295
PMCPMC4166980
OpenAlexW2114094089

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.