The objective of this study was to describe the sociodemographic characteristics and behavioral factors that are associated with syphilis seroprevalence in a cohort of young Black men who have sex with men (YBMSM) in Chicago, USA (n = 606). The weighted syphilis seroprevalence in the study population was 29.2% (95% CI 23.9, 35.1). A bivariate probit multiple regression model was used to estimate the outcomes. Characteristics that were positively associated with syphilis seropositivity included being age 19-20, 21-24, and at least age 25 compared to the reference group (age 16-18 years old) (0.72 [95% CI 0.18, 1.25], 1.40 [95% CI 0.68, 2.13], and 1.34 [95% CI 0.75,1.94], respectively), using social media to meet sexual partners (0.33 [95% CI 0.05, 0.61]), using condoms more often (0.39 [95% CI 0.02, 0.76]), and a history of criminal justice involvement (0.25 [95% CI 0.06, 0.44]). Our study results suggest that among YBMSM in Chicago, interventions promoting condom use may be less effective for syphilis prevention compared to HIV prevention in this population. The contribution of nonpenetrative sex to syphilis prevalence requires additional research as does how best to implement routine syphilis screening and treatment for YBMSM in the context of ongoing syphilis transmission.
Keywords: HIV infection; Young Black men who have sex with men; health disparities; sexually transmitted infections; syphilis seroprevalence; transgender women.