Is it time to rethink syphilis control?

To the Editor—We read with interest the iPrEx substudy by Solomon et al electronically published in the journal on 13 June [1]. This demonstrated a strikingly increased human immunodeficiency virus (HIV) incidence associated with incident syphilis infection (2.8 cases per 100 person-years for no syphilis vs 8 cases per 100 person-years for incident syphilis (hazard ratio, 2.6; 95% confidence interval [CI], 1.2–4.1; P < .001). These data add substantial weight to the evidence base demonstrating the strong link between incident syphilis infection and HIV acquisition risk among gay and other men who have sex with men (GMSM) and raise the importance of prevention strategies focusing on all sexually transmitted infections (STIs) including HIV.