LAUSR

Identifying individuals with early syphilis who would benefit from HIVpreexposure prophylaxis (HIVPrEP) is important to reduce HIV transmission. 2 There were 171 individuals diagnosed with early syphilis in our clinic between July 2021 and June 2022. Of the 88 (51%) HIVnegative individuals, 33 (38%) were not using HIVPrEP; 21 (64%) started HIVPrEP; a further 2 (6%) started at a subsequent clinic visit; 6 (18%) declined; and 4 (12%) were lost to followup. Individuals already using HIVPrEP and people living with HIV were more likely to have had previous syphilis (p<0.04) and be UKborn (p<0.03) compared with non HIVPrEP users (table 1). This study suggests that a significant proportion of HIVnegative MSM/transgender women (TGW) (38%) with early syphilis are not using HIVPREP and that nonUK born, HIVnegative MSM/TGW who have acquired syphilis for the first time are a key population to be offered HIVPrEP. Transitioning HIVnegative MSM/TGW with early syphilis to HIVPrEP should be a public health priority.