The paradox of rising syphilis among MSM living with HIV amid declining HIV infections: a 33-year analysis.

In an STI/HIV Unit in Italy, the last 33 years saw a significant increase in syphilis diagnoses among MSM, particularly those living with HIV. This increase occurred alongside a recent drastic decline in HIV diagnoses among syphilis patients. These divergent trends likely reflect the success of HIV prevention strategies, yet underscore the need for integrated approaches to manage the risk of syphilis and other STIs in populations where these strategies are increasingly accessible.