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The syphilis incidence rates in the intervention and control groups were 11.3 per 100 person-years and 20.6 per 100 person-years respectively. The multivariable-adjusted hazard ratio (95% CI) for syphilis in case management group was 0.34 (0.14-0.87). The percentages of participants who resumed risky sexual behaviors in both groups were significantly reduced (p 0.05), but did not significantly differ between two groups. A case management intervention reduced the incidence of syphilis in HIV-positive MSM. We should further increase