Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2014

Open Access 01-12-2014 | Research article

Risk factors associated with prevalent and incident syphilis among an HIV-infected cohort in Northeast China

Authors: Qing-hai Hu, Jun-jie Xu, Hua-chun Zou, Jing Liu, Jing Zhang, Hai-bo Ding, Han-Zhu Qian, Si-ruo Li, Yu Liu, Yong-jun Jiang, Hong Shang, Ning Wang

Published in: BMC Infectious Diseases | Issue 1/2014

Login to get access

Abstract

Background

Sexually transmitted infections (STIs) increase HIV infectivity through local inflammatory processes. Prevalent and incident STIs among people who live with HIV/AIDS (PLWHA) are indicators of high-risk sexual behaviors and imply potential spread of HIV. Little is known about the prevalence and incidence of concurrent syphilis and associated risk behaviors among PLWHA in China.

Methods

A retrospective cohort study was conducted among PLWHA who attended the outpatient clinic of a designated AIDS treatment hospital in Shenyang, China, between March 2009 and May 2013. Physical examinations and syphilis serology were conducted at each visit. A questionnaire on demographic characteristics was also collected.

Results

A total of 1010 PLWHA were enrolled, of whom 77.0% were men who have sex with men (MSM). The baseline syphilis prevalence among PLWHA was 19.8% (95% confidence interval [CI]:17.3–22.3%). During follow-up, 78.3% retained in the cohort, and contributed a median follow-up of 9.4 months (interquartile range: 5.9-18.7 months). Syphilis incidence among PLWHA was 18.7 (95% CI: 15.5–21.8) per 100 person years. Mulitvariate logistic analysis showed that receiving antiretroviral therapy (ART) (adjusted OR [aOR] = 0.48), older age (≥40 years vs. ≤24 years, aOR = 2.43), being MSM (aOR = 2.30) and having higher baseline HIV viral load (>100000 copies/mL vs. ≤100000 copies/mL, aOR = 1.56) were independent predictors for syphilis infection among PLWHA at enrollment (p < 0.05 for all). Mulivariate Cox regression found that receiving ART (adjusted hazard ratio [aHR] = 1.81), older age (≥40 years vs. ≤24 years, aHR: 5.17) and MSM status (aHR = 2.68) were independent risk factors for syphilis seroconversion (each p < 0.05).

Conclusions

Syphilis prevalence and incidence were high among PLWHA in Shenyang. A campaign focusing on detection and treatment of syphilis among PLWHA is urgently needed, especially one with a focus on MSM who are at a higher risk for syphilis.
Appendix
Available only for authorised users
Literature
1.
2.
Chen ZQ, Zhang GC, Gong XD, Lin C, Gao X, Liang GJ, Yue XL, Chen XS, Cohen MS: Syphilis in China: results of a national surveillance programme. Lancet. 2007, 369 (9556): 132-138. 10.1016/S0140-6736(07)60074-9.CrossRefPubMed
3.
Chen XS, Peeling RW, Yin YP, Mabey DC: The epidemic of sexually transmitted infections in China: implications for control and future perspectives. BMC Med. 2011, 9: 111-10.1186/1741-7015-9-111.CrossRefPubMedPubMedCentral
4.
5.
Savage EJ, Marsh K, Duffell S, Ison CA, Zaman A, Hughes G: Rapid increase in gonorrhoea and syphilis diagnoses in England in 2011. Euro Surveill 2012; 17(29)
6.
7.
8.
9.
Padian NS, McCoy SI, Karim SS, Hasen N, Kim J, Bartos M, Katabira E, Bertozzi SM, Schwartlander B, Cohen MS: HIV prevention transformed: the new prevention research agenda. Lancet. 2011, 378 (9787): 269-278. 10.1016/S0140-6736(11)60877-5.CrossRefPubMedPubMedCentral
10.
Montano DE, Phillips WR, Kasprzyk D, Greek A: STD/HIV prevention practices among primary care clinicians: risk assessment, prevention counseling, and testing. Sex Transm Dis. 2008, 35 (2): 154-166. 10.1097/OLQ.0b013e3181574d97.CrossRefPubMed
11.
Bunnell R, Mermin J, De Cock KM: HIV prevention for a threatened continent: implementing positive prevention in Africa. JAMA. 2006, 296 (7): 855-858. 10.1001/jama.296.7.855.CrossRefPubMed
12.
Crepaz N, Lyles CM, Wolitski RJ, Passin WF, Rama SM, Herbst JH, Purcell DW, Malow RM, Stall R: Do prevention interventions reduce HIV risk behaviours among people living with HIV? A meta-analytic review of controlled trials. AIDS. 2006, 20 (2): 143-157. 10.1097/01.aids.0000196166.48518.a0.CrossRefPubMed
13.
Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, Hakim JG, Kumwenda J, Grinsztejn B, Pilotto JH, Godbole SV, Mehendale S, Chariyalertsak S, Santos BR, Mayer KH, Hoffman IF, Eshleman SH, Piwowar-Manning E, Wang L, Makhema J, Mills LA, de Bruyn G, Sanne I, Eron J, Gallant J, Havlir D, Swindells S, Ribaudo H, Elharrar V, Burns D, et al: Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011, 365 (6): 493-505. 10.1056/NEJMoa1105243.CrossRefPubMedPubMedCentral
14.
Jia Z, Mao Y, Zhang F, Ruan Y, Ma Y, Li J, Guo W, Liu E, Dou Z, Zhao Y, Wang L, Li Q, Xie P, Tang H, Han J, Jin X, Xu J, Xiong R, Zhao D, Li P, Wang X, Wang L, Qing Q, Ding Z, Chen RY, Liu Z, Shao Y: Antiretroviral therapy to prevent HIV transmission in serodiscordant couples in China (2003-11): a national observational cohort study. Lancet. 2013, 382 (9899): 1195-1203. 10.1016/S0140-6736(12)61898-4.CrossRefPubMed
15.
Graham SM, Holte SE, Dragavon JA, Ramko KM, Mandaliya KN, McClelland RS, Peshu NM, Sanders EJ, Krieger JN, Coombs RW: HIV-1 RNA may decline more slowly in semen than in blood following initiation of efavirenz-based antiretroviral therapy. PLoS One. 2012, 7 (8): e43086-10.1371/journal.pone.0043086.CrossRefPubMedPubMedCentral
16.
Lambert-Niclot S, Tubiana R, Beaudoux C, Lefebvre G, Caby F, Bonmarchand M, Naouri M, Schubert B, Dommergues M, Calvez V, Flandre P, Poirot C, Marcelin AG: Detection of HIV-1 RNA in seminal plasma samples from treated patients with undetectable HIV-1 RNA in blood plasma on a 2002-2011 survey. AIDS. 2012, 26 (8): 971-975. 10.1097/QAD.0b013e328352ae09.CrossRefPubMed
17.
Elford J, Bolding G, Maguire M, Sherr L: Combination therapies for HIV and sexual risk behavior among gay men. J Acquir Immune Defic Syndr. 2000, 23 (3): 266-271. 10.1097/00126334-200003010-00010.CrossRefPubMed
18.
Dukers NHTM, Goudsmit J, de Wit JBF, Prins M, Weverling G-J, Coutinho RA: Sexual risk behaviour relates to the virological and immunological improvements during highly active antiretroviral therapy in HIV-1 infection. AIDS. 2001, 15 (3): 369-378. 10.1097/00002030-200102160-00010.CrossRefPubMed
19.
Imrie J, Lambert N, Mercer C, Copas A, Phillips A, Dean G, Watson R, Fisher M: Refocusing health promotion for syphilis prevention: results of a case-control study of men who have sex with men on England’s south coast. Sex Transm Infect. 2006, 82 (1): 80-83. 10.1136/sti.2005.015156.CrossRefPubMedPubMedCentral
20.
Tucker JD, Yin YP, Wang B, Chen XS, Cohen MS: An expanding syphilis epidemic in China: epidemiology, behavioural risk and control strategies with a focus on low-tier female sex workers and men who have sex with men. Sex Transm Infect. 2011, 87 (Suppl 2): ii16-ii18. 10.1136/sti.2010.048314.CrossRefPubMedPubMedCentral
21.
Tang W, Huan X, Mahapatra T, Tang S, Li J, Yan H, Fu G, Yang H, Zhao J, Detels R: Factors associated with unprotected anal intercourse among men who have sex with men: results from a respondent driven sampling survey in Nanjing, China, 2008. AIDS Behav. 2013, 17 (4): 1415-1422. 10.1007/s10461-013-0413-4.CrossRefPubMed
22.
Buchacz K, Patel P, Taylor M, Kerndt PR, Byers RH, Holmberg SD, Klausner JD: Syphilis increases HIV viral load and decreases CD4 +cell counts in HIV-infected patients with new syphilis infections. AIDS 2004, 18(15):2075–2079.,
23.
Zhu H, Napravnik S, Eron JJ, Cole SR, Ma Y, Wohl DA, Dou Z, Zhang Y, Liu Z, Zhao D, Yu L, Liu X, Cohen MS, Zhang F: Decreasing excess mortality of HIV-infected patients initiating antiretroviral therapy: comparison with mortality in general population in China, 2003-2009. J Acquir Immune Defic Syndr. 2013, 63 (5): e150-e157. 10.1097/QAI.0b013e3182948d82.CrossRefPubMedPubMedCentral
24.
Zhang F: China Free Antiretroviral Therapy Manual. 2012, People's Medical Publishing House, Beijing, 2012
25.
Ko NY, Liu HY, Lee HC, Lai YY, Chang CM, Lee NY, Chen PL, Wu CJ, Ko WC: One-year follow-up of relapse to risky behaviors and incidence of syphilis among patients enrolled in the HIV case management program. AIDS Behav. 2011, 15 (5): 1067-1074. 10.1007/s10461-010-9841-6.CrossRefPubMed
26.
Gao K, Wang C, Chen L, Xu H, Han Z: Syphilis infection analysis in people living with HIV/AIDS in Guangzhou, 2011. South China J Prev Med. 2013, 39 (2): 32-35.
27.
Luo P, Liu Z, Zhao Y: Present situation of HIV, HCV and TP coinfection in HIV-infected patients in Liuzhou Area. J Trop Med. 2008, 8 (9): 917-919.
28.
Kalichman SC, Pellowski J, Turner C: Prevalence of sexually transmitted co-infections in people living with HIV/AIDS: systematic review with implications for using HIV treatments for prevention. Sex Transm Infect. 2011, 87 (3): 183-190. 10.1136/sti.2010.047514.CrossRefPubMedPubMedCentral
29.
Park WB, Jang H-C, Kim S-H, Kim HB, Kim NJ, Oh M-d, Choe KW: Effect of highly active antiretroviral therapy on incidence of early syphilis in HIV-infected patients. Sex Transm Dis. 2008, 35 (3): 304-306. 10.1097/OLQ.0b013e31815b0148.CrossRefPubMed
30.
Yin L, Qin GM, Ruan YH, Zhang L, Hao QN, Chen XH, Jiang ZQ, Song BL, Liu SZ, Cao XY, Hao C, Chen KL, Shao YM: A propective cohort study on human immunodeficiency virus and syphilis seroconversion among injecting drug users. Chin J Epidemiol. 2006, 27 (4): 293-297.
31.
Tian LG, Ma ZE, Ruan YH, Cao XY, Huang JP, Wang DR, Zhu GP, Yao HM, Han L, Hao C, Yin L, Liang S, Qin GM, Chen KL, Wang J, Wang N, Shao YM: Incidence rates of human immunodeficiency virus and syphilis as well as the rate of retention in a 6-month follow-up study of female sex workers in areas with heavy drug use in Xichang of Sichuan province, China. Chin J Epidemiol. 2006, 27 (11): 939-942.
32.
Arora PN, Sastry CVR: HIV infection and genital ulcer disease. Indian J Sex Transm Dis. 1992, 13 (2): 71-73.PubMed
33.
Morin SF, Shade SB, Steward WT, Carrico AW, Remien RH, Rotheram-Borus MJ, Kelly JA, Charlebois ED, Johnson MO, Chesney MA: A behavioral intervention reduces HIV transmission risk by promoting sustained serosorting practices among HIV-infected men who have sex with men. J Acquir Immune Defic Syndr. 2008, 49 (5): 544-551. 10.1097/QAI.0b013e31818d5def.CrossRefPubMedPubMedCentral
34.
Stolte IG, Dukers NHTM, de Wit JBF, Fennema JSA, Coutinho RA: Increase in sexually transmitted infections among homosexual men in Amsterdam in relation to HAART. Sex Transm Infect. 2001, 77 (3): 184-186. 10.1136/sti.77.3.184.CrossRefPubMedPubMedCentral
35.
Crepaz N, Hart TA, Marks G: Highly active antiretroviral therapy and sexual risk behavior. JAMA. 2004, 292 (2): 224-236. 10.1001/jama.292.2.224.CrossRefPubMed
36.
Cicconi P, Cozzi-Lepri A, Orlando G, Matteelli A, Girardi E, Degli Esposti A, Moioli C, Rizzardini G, Chiodera A, Ballardini G: Recent acquired STD and the use of HAART in the Italian Cohort of Naive for Antiretrovirals (I. Co. NA): analysis of the incidence of newly acquired hepatitis B infection and syphilis. Infection. 2008, 36 (1): 46-53. 10.1007/s15010-007-6300-z.CrossRefPubMed
37.
Huang YF, Nelson KE, Lin YT, Yang CH, Chang FY, Lew-Ting CY: Syphilis Among Men Who Have Sex With Men (MSM) in Taiwan: its association with HIV prevalence, awareness of HIV status, and use of antiretroviral therapy. AIDS Behav. 2013, 17 (4): 1406-1414. 10.1007/s10461-012-0405-9.CrossRefPubMed
38.
Katz MH, Schwarcz SK, Kellogg TA, Klausner JD, Dilley JW, Gibson S, McFarland W: Impact of highly active antiretroviral treatment on HIV seroincidence among men who have sex with men: San Francisco. Am J Public Health. 2002, 92 (3): 388-394. 10.2105/AJPH.92.3.388.CrossRefPubMedPubMedCentral
39.
Branger J, van der Meer JTM, van Ketel RJ, Jurriaans S, Prins JM: High incidence of asymptomatic syphilis in HIV-infected MSM justifies routine screening. Sex Transm Dis. 2009, 36 (2): 84-85. 10.1097/OLQ.0b013e318186debb.CrossRefPubMed
40.
Choi K-H, Gibson DR, Han L, Guo Y: High levels of unprotected sex with men and women among men who have sex with men: a potential bridge of HIV transmission in Beijing, China. AIDS Educ Prev. 2004, 16 (1: Special issue): 19-30. 10.1521/aeap.16.1.19.27721.CrossRefPubMed
41.
Li HM, Peng R, Li J, Yin YP, Wang BX, Cohen MS, Chen XS: HIV incidence among men who have sex with men in China: a meta-analysis of published studies. PLoS One. 2011, 6 (8): e23431-10.1371/journal.pone.0023431.CrossRefPubMedPubMedCentral
42.
Feng Y, Wu Z, Detels R, Qin G, Liu L, Wang X, Wang J, Zhang L: HIV/STD prevalence among men who have sex with men in Chengdu, China and associated risk factors for HIV infection. J Acquir Immune Defic Syndr. 2010, 53 (Suppl 1): S74-S80. 10.1097/QAI.0b013e3181c7dd16.CrossRefPubMedPubMedCentral
43.
Chen X, Li X, Qin B, Zheng J, He J, Wang L, Wang N, Hsu A, Khoshnood K: Older HIV-positive adults in Xiangxi, China: infection modes and associated risk factors. Sex Transm Dis. 2012, 39 (9): 716-719. 10.1097/OLQ.0b013e31825af361.CrossRefPubMed
44.
Pearline RV, Tucker JD, Yuan L-F, Bu J, Yin Y-P, Chen X-S, Cohen MS: Sexually transmitted infections among individuals over fifty years of age in China. AIDS Patient Care STDS. 2010, 24 (6): 345-347. 10.1089/apc.2009.0323.CrossRefPubMedPubMedCentral
Metadata
Title
Risk factors associated with prevalent and incident syphilis among an HIV-infected cohort in Northeast China
Authors
Qing-hai Hu
Jun-jie Xu
Hua-chun Zou
Jing Liu
Jing Zhang
Hai-bo Ding
Han-Zhu Qian
Si-ruo Li
Yu Liu
Yong-jun Jiang
Hong Shang
Ning Wang
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2014
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-014-0658-1

Other articles of this Issue 1/2014

BMC Infectious Diseases 1/2014 Go to the issue

Research article

Forecasting ESKAPE infections through a time-varying auto-adaptive algorithm using laboratory-based surveillance data

Research article

Cross-sectional study of cytomegalovirus shedding and immunological markers among seropositive children and their mothers

Research article

Epidemiology of the avian influenza A (H7N9) outbreak in Zhejiang Province, China

Research article

Anopheles arabiensisseasonal densities and infection rates in relation to landscape classes and climatic parameters in a Sahelian area of Senegal

Research article

Rickettsial infection among military personnel deployed in Northern Sri Lanka

Research article

HIV patients with latent tuberculosis living in a low-endemic country do not develop active disease during a 2 year follow-up; a Norwegian prospective multicenter study
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits